The Year of the Sensor, round 2: COVID contact tracing + sensor wearables in LTC facilities; Ireland’s long and pivoting road to a contact tracing app

Wearables + sensors being used in long-term/post-acute care facilities for COVID contact tracing, decontamination. Historically ‘unsexy’ to digital health techies, long-term and post-acute care (LTPAC) came into sharp focus as the epicenter of COVID-19 deaths in the past four months. 45 percent of US COVID-19 deaths (over 54,000) occurred in nursing homes and assisted living residences, with the percentages being far higher in states like New Hampshire and Rhode Island (80%), Massachusetts and Connecticut (63%), Pennsylvania (68%), and New Jersey (48%). Freopp.org has a wealth of state-level information.

This created opportunities for companies that already had relationships with LTPAC to create systems to 1) contact trace individuals and residents, 2) trace locations not only of residents and staff but also contaminated areas, and 3) help focus ongoing decontamination and sanitization efforts. Featured in this surprising TechRepublic article is CarePredict, which back in March started to develop a response to COVID spread including what they dubbed the PinPoint Toolset. CarePredict already had in place a sensor-based system for residents that consolidated sensors into a wrist-worn resident ADL tracker with location and machine learning creating predictive health analytics that appear in a dashboard form. They expanded their analytics to staff and visitor contact plus locating frequently visited area by residents and staff so that decontamination efforts can be focused there. Also featured in the article are VIRI (website) and Quuppa, a real-time locating system (RTLS) repurposed from manufacturing and security. (Disclosure: Editor Donna consulted for CarePredict in 2017-18)

Ireland’s long and winding road to a national contact tracing app is the subject of an article in ZDNet. Waterford-based NearForm was called in by Ireland’s Health Services Executive (HSE) on week 1 of the lockdown and started work immediately. They had a prototype oapp running on a mobile phone by the end of the week, nonfunctioning but giving the HSE a look at the user interface. NearForm worked on a centralized model first, which was basically terminated by Apple’s insistence on blocking BTE, then in April pivoted to the decentralized Apple-Google (Gapple? AppGoo?) Exposure Notification system, once the HSE secured beta access to the new technology. By 7 July, Ireland launched and had over a million downloads in 48 hours. Germany had a similar saga and timing. Both Ireland, Germany, and other countries moved quickly to adopt Apple and Google’s APIs, when Apple blocked their original centralized app methodology. UK and NHSX did not pivot and are In The Lurch with Test and Trace [TTA 18 June, more deconstruction in VentureBeat]. Editor’s Note to Matt: go to your neighbor island, don’t be shy, and make a deal deal’ for the app. Solves that problem. 

National Health Summit Ireland–Special Report

Reader Andrew Macfarlane, Commercialisation & Centre Manager, CASALA at The Netwell Centre of the Dundalk Institute of Technology, stepped forward to report on this past Wednesday’s Summit. (Please note the excellent cross-references for those who may not be familiar with Ireland-specific programs.) Many thanks Andrew from Editors Toni and Donna!

From an Industrial Age to Information Age Healthcare – National Health Summit, Ireland

The 10th National Health Summit, which took place in Dublin, Ireland, saw a good attendance and an impressive range of speakers. The event is primarily targeted at decision-makers involved in leading and managing the delivery of healthcare services in Ireland.

The morning session outlined the changing landscapes of healthcare delivery both in an Irish and International context. Next up, separate tracks covering Health Insurance (as the Irish government seeks to introduce Universal Health Insurance), Hospital Management & Digital Healthcare (the primary topic covered by this post). The final session covered helping patients stay healthy at home and an insightful panel discussion on reform of the health service.

Tony O’Brien, Director General of the Health Services Executive (HSE) provided the opening address, entitled “Choices for our health service”. The HSE is a large organisation of over 100,000 people, whose job is to run all of the public health services in Ireland. He highlighted that like most health care systems, they are facing rising demand and costs (current budget €13.6bn), and that at the same time has endured significant health budget cuts, 26% since 2008, with €600+m planned savings in 2014. The annual National Service Plan sets out key priorities.

Key takeaway from a digital health point of view is the policy aim of A New Model of Care Treatment at the Lowest Level of Complexity that is Safe, Timely, Efficient and as Close to Home As Possible. The HSE envisages transforming from an industrial age healthcare to information age healthcare, with cost-effective use of ICT. Challenging perhaps with a historical under-investment in ICT at 0.85% of budget vs EU average of 2-3%, a number of speakers referenced the “Ghost of PPARS” as reason for under investment.

Professor Aidan Halligan, Director of Education, University College London & Principal, NHS Staff College, England in a lively storytelling highlighted that the Cathedrals to Disease  (more…)