Flattening the curve.
The phrase that politicians repeat daily in the news. However, achieving this requires strategies that guarantee the safety of both infected patients and doctors and other medical personnel at the forefront of the crisis.
This article puts into perspective the capacities of the different health systems in Latinamerica and the response that some health entities in Colombia have implemented to improve the response to patients and prevent saturation of medical institutions.
A TED talk has been circulating where Bill Gates talks about the consequences of a global pandemic. The talk was recorded in March 2015 and seems to be a prediction of what is currently happening.
Gates argues that part of the problem is the lack of health systems capable of responding to a pandemic. According to Gates, there are three problems to solve:
1. The inability to monitor and collect data on the evolution of the epidemic
2. Available medical personnel is not prepared to respond to an increase in the number of patients.
3. There are no tools that allow developing a data-based treatment to decrease the number of fatalities.
While Gates speaks in the context in which Ebola occurred, he also talks about the severity of not addressing these issues.
Today, not only are we dealing with a highly contagious virus through the air, as Gates predicted, but the same three problems persist and are beginning to be reflected in health systems and healthcare providers around the country.
How to deal with problems then?
First, decision-making based on data collected by international organizations should be neglected. Although they represent the authority on prevention issues and action protocols, data collection is slow.
To allow access to more reliable data and efficiently monitor the progression of the epidemic, health entities should resort to tools that allow them to have permanent contact with patients and their locations. This is especially true now that COVID19 tests are more available.
One of the greatest challenges in the country is the affordability of healthcare and access to medical attention in rural areas such as the middle of the country.
This is why it is extremely important that the tool that is implemented has free access, is easy to use, and can collect as much information at the lowest possible cost for health entities and users.
By collecting information on the location of suspected patients, the results of tests performed, and the evolution of the patient’s symptoms, the door is opened to more informed decision-making that allows for more effective measures that finally contain the spread of the virus.
In the same way, by having first-hand data, it can be more easily monitored by government entities in charge of coordinating the response to the pandemic. In other words, States would go from making decisions based on projections of what happened in other cities to make decisions based on real-time data collected throughout each city and county within the State.
The second problem Gates mentioned is the inability of medical personnel to respond to a pandemic.
In the United States, for example, medical personnel are no longer able to treat the growing number of patients. Retired doctors, nurses, and army medical personnel had to be called upon to collaborate to care for the patients.
In Latin America, the problem is even worse.
Access to health care is much less than in the United States and the poorest population in rural areas often do not have access to receive medical care.
Something that could help improve the situation for both doctors and patients is to open a communication channel that allows healthcare workers to take care of patients remotely. I am not talking about telemedicine, where the doctor makes a video call with the patient replacing the face-to-face consultation.
I am talking about diagnosis, consultation of the result of a test, and evolution of symptoms from home that automatically update a national database with no extra staff needed.
But if the results of the self-diagnosis conclude that the person may have the virus, or the result of the sample collection is positive, the patient will be in immediate contact with medical personnel to guide them on what to do, when and how.
The secret of this is chatbot technology and a tool capable of automating the process of triage questions to determine the severity of a patient’s symptoms associated with COVID19.
For example, assuming that a patient has access to a hospital, he goes to the emergency room where he is received by a nurse who asks some questions to determine his condition.
Subsequently, the patient must wait, for several hours, surrounded by other patients, in the waiting room to be attended by the doctor on duty.
In the context of the patient being infected with COVID19, the scene suddenly changes.
This patient is highly contagious. On the way to the hospital, he probably had contact with several people. Upon arrival at the hospital, the nurse could be exposed to the virus, as well as the rest of the patients in the waiting room. Hence the need to be able to serve him remotely if his symptoms don’t require hospitalization.
It is not scaremongering, it is reality.
Although self-diagnosis does not replace the taking of samples in the laboratory, those suspicious patients would be identified, controlling the focus of the virus, protecting the vulnerable population that could be exposed, and releasing medical personnel who can dedicate themselves to caring for those in critical condition.
The third and final problem Gates mentions is more complex. To solve this, not only must there be the ability to access a database on all reported cases, but there must also be a common database where the treatment provided to each patient can be consulted in such a way that it is determined what treatment works and what doesn’t work.
The above represent great challenges.
First, healthcare workers need access to a common database.
Second, accessing the medical records of thousands of confirmed and suspected patients securely so that there is no breach of personal data.
Faced with this last problem, the chatbot technology implemented in Colombia and might help here in the US is structured on three levels.
Access is opened to the population and to hospitals and different healthcare institutions to guarantee data collection and constant communication remotely.
A communication channel is opened between these institutions and the States and city authorities.
Finally, the aggregated data collected and administered at the local level are sent to the entity in charge of monitoring the epidemic at the federal level so that appropriate measures are taken.
Unifying the handling of information and data collected from thousands of patients in this way reduces the possibility of generating false information and that there is a data leak that puts the privacy of thousands of citizens at risk.
Currently, in Colombia, this tool is being implemented free of charge, to guarantee access to care for patients infected with the virus, and those patients in vulnerable conditions who cannot travel to hospital centers.
The program has been so well received that the same medical staff at the clinics are devising new ways to use the platform. Not only connecting patients with medical staff but the civilian population with psychologists to monitor citizens’ mental health during quarantine (solving a problem that even Gates could not predict).
Twnel was available for free to public and private entities globally in response to COVID19 and helped thousands of patients and healthcare workers since the beginning of the pandemic.
Right now, it is providing a tool so workers in other industries can report the changes in their symptoms so that they can return to the office and working sites safely.
If you are interested or if you know of any interested entity, I invite you to join our cause and share the article.
If you want to know more about how Twnel might help healthcare workers and patients affected by COVID19 in the United States follow this link.