Digital Doctors Provide a Shot in the Arm for Telemedicine

By Ian Ransom, Contributor

Although on the rise for a number of years, telemedicine is yet to hit the mainstream due to the long-held custom of seeing doctors in person. Yet with multiple countries under quarantine to curb the spread of COVID-19, remote healthcare quickly became a vital part of the containment response.

Much of the technology to enable basic diagnoses and initial medical advice already exists, so public health authorities and private companies are working to fast-track digital solutions that can both reassure patients and protect essential health workers.

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“What telemedicine is doing is lowering the probability of COVID-19 infection between the patient and the health worker, but also between the patient and any other patients that might be at a clinic or a hospital,” says Dr. Chris Moy, South Australia state president of the Australian Medical Association. “It’s about probability reduction.”

While no catch-all medical solution to the coronavirus currently exists, telemedicine is expected to be one of the pandemic’s enduring legacies, nudging doctors, health services, and governments to be more judicious about offering face-to-face consultations.

The Virtual Doctor Will See You Now

Moy, a general practitioner (GP) based in Adelaide, has switched to video consultations on alternate days to reduce risk of infection. He believes more than half of a typical GP’s appointments can be conducted online, which would greatly reduce the threat of transmission.

Even before doctors and nurses face patients online, artificial intelligence (AI)-powered chatbots are offering triaging services by asking basic questions about symptoms such as fever, sore throat, or runny nose. Microsoft has collaborated with the United States’ Centers for Disease Control and Prevention to produce a coronavirus “self-checker” chatbot, which can help people assess whether they need to go to hospital to seek treatment. The bot was built to relieve public health organizations, hospitals, and healthcare workers for which screening patients is a “bottleneck that threatens to overwhelm health systems coping with the crisis,” according to Microsoft.

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Stethoscopes are gradually being replaced by microphone-enabled apps on smartphones which can allow patients to perform self-examinations. Other pipeline innovations that promise to reduce doctor-patient interactions show the potential to be employed in future outbreaks of diseases, if not in the current pandemic. Coughs can be analyzed digitally for patients who present COVID-19 symptoms (which can include a dry cough). Last year, Australian researchers at Curtin University and University of Queensland created an AI-powered smartphone app that diagnoses respiratory disorders by “listening” to the user’s cough. The technology, similar to speech recognition technologies, was 81-97 percent accurate in detecting asthma, pneumonia, bronchiolitis, croup, and lower respiratory tract infections, according to a study by the researchers.

“It can be difficult to differentiate between respiratory disorders in children, even for experienced doctors,” says pediatrician Dr. Paul Porter, the study’s author. “This study demonstrates how new technology, mathematical concepts, machine learning, and clinical medicine can be successfully combined to produce completely new diagnostic tests utilizing the expertise of several disciplines.”

An AI-powered tool that can diagnose diseases from exhaled breath, by using highly sensitive nanotechnology-based chemical sensors, is now being trialed in Europe. The SniffPhone project, run by a global consortium and funded by the European Union’s Horizon 2020 Program, has developed hand-held devices that can be attached to smartphones to allow remote diagnosis of 17 diseases with 86 percent accuracy, according to its researchers. The device measures users’ “volatile organic compounds” in their breath and sends data to a cloud platform for analysis by medical personnel.

Measuring Viral Hotspots With Smart Thermometers

On a macro level, technology is poised to take the fight against coronavirus into the command-and-control centers of national health authorities. Time-honored tools of the medical trade are becoming juiced-up data collectors that can be used to pinpoint outbreaks and enable local governments and epidemiological centers to produce more effective modeling and response strategies.

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San Francisco-based health technology company Kinsa, Inc. has produced “smart thermometers” that upload body temperatures to its website. By recording hotspots for fevers, Kinsa has accurately forecast the onset of seasonal flu outbreaks in the United States since 2018. The data “acts as an early warning system for illness spreading,” says Inder Singh, the company’s founder. Kinsa has collected data during the coronavirus from more than a million thermometers sold or given away to American households, and does daily updates of its maps that show which counties are seeing spikes in fevers.

Telemedicine is pushing another frontier in the adoption of electronic prescriptions, which promise to break down the entrenched and widespread practice of seeing doctors purely to secure medicine. The U.S. and a number of European countries have implemented e-prescription systems to varying degrees, while Australia is set to debut its own digital framework this month. Authorities in Greece added its e-prescriptions service to a centralized government website since the coronavirus hit the country in late-February and said more than 200,000 people had used it during a 10-day period.

Finding a Balance Between Technology and Regulation

Telemedicine still faces a number of headwinds, ranging from technological constraints to regulatory demands. Older patients can be less tech-savvy and reluctant to abandon the human touch. Vendors that specialize in one link of the telemedicine chain, such as online-booking providers or health-record keepers, may not plug into end-to-end systems. The health industry is also grappling with a proliferation of “pop-up” telemedicine providers that offer services for prescriptions, but undertake none of the risk of providing face-to-face care.

“I think [the virus] has shown that telemedicine is doable. A lot of patients were wondering why they were coming into practices in the first place when we could have done it remotely.”

—Dr. Chris Moy, South Australia state president, Australian Medical Association

“There are some groups that are dodgy coming out of the woodwork. They’re creating a pure telehealth service on commercial terms. They can’t just do the easy part without providing the personalized services,” says Moy.

Striking a regulatory balance that nurtures the industry and produces optimal health outcomes will be an ongoing challenge but the immediate benefits of telemedicine are clear to the workers on the front-line of the pandemic.

“I think [the virus] has shown that telemedicine is doable,” adds Moy. “A lot of patients were wondering why they were coming into practices in the first place when we could have done it remotely.”