Leveraging digital health in times of COVID-19 and beyond

The HIMSS APAC Malaysia Digital Health Summit (7-8 July 2020) started with a keynote dialogue on “Leveraging Digital Health in Times of COVID-19 and Beyond”, moderated by Dr Tim Kelsey, Senior Vice President from HIMSS Analytics International. Panelists Dr Francis Qiu, Chief Hospital Commissioning Officer, Taikang Healthcare, China and Dr Helmi Zakaria, Chief Executive Officer, AIME Inc, Selangor COVID-19 Task Force Committee Member, Malaysia, shared their insights and first-hand experience in exploiting technologies to battle the pandemic in China and Malaysia, respectively.

Lessons Learnt

In his experience working with the China authorities to fight the outbreak during the early days, Dr Qiu noted some key factors from a country’s perspective in quickly containing the disease.

First was prompt action and execution. The central and local governments, together with other parties, were galvanized to consolidate resources and pool energy to control the spread and flatten the curve. Second, strong public and private partnership to tackle the challenge in a concerted manner. 

Third, technology such as contact tracing app from tech giants Wechat and Alibaba was rapidly deployed. The government was able to swiftly conduct contact tracing using the ubiquitous Alipay and QR code.

Fourth, the Chinese citizenry’s willingness to comply with measures such as wearing masks and constantly washing their hands, which have become a norm. And finally, large-scale testing. For instance, tests were performed on more than 10 million people in Beijing, which houses a 23 million population, resulting in a net case of zero infection as of 6 July.

From a company’s perspective, Dr Qiu said Taikang Healthcare has established and operated a medical network to provide patients a virtual care platform, preventing unnecessary hospital visits to eliminate infection risk.

For Dr Helmi, who heads the Digital Epidemiology and Data Analytics portfolio in the Selangor Task Force for COVID-19, the team delivered two solutions: the population and location risk-ranking analytics platform for COVID-19 and a digital contact tracing initiative leveraging on QR technology. This is the first time his AI medical epidemiology company engaged the population directly as it needed to deploy an acceptable model of contact tracing. 

The team created a QR code for digital contact tracing that does not require sharing of personal data. Only the telephone number is captured, thus is highly acceptable by users. Each shop and premises are given unique QR codes, which patrons scan when entering. Out of Selangor state’s 6.2 million population, an impressive 5.9 million or about 95% used the codes. Should an establishment be linked to a COVID-19 case, all the visitors could be traced and contacted, thus corralling the transmission. 

As of now, store visits totaled some 30 million, but the team has managed to detect 225 patients and 1,075 contacts, an amazing datamining feat. 

Sustaining Digital Health Advances

The pandemic has accelerated the pace of online and app adoption by hospitals, as well as government approval for such services. However, policies and specifications for adoption still need to be enhanced, noted the panel.

Dr Qiu pointed out that one area lies in the health network, which needs to be more integrated especially between the public and private health facilities, to grant seamless sharing of patients’ medical information. Another facet is that local governments need to step up oversight and validity to proffer a standard platform that incentivizes adoption by hospitals and patients.

Dr Helmi agreed on the societal benefits of information sharing by illustrating his team’s experience in charting the population density, demographics of neighborhoods and transmission sites using the early data on infection. However, to build a prioritization map of at-risk populations, they tapped disparate data stored in silos, which included pension fund information, elderly care scheme and general practitioner register. By simulating infection clusters, they identified the neighborhoods potentially facing similar magnitude of outbreak. 

This practical analytics translation allowed the improved allocation of limited resources, more granular lockdown at the neighborhood level for managing aid, door-to-door screening and spotting of clusters before they grew. This was significant because about 85% of the cases caught were asymptomatic.

Dr Helmi reinforced the advantages of a collaborative data-sharing network encompassing health and non-health organisations, as the Ministry of Health lacks population health data. During an infection, other factors ought to be considered include interaction, demographic, and the environment such as the physical structure and urban planning. 

Since Selangor is the most populous state in Malaysia and a technology forefront, its success paved the way for the rest of the country. The QR approach was replicated by the federal government and then nationwide. The team’s area profiling and risk app enabled active detection, which has also been adopted throughout Malaysia.  

Next Steps

Looking forward on the digital momentum spurred by COVID-19, Dr Qiu advocated that digital health should be gelled in the healthcare delivery or policy ecosystem and not as a standalone entity. Hospitals have to work with society to review operations and design –controlling workflow and technology to support enablement, extension and embedding into digital health. Taikang is incorporating these aspects into a “smart hospital” being built in Shenzhen, integrating data from patients, tests, hospital front and backend operations, logistics, and other aspects.

Dr Helmi felt that although interoperability and standardization are essential in providing real-time information and accuracy, digital innovations for healthcare must be people-centric, for both provider and client. For instance, the QR contact app his team developed serves the healthcare provider, population as well as businesses, which could remain open. He concluded, “The government can dictate policies, but the new norm will be determined by the people.”

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