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Please read the article by Jobie Budd, et al. Digital technologies in the public-health response to COVID-19. (2020) Nature Medicine. Vol 26:1183-1192
This article gave examples on the application of digital technologies to enhance COVID-19 surveillance and response. Please give 1 technology or tool that you like most and briefly explain how it works and how important it is.
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I would like to introduce you to digital technology that has been implemented in some hospitals and should be generally implemented throughout Thailand. The technology of emergency calling for a emergency team, for instance, if there is a person experiencing sudden cardiac arrest.
Bystanders, the people who are close to the patient and see the event, can get a nearby automated external defibrillator (AED) which has been installed all over the hospital. Basic life support including high-quality chest compression and AED use can be performed by bystanders. Once the AED cabinet is opened, the emergency medical team (MET) is automatically activated. In addition, the cabinet is coded with its position in the hospital, therefore, the MET can know where the patient is. This leads advance life support (ALS) be able to perform as soon as possible.
Cardiac arrest is time-sensitive condition. If we can early recognition, performing high quality chest compression, and put the patient to ALS algorithm, the outcome will be better than delayed process.
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Great example. In my hospital when there’s such an incident, we use conventional method. It’s like an emergency code if someone witness unconscious person in the hospital area then call an operator for activating the code. They will loudly repeat announce via intercom with a phrase “team CPR at….”. All nearby assigned staffs will approach to the scene.
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An example of surveillance technology that is being applied in my country is a mobile phone with specific purpose for contact tracing. With the great function of mobile app, it can be useful to support the Covid-19 epidemiological investigation and monitoring history of patients’ closest physical contact.
How does it work? Seems pretty and simple. After the user installed the app into their device, they need to activate the Bluetooth button. The mobile app works with Personal Area Network (PAN) that enables anonymous information exchanges when two or more people come into contact less than 2 metres distance in a populous area. In case one of them has positive to Covid-19 for up to 14 days, all identified contacts will get an alert which notify they had been in close contact with someone with Covid-19. The alert will also advise them to get tested and quarantined.
For me, the app’s performance is impressive to rapidly track all contacts of a confirmed case and know the spread of virus transmission. With the advancement of technology, mobile phone has ability to do as much as disease intelligence can do. Imagine that without its assistance, Covid-19 investigation is likely to be conducted manually which pushes health workers to find the contact in the field and take interview immediately.
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Impressive m-health example! I think it is nice to have this sort of personal radar for potential COVID-19 transmission. It would be fascinating to see the performance of this system such as from a user or field report.
Looking forwards to see other m-health applications!
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Although compare to other ASEAN countries, Myanmar contact tracing system is largely low tech and mixed results due to various systems being implemented in different regions of Myanmar. So, I would like to share the TraceTogether App that Singapore use during 2020 through 2022 which I have a chance to use when I was in Singapore last month and was very impressed with the roll out and the technology.
The primary objective is to rapidly identify those who may have come into direct contact with a person who has tested positive for COVID-19. Combined with SafeEntry, it reveals hotspots where the disease could spread among close associates.
In order to track down patients, the Ministry of Health (MOH) offers time-limited anonymous temporary IDs. When two users of the app pass one other in the street, the software utilizes the Bluetooth readings between devices over time to estimate the users’ proximity to one another and the length of their contact.The phone will keep track of their location and how long they’ve been there for a total of 25 days. After a user has tested positive for an infection, the MOH will work with them to create a schedule of their whereabouts and interactions during the previous two weeks.
The app also boasts of a number of privacy-protecting measures, such as user ID rotations and little data storage. Despite initial resistance due to privacy fears, the app gained widespread usage in Singapore. Those who are a part of certain demographics or who are trying to gain access to restricted areas or events must now use the app.
This app is very useful to lower the impact of pandemic and Singapore and there are several peer-reviewed paper saying the use of digital technologies to strengthen pandemic management and future preparedness for COVID-19 and other infectious diseases is essential.
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Data visualization is one kind of tool from digital technology which has been used during COVID-19. Many organizations have provided online-dashboard from world organizations such as dashboard from WHO https://covid19.who.int/ and Country organization such as https://ddc.moph.go.th/covid19-dashboard/
The Dashboard collected important real time data such as Infected cases, Recovery and Death from COVID-19. It was a real-time national size surveillance because data has been aggregated from Provincial to Tambon (local unit) which were very useful to track and control infected disease. By using active dashboard from the official organization, time-series charts and geographic maps can be applied for effective communication. Moreover, active dashboard could have a variety of designs for users’ convenience and perception.
These data visualization were useful during the outbreak. Without official data dissemination, it might be confusing for the media reporter and general users, and replicated work for staff to collect and report numbers. Only numeric reports might not create effective communication, visualized online information make it quick and easy for people to perceive information. Moreover, because of the online data sources, these could reach a big population which help people to correctly understand the situation and reduce panic.
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I would like to tell you about telemedicine apps in Thailand. Telemedicine has greatly improved during the coronavirus pandemic. Patients with ATK for covid-19 positive do not need to go to the hospital. Patients can consult a doctor online and the medicine can be delivered to their homes within 3 hours (in Bangkok and provinces around Bangkok). This app reduces the spread of infection due to patients do not need to travel, reducing the risk of spreading the infection in public areas.
Nowadays, after coronavirus has become endemic, people still use telemedicine to treat common illnesses such as flu, diarrhea, AGE, etc. In the future, there will even be a blood test or an X-ray at home, which would help reduce the congestion in the hospital.
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Thanks for sharing about telemedicine apps. Irrefutably, telemedicine is going to change medical practice globally. I agree with your post that the applications support the practice leading to several implementations and will be so even after the COVID-19 pandemic.
Looking forwards to seeing more telemedicine examples and applications!
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I could think of digital technology development of wearable device “apple watch” on fall detection feature. With fall detection enabled, once an apple watch detects a hard fall, it will automatically connect and send a message to emergency contact.
Once you are falling, the watch detects that you’re moving, it waits for you to respond to the alert and won’t automatically call emergency services. If the watch detects that you’re immobile for about a minute, it begins a 30-second countdown, while tapping you on the wrist and sounding an alert. The alert gets louder, so that you or someone nearby can hear. When the countdown ends, it will make the call automatically.
After the call ends, the watch sends a message to your emergency contacts with your location letting them know that your watch detected a hard fall and dialed emergency services.The technology is very useful when you use it in the right way. I would like to share this fall detection feature has already saved one’s life in the real world setting
Police officer shares firsthand experience with ‘cool’ Apple Watch fall detection feature
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Thanks for sharing this fall-detection feature from the Apple watch. I think they are going in the right direction since pretty much the whole world is facing an era of an aging population. Fall is definitely a condition that needs to be detected!
Hope we will see more applications for the aging society!
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During COVID19 outbreak in Thailand, digital technology that I think really useful and make an impact in our healthcare system is the data visualization/dashboard. Around April-May 2021 peak ripple in Bangkok, government by MOPH, with collaboration with GBDi of DEPA , developed and implemented the system called “Co-Link”system for allocating beds for COVID-19 patients.
Co-Link system is a center for collecting data from various sources via “Co-Lab”,”Co-Ward, and “Co-finding” subsystem, whether it be Hotline 1668, 1669 or 1330, including IUDC to allow officers to use information to make decisions quickly and makes allocating beds to patients more efficient. Head of EOC can monitor the dashboard that show all the information such as patient statistics in Red/Yellow/Green group based on severity symptom, Home isolation profiles, Community Isolation profiles, the highlight beds situation that need attention and critical management. The executive team can use this real-time dashboard for make an important decision and improve quality of care.
MOPH-Ministry of Public Health
GBDi-Government Big Data Institute
DEPA-Digital Economy Promotion Agency
IUDC-Institute for Urban Disease Control and Prevention
EOC-Emergency Operation Center -
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This article gave examples on the application of digital technologies to enhance COVID-19 surveillance and response. Please give 1 technology or tool that you like most and briefly explain how it works and how important it is.
From my personal field, I really am into artificial intelligence. Machine Learning is really popular these days, not that it will replace human but unarguably they are a powerful tools which in turns help us handling a large quantity of data, including COVID-19 data. Processing all of the data, collecting from multiple sources can not be done manually by human alone. Machine learning helps us to analyse those data and more importantly, predictions!
Allow me to introduce one of my favourite innovation and application of machine learning. Screening for COVID-19 from COUGH SOUND (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9138020/). It is something that, say, people from decades ago might say it’s impossible. Now it is. This is just one application from using machine learning, but it may give some of you a bigger picture and see what it is capable of.
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Thank you for giving us an example of AI and machine learning implementation for nowadays society. Screening Covid-19 by observing the performance of cough sounds seems fantastic, out of the box, and beyond something ordinary. I skimmed the article to gain this systematic review at a glance and found that some identical experiments were conducted with surprising sensitivity results.
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From the article provided, I would like to pick up the application called “SwissCovid” SwissCovid is the contact tracing mobile application. This application was launched on 25 June 2020 by FOPH. Using this application is voluntary
SwissCovid tracked the digital contact using the Bluetooth low energy Decentralized Privacy-Preserving Proximity Tracing (dp3t).
Basically, the system use the “key” transferring mechanism via Bluetooth. Once user contacted the nearby user. The key would be automatically transferred. Let’s say A contacted B. A would have B’s key.
If one of the contacted person tests positive for COVID-19, his/her key would send to the server. The key would subsequently send the user who have match key (which mean contacted to confirmed case).
Once the key is matched, the user would be alerted.By using this application, the contact history for each user is accurately tracked and allow user to know and quarantine themselves to prevent the further spreading of the disease.
In Thailand, we need to register once we enter to each public place to ensure that our location was tracked. If this application were implemented in Thailand during pandemic, it may could help us control the pandemic much more easier!
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During COVID-19 pandemic, the disease could spread rapidly. It is crucial that we have early detection. There are many technologies that would enhance COVID-19 surveillance and response. One technology that I would like to share is the technology that aggregated data worldwide to provide epidemiology insights, such as HealthMap first developed at Boston Children’s Hospital in 2006. HealthMap collects data from public sources to visualize a simple and easy-to-use map. The map can be used for disease outbreak monitoring and real-time surveillance of COVID-19 diseases. In addition, HealthMap shares the available dataset publicly to be used for further analysis of outbreak and preparation. Real-time surveillance supports rapid action taken to control the disease. Rather than COVID-19 disease, HealthMap also has other disease data such as Flu, Ebola, etc. For more information, please see https://healthmap.org/about/. Thank you.
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