In This Article
- Massachusetts General Hospital's Respiratory Illness Clinic piloted a mobile app that included a questionnaire allowing people to monitor their health during the height of the COVID-19 surge
- Mass General is collaborating with CarePassport, AstraZeneca, and other technology companies to work on digital initiatives to detect and monitor symptoms for COVID-19, as well as digital care tools for patients in need of remote care
- The CoronaCare app, co-developed between Mass General and CarePassport, identifies where you have been in contact with people who have tested positive for COVID-19
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Recognizing that digital tools can effectively coordinate the fight against COVID-19, Massachusetts General Hospital has co-developed a series of applications that make use of real-time data to assess health and notify people if they have been in contact with someone who has the coronavirus.
The apps, spearheaded by Mass General's Center for Innovation in Digital HealthCare (CIDH), assist users in self-monitoring for symptoms, accelerating the time in which COVID-19 can be newly diagnosed and, once diagnosed, monitoring for deterioration or progress toward recovery. Moreover, recently added features to the CoronaCare app can be activated to notify users who have had contact with a diagnosed patient, aiding in efforts to reduce the spread of COVID-19.
Now with clinical oversight from Mass General Nursing and Patient Care Services, the CoronaCare app can aggregate the collective users' data to give public health officials and private enterprises the information that is necessary to allow virus-free people to work in offices, shop, use public transportation and continue to relax quarantine measures.
"With CoronaCare, we are ready to deploy something that could help the entire state of Massachusetts and beyond. We have been able to fully integrate our clinical know-how and capabilities with this excellent technology to create a software-enabled solution to aid in community recovery, while establishing the foundation for rolling out additional clinical care-paths in the not-so-distant future." says Sara Silacci, the director of Strategic Initiatives and Alliances at CIDH.
Learnings Aided in Future Developments
During Boston's COVID-19 surge, Silacci and her colleagues rolled out a simple instance of the application to patients seen in Mass General's Respiratory Illness Clinics (RIC) suspected of exposure to COVID-19.
"At the time," she says, "our clinicians requested a quickly-deployable solution to help monitor multiple patients who didn't yet present symptoms or need to be admitted, but were still at risk."
The patients answered survey questions within the app such as whether or not they had a temperature or shortness of breath, and clinicians from the RIC monitored a patient dashboard using the app to identify who was in need of new or additional clinical care.
It took only eight days to customize the software to build-in a COVID-focused questionnaire in English and Spanish, deploy the software and train the clinicians. But, ultimately, without the ability to fully integrate the app into the workflow and electronic health record (EHR), the app program ended after six weeks.
Regardless, the experience gave Silacci and her colleagues an understanding of how to approach the construction and implementation of patient- and provider-facing application, and how it could be one of several tools in a wider suite of software enabled clinical services in assessing and tracking the virus, as well as other illnesses.
CIDH's work on a COVID-19 app didn't end with the RIC pilot program, or COVID-19. CIDH has been working with industry leaders like CarePassport and AstraZeneca to co-develop virtual care and monitoring tools. The CoronaCare App has already been deployed at a global scale, and later this year CIDH will oversee the pilots of two AMAZE applications developed in collaboration with AstraZeneca, for heart failure prevention and asthma management.
Key Questions for Technology Moving Forward
On a fundamental level, Silacci wants to know if new technology either relieves or adds a burden to the routines of patients, clinicians and the staff members that would support it. She wants to ensure the technology improves patient outcomes, creates efficiencies for clinicians and is sustainable.
"Ultimately, if the tech does not justify changing the standard of care, we should not be using it," she says. "And especially in these tenuous financial times, the delta between benefit and cost simply can't exist."
In the continued fight against COVID-19, Silacci hopes various configurations of the application will be piloted in both clinical and non-clinical settings to better observe its effectiveness and affirms that, like in traditional medicine, there is no "one-size fits all" to a solution when it comes to digital health care. As such, she says CIDH only partners with companies who have conducted or agree to conduct a rigorous clinical validation of the technology to ensure "anything we are recommending or deploying actually is reaching and helping the patient at the end of the day."
The formation of CIDH validates the concept that, while technology should solve many problems health care faces today, such as accessibility, there is still much work to be done all around. Silacci says, "a successful digital health initiative is not just about the tech. Adoption and adherence really depends on a successful change-management initiative for the patient, the provider and the health system."
She observes that change seemed most challenging for providers in the post-EHR era. But in the post-pandemic era, the barriers to change are more around financial implications to the health system, and the scalability and efficacy of the tech.
"The impact of the divide between where digital health tools are today versus where they need to be is now much more profound. CIDH is here to facilitate the innovation to help close the gap," she says.
To this point, Silacci believes it is critically important to continue working with the tech industry to innovate responsibly and build better solutions that are affordable and truly accessible for all. She sees the CoronaCare solution co-developed with CarePassport, and the collaboration with AstraZeneca to develop chronic disease management tools as two flagship examples.
"Now more than ever, health care systems need to enable meeting a patient where they are and empowering a clinician to care for a patient from wherever they are," says Silacci. "At Mass General, we have the world's leading clinicians. The power and promise of digital health is the ability to scale that know-how to patients globally, while allowing a clinician to connect with their own patient, too. At CIDH we will continue to prioritize the collaborations that enable us to send Mass General care here, there and everywhere."
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Learn about the Center for Innovation in Digital HealthCare (CIDH)