Population Health

Health IT professional and COVID-19 survivor Frank Cutitta, now 100 days in care, gives a firsthand look at what healthcare gets right, and wrong.

Although providing services to patients virtually can improve provider efficiency, it's important to consider individual technological capabilities.

Two of the largest private hospital groups in the United Arab Emirates have made an FDA-authorised COVID-19 serology test available to the public. Mediclinic Middle East and King’s College Hospital London now offer the SARS-CoV-2 IgG antibodies test, which is used to confirm the presence of antibodies against COVID-19 produced by the immune system. These antibodies are likely to have resulted from an infection with the coronavirus causing COVID-19.  This type of test is useful in confirming a previous diagnosis of COVID-19 that didn’t result in major symptoms, or one in those who may have suspected COVID-19 but tested negative on a standard polymerase chain reaction (PCR) test. Said to have a 99.5% accuracy rate, the test “indicates with high certainty” that an individual has been exposed to the virus, and therefore is more likely to have immunity to the infection compared to an individual who tests negative. Whilst local authorities have previously stated that there have been no cases of reinfection in the UAE, it remains unclear whether those who recover from COVID-19 are 100% immune from being reinfected with the virus. THE LARGER CONTEXT While the test can offer peace of mind to individuals, it is also useful in helping businesses ensure their employees are safe as they return to their work environments.  “This test can also be used to assess if someone could be eligible for convalescent plasma donation,” added Mohamed Abdelmalek Mahmoud, Specialist Clinical Pathology at Mediclinic Al Noor Hospital. “It may be best to test individuals who need to know if they have been in contact with the virus in the past. A positive IgG [test] would confirm that they have been exposed and – if they were asymptomatic at the time of the test – that they have recovered. RELATED: Dubai Health Authority bans rapid viral testing for COVID-19 “Patients who have had a positive COVID-19 swab have no need for an IgG test for confirmation. [However,] patients with a negative COVID-19 swab and persisting flu-like illness symptoms may benefit from an antibody test,” he continued. “The symptoms will have to be ongoing for a couple of weeks for the test to have a good likelihood of being positive.” The tests offered at Mediclinic Middle East and King’s College Hospital London locations are not covered by health insurance; they are available for AED 265 (approx. $72), which excludes a mandatory doctor consultation – an additional AED 300 ($82) at King’s and AED 587 ($160) at Mediclinic. Test results are delivered within 24-72 hours. In calls to other hospitals and clinics in the UAE, both Medcare and Aster private hospitals and clinics confirmed that they are currently not providing the antibodies test as a paid service. Dubai Health Authority’s government hospitals and clinics also confirmed the same. ON THE RECORD “An antibody test can indicate current as well as past infection. The COVID-19 antibodies test is a semi-quantitative test for IgG antibodies. Unlike the PCR test which detects viral nucleic acid in the specimen, the antibody test can detect the specific COVID-19 antibodies generated in the body after infection, in response to the virus,” said Mahmoud. “Nearly all immune competent individuals will develop an immune response following COVID-19 infection. “Two kinds of antibodies are produced by the immune system after exposure to the virus. First is the IgM antibody which is generated in the acute infection phase and can be used to detect the active phase of infection,” he continued. “The secondary response generated by IgG antibodies are more specific to the virus, and can circulate in the blood for months after recovery indicating past infection. IgG antibodies are produced once the immune system has had time to go through a selection process of clonal lymphocytes and are highly specific and have high affinity for parts of the virus. It takes usually around two weeks – minimum – for the lymphocytes to reach adequate maturity and production capacity in order to detect IgG antibodies.”

After 15 years as a health IT innovation leader, the nonprofit MAeHC will be winding down operations in 2020, with many of its assets transferred to other like-minded organizations.

GE HEALTHCARE LAUNCHES NEW AI SUITE TO DETECT CHEST X-RAY ABNORMALITIES Leading global medical technology solutions innovator, GE Healthcare has launched the Thoracic Care Suite, which uses AI to scan for eight chest X-ray abnormalities, including pneumonia indicative of COVID-19, which is a key cause of mortality in patients who contract the virus. The launch of the AI suite is a part of GE Healthcare’s larger effort to help ensure clinicians on the frontlines have the equipment they need to quickly diagnose and effectively treat COVID-19 patients. It will also feature an algorithm to detect tuberculosis, which according to the World Health Organisation, affects approximately 10 million people every year. “The pandemic has proven that data, analytics, AI and connectivity will only become more central to delivering care. This new offering is the latest example of how X-ray and AI can uphold the highest standard of patient care amidst the most modern of disease threats,” says Kieran Murphy, president & CEO, GE Healthcare. VIDEO GAME PRESCRIPTION TREATMENT FOR CHILDREN WITH ADHD Akili announced that it has received approval from the Conformité Européenne (CE) to market EndeavorRx as a prescription-only digital therapeutic software intended for the treatment of attention deficit hyperactivity disorder (ADHD). Delivered through a video game experience, EndeavorRx has been studied across five clinical studies with more than 600 children diagnosed with ADHD. This included a prospective, randomised, controlled study published in The Lancet Digital Health journal, which showed EndeavorRx improved objective measures of attention in children with ADHD. While EndeavorRx is not yet available in Europe, the CE Mark enables Akili to market EndeavorRx in European Economic Area (EEA) member countries. The CE Mark follows last week’s US Food and Drug Administration (FDA) decision, which made EndeavorRx the first FDA-cleared prescription treatment delivered through a video game.  “Following our recent FDA clearance, the CE mark is another important milestone for Akili,” said Anil Jina, MD, chief medical officer of Akili. “This approval provides a path for the future expansion into Europe and will allow us to offer a new non-drug treatment option to families of children living with ADHD.” LONDON'S HEALTH HELP NOW APP TO CLOSE From the end of June, the Health Help Now app will no longer be available, following a decision by the NHS in North-West London to decommission the service. The app was introduced to provide residents in North-West London with digital support and to direct them to a range of health support and advice services. However, due to the app not being widely taken up across the eight boroughs and the lack of local NHS clinical resource, it no longer had the financial resource to be widely promoted and was consequently not able to generate key clinical content that residents once relied on. Taking into account these concerns, the local NHS engaged with stakeholders and undertook an equality and health inequalities analysis (EHIA) screening exercise to consider the viability of Health Help Now. Stakeholders expressed the views that the lack of clinical oversight made the app clinically unsafe. Furthermore, It is understood that there were calls for the app to be stopped around three years ago. Residents are now being encouraged to sign up for the NHS app, which offers NHS services such as repeat prescription ordering, appointment booking, symptom checkers, and advice about coronavirus. Kevin Jarrold, joint chief information officer of North-West London Health and Care Partnership said: “Following the decision to close Health Help Now we need to concentrate on encouraging people to download and use the national NHS App which offers an excellent alternative that is backed by NHS England and NHSX.” STUDY SHOWS DIGITAL MENTAL HEALTH THERAPY LONG-TERM BENEFITS A new study published by npj Digital Medicine has revealed that digital mental health interventions have a significant long-term impact on anxiety and depression recovery. The research was undertaken by digital therapeutics provider, SilverCloud Health, with the School of Psychology at Trinity College, the University of Dublin, and health economics analysis from the University of Sheffield. With more than 360 service users in England on the Improving Access to Psychological Therapies (IAPT) programme involved, the findings are the world’s largest-ever study of its kind. The study comes as mental health providers anticipate significant growth in disorders and anxieties linked to the pandemic and emerging as the lockdown continues to ease. The research highlights how digital cognitive behavioural therapy (iCBT) as part of wider psychological care can deliver strong clinical improvements and recovery. Psychiatric interviews of participants at three months after treatment found that, overall, 56.4% no longer had a diagnosis of anxiety and/or depression. A further decrease in symptom scores was seen after 12 months, on average a 50% decrease. Judith Chapman, development director at Berkshire Healthcare, said: “The trial has demonstrated that digital treatment has a strong place alongside conventional face-to-face mental health therapy, which is not a second class treatment offer but a robust evidence-based and accessible treatment for the population, especially during the unprecedented and challenging times we are experiencing due to COVID-19.” SOMERSET NHS FOUNDATION TRUST ADVANCES ITS OPEN IT STRATEGY  Somerset NHS Foundation trust has gone live with its e-prescribing and medications management solution from Better. The trust, which was formed on 1 April 2020 when the Somerset Partnership and Taunton and Somerset NHS foundation trusts merged, is using OPENeP across its surgical services. The move is an important milestone for the trust’s IT strategy, which is to integrate key systems using the Better openEHR platform and to add clinical functionality by using the Better Form Builder. It has also supported the trust’s COVID-19 response and laid the foundations for launch across the trust’s medicine directorate later this summer. Andrew Forrest, the trust’s CIO, explained: “We decided to pursue an open platform and portal-based approach to developing an electronic patient record. “This offered several advantages, such as allowing us to create a central record and clinical data repository that we can use to feed the best of suite clinical systems that we are adding according to our needs and resources.” CLINERION’S PATIENT NETWORK EXPLORER OFFERS CLINICAL TRIAL PERFORMANCE DATA Switzerland-based data technology company, Clinerion has launched Clinerion’s Patient Network Explorer, a new functionality for analysing clinical site performance. This platform will add new, actionable functionality to support clinical trial sponsors during site selection as a result of Clinerion’s collaboration with LongTaal, a clinical trial informatics company. Users of Clinerion’s Patient Network Explorer can review clinical trial statistics on an individual hospital level. Derived and mapped from multiple public sources, this new functionality allows for browsing, filtering, reviewing, and comparing site trial performance statistics. This will include breakdowns on studies by condition, trial phase and recruitment status. “It is crucial, during site selection, to have as much information at hand as possible, to avoid expensive detours and dead ends,” says Ian Rentsch, CEO of Clinerion. “Patient Network Explorer is becoming everything a sponsor needs to identify the right site for their trials.” NEW COVID-19 TRACKING TOOL APPEARS ON SMARTPHONES This week, a COVID-19 tracing software appeared in the settings of both Android and iPhones as part of a system update that will let future contact tracing apps measure the distance between two handsets. Not to be mistaken for a tracing app itself, the “exposure notification” is a tool jointly created by Google and Apple that will enable contact tracing apps to send a notification if you have been exposed to COVID-19. Apple and Google state that “Contact tracing apps will be developed by your local public health authority, not by Google or Apple.” “Public health authorities around the world are building apps that use the Exposure Notifications System to help their contact tracing efforts.” Once you opt-in to the notification system, the tool will generate a random ID for your device and enable an app to run in the background while still using Bluetooth. The tool is switched off by default.

Healthcare providers have ramped up tools to fight the pandemic at a breakneck speed, but CIOs say innovation must deploy technology with people in mind.

A number of pregnancy-related services, including lactation support, at-home monitoring and mental healthcare, can be provided virtually.

Ascom UK, Person Centred Software, ATLAS eMAR and PainChek are partnering to help care home-owners and staff go digital.

The new EPR will be powered by Cerner Millennium and will be internally referred to by staff as Surrey Safe Care.