How digital health can -- and already does -- help contain Ebola

By Jonah Comstock
Share

JONAH_COMSTOCK_HEADSHOTAlthough relatively few cases have been reported outside West Africa, Ebola is both a top headline and a public health concern in the Western world, with eight confirmed cases in the United States. Even in the UK, Ebola was a topic of discussion at a recent TechCrunch Disrupt Conference panel on digital health.

"I think the question is no longer if, but it's when," Dominic King, a surgeon at Imperial College and a member of the HELIX Centre healthcare design group, said at the panel. "We are definitely going to have people with Ebola coming in to a world city like London. And when this city was a market for fish rather than ideas, we had dozens of hospitals that dealt with infectious diseases. Now our bread and butter is non-communicative diseases like diabetes. We’re very good at managing chronic conditions. But how’s our health system going to deal with a potential epidemic? Well maybe not an epidemic, but in the next couple of months half of us are going to develop colds and fevers as part of normal seasonal flus. How are we going to deal with that? Everyone’s going to wonder 'Is this Ebola?' and I think technology has a massive potential role to play."

King suggested that mobile technology is a good fit for addressing a disease that spreads through contact. By using telemedicine, potential Ebola patients can be assessed and monitored without coming into the hospital. 

"We do not want these people coming into the hospital saying ‘I think I might have Ebola,’" King said. "We should be managing these people at home, ideally with face to face consultations online if we can. The use of targeted information and support is going to be key to managing what could be a massive challenge to our health system."

This sort of technology -- specifically Vivify Health's software-as-a-service remote monitoring platform -- is already in use in the United States to monitor people who had contact with Thomas Duncan, the Dallas man who was the first and, so far, only US victim of the disease. Dozens of people in Texas are using the platform to check in daily on video visits with nurses, who can forward them to a doctor in the event of a preponderance of Ebola-like symptoms.

At the TechCrunch event, Tim Kelsey, the UK National Health Service's National Director for Patients and Information, shared a few other ways the NHS is preparing to use technology to face Ebola if it comes to England, including noncontact vitals sign monitoring, big data, and genomics.

"From a digital perspective, I guess there are kind of three elements that we can see how important the role of technology will be in managing not just this epidemic, but other ones as well," he said. "The first one is simply vital signs analysis in the hospital where actually the patient is taken. We don’t want clinicians to come into contact with those people so some very high tech devices come into play to monitor vital signs and administer drugs in a way that is otherwordly. Second thing is that we’re very actively using big data to start to map the likely prevalence of the disease, to start to have very educated guesses about which ports to be looking at most closely, what kinds of people, to start segmenting the likely instance of the disease as it could occur. And then thirdly, as NHS England we are very much involved in driving hard the genomics agenda, you know, sequencing genes, and this will be how we get eventually a cure for ebola and other similar diseases."

The BBC is also using smartphone technology to help keep populations informed about Ebola in West Africa, where the outbreak is centered. The broadcasting company launched a service last week to send Ebola-related notifications over the popular WhatsApp texting application.

The notion that telemedicine and decentralized care could help prevent the spread of epidemics is not a new one: in the early days of digital health in 2009, IBM's chief medical officer Dr. Richard Bakalar recommended a similar approach in dealing with H1N1 or swine flu, the disease scare of the day.