The Impact of COVID on Digital Health

John Whyte, MD, MPH; Bertalan Meskó, MD, PhD

Disclosures

August 06, 2020

Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

  • Artificial intelligence may be used to anticipate future virus outbreaks.

  • There has been a rise in at-home diagnostic devices and lab tests, and their diagnostic accuracy will probably improve.

  • Using ultraviolet light, disinfecting robots can clean a hospital room in just a few minutes.

  • Patients are the most underused resource in healthcare; they could be collecting individualized health and lifestyle data through wearables.

  • A physician today is "a key holder to the gate of the ivory tower of medicine," but that ivory tower is crumbling as patients gain access to the same resources. Doctors in the future will transition into being more of a guide for their patients in healthcare.

This transcript has been edited for clarity.

John Whyte, MD, MPH: You're watching Coronavirus in Context. I'm Dr John Whyte, chief medical officer at WebMD.

What's the future of healthcare right now during COVID and post-COVID? To answer these questions, I've asked Dr Bertalan Meskó. He is a self-described geek physician — his words — with a PhD in genomics and is a medical futurist. Dr Meskó, thanks for joining me.

Bertalan Meskó, MD, PhD: Of course. Thank you for having me.

Whyte: First of all, what's a medical futurist?

Meskó: I launched The Medical Futurist website about a decade ago when I wanted to bring in two kinds of aspects. First was the futuristic foresight aspects, thinking about and focusing on the future of healthcare. The second one was the more technological aspect: how we can look at new medical technologies, especially digital health technologies that are available to both patients and physicians, and how we can bring these two fields together, creating a new kind of field of science or profession. That's how the Medical Futurist started.

Then I launched The Medical Futurist Institute, where they do the same but through peer-reviewed research.

Whyte: You had a great article recently that talked about what we've missed during COVID, some of the latest technological advances, particularly in digital health. Tell our audience what they might not have seen during this COVID pandemic.

Meskó: If you look around the world, every country and research institution right now, everyone is focusing on COVID-19. The technological news that came out and was not related to COVID was not so significant as we usually see in the news. I'm afraid everything that matters now has to do something with COVID-19.

Whyte: We all have talked about the role of telehealth, where it really has had this accelerated adoption. What are some of the other technologies that are going to be here to stay post-COVID?

Meskó: I think there are a few exciting ones. One is obviously artificial intelligence, in a way that it could be used to predict future outbreaks. We now know as fact that the first report about the outbreak in Wuhan came out of a Canadian startup called BlueDot. They were the first ones to predict the outbreak with an artificial intelligence–based algorithm that had access to data from national institutions [eg, Centers for Disease Control and Prevention] and airline ticketing data.

Artificial intelligence is now being used by many governments in trying to find out what happens next — how to prepare for a second wave, when the second wave could take place. The vast amount of computing power of these algorithms cannot be compared to how even the best epidemiologists in the world can digest data. The amount of data we receive through the systems now is just enormous. We need to use these artificial intelligence–based systems to at least try to support the job of public health officials. That's certainly one thing.

The second thing that comes to my mind is that there is a rise of at-home diagnostic devices, and even at-home lab tests. During the first days of the pandemic, we knew that even going to get a lab test to find out whether you have the virus itself or antibodies against it had a risk of being exposed to possible infections. We have been seeing a rise in at-home lab tests. I even took an antibody test at home through a few droplets of blood.

Whyte: How did you do it at home by yourself?

Meskó: I was surprised by that too. I received the package from an Italian company that developed a test, and they gave instructions about how to provide a few droplets of blood. As they use a quite sensitive technology called ELISA, I could send back the test myself through a biological sample in a package, and they could analyze it. In about 1 week or so, I received the results.

Whyte: In fairness, we do have issues with diagnostic accuracy of some of these tests, especially point-of-care testing. Do you expect that to be improved upon in the next few years?

Meskó: There is no doubt about that. It all started with the revolution about genomic and genetic testing. You've seen companies like 23andMe flourishing and having tens of millions of customers in the past couple of years. I had about six genomic tests myself. I had my whole genome sequenced without going to a lab to provide a sample.

There are doubts not only about the accuracy of these tests, but also about the privacy issues related to the results — how these companies store the results and whether they shared them with third parties, even when they just use it for research purposes. That's an ongoing debate, but I have no doubts that at-home lab testing will stay with us.

Whyte: You talk about disinfecting robots for the future. Is that what we're going to be seeing?

Meskó: We've been talking about these robots far before COVID-19 hit. The robots can disinfect the hospital room in seconds, if not 1 minute or so, with UV light. We thought that these robots could be a good addition to the technological park that these hospitals are using. When COVID-19 hit, it was not a matter of choice; hospitals had to reach out to certain technologies with which they could still provide care. They had two options: Use the technology that many of them had been rejecting or had been against for a decade or so, or not be able to provide care at all.

Whyte: Now everyone's talking about wearables. But you're talking about wearables in the eye, wearables in the heart. Tell us about that technology.

Meskó: The most underused resource or resources in healthcare are the patients. We could measure data, provide parameters, and give them data about their daily lives without the need to go to the actual point-of-care facility. I think it has shown the real power of digital health. That's what these valuable devices can bring to us.

Whyte: What's the role of the doctor in the future? Is it going to be like it is today, or is it going to be vastly different?

Meskó: I think it's going to be different. The role that physicians have today is being a key holder to the gate of the ivory tower of medicine. As the ivory tower is breaking down, the patients have access to almost the same kind of information and data through the internet and peer social networks. In using technologies at home, there is no ivory tower anymore.

I think the physician's role is going to transition into being a guide for their patients in the jungle of digital and health information. I think it's a much more comforting role, leading to less burnout and stress, and feeling the chance that they could care for their patients and are not the only ones having the responsibility. They can share some responsibility with their patient because they want to get involved with their health and disease management.

Whyte: I'm just going to ask you a couple of rapid-fire questions. You tell me which one. iPhone or Galaxy?

Meskó: Android. That's a fair question.

Whyte: Tesla or Ferrari?

Meskó: Tesla.

Whyte: Twitter or Instagram?

Meskó: Still Twitter.

Whyte: Fitness app or online exercises?

Meskó: That's a good question, but I would go with the app.

Whyte: Print blog or video blog?

Meskó: Video blog.

Whyte: All right, thank you. Your home is in Hungary right now, correct?

Meskó: Absolutely.

Whyte: How is the adoption of technology different in Hungary than it is in the United States?

Meskó: I thought you would ask me about COVID-19. That would be a different answer for sure.

Whyte: We've been talking COVID all the time, Dr Meskó.

Meskó: You are right. The adoption is not perfect, but it's all right. With the pandemic going on, physicians and patients have to accept that these things are the new norm and telemedicine is now part of our lives. It has been a luxury to be able to get access to a physician in person with any kind of health issue.

With the doctor shortages worldwide and the rising number of patients having a chronic condition, we have to reach out to these digital health technologies and make sure that patients and physicians can get access to data. In Hungary, we are getting there. It's much better now than it has been in the past couple of years.

Whyte: Tell viewers where they can go to learn more about your readings and your predictions.

Meskó: We publish context around digital health news and also some foresights and predictions on medicalfuturist.com.

Whyte: Dr Meskó, thanks for joining me.

Meskó: The pleasure was all mine. Thank you for having me.

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