My writing focuses on technological and institutional innovation in healthcare. The ominous spread of coronavirus bolsters the case for such advances: telemedicine; drones; artificial intelligence, machine learning, and Big Data; and more flexible regulation of healthcare personnel and institutions.
Telemedicine:
I often describe how unofficial telemedicine likely saved my then-92-year-old mother’s life. During a social conversation via FaceTime, her grandson, a physician, realized Mom was in the early stages of septic shock. A day’s delay in treatment might have proven fatal.
Similar tales emerge from professional telemedicine doctors. I’ve suggested the advantages of telemedicine for, say, a migrant worker family on a remote ranch whose child becomes ill in the wee hours. The moral of these stories is that telemedicine offers patients speed, convenience and cost savings.
But coronavirus offers another advantage — more capacity to provide care while minimizing the opportunity for contagion. Patients with non-coronavirus complaints can receive care without mingling with other patients — perhaps coronavirus sufferers — in crowded waiting rooms.
Potential coronavirus sufferers can use telemedicine to make preliminary contact with medical professionals to devise strategies for care that minimize risks to themselves and to others.
Telemedicine can smooth demand for medical services. Right now, Washington state physicians are likely overburdened with real and imagined coronavirus cases.
Rather than waiting in long queues, finding no appointments available, or sitting for hours amid the sick, some patients can seek care from doctors in other states. The current outbreak helps make the public case for more telemedicine.
Drones and Contagion:
In 2016, Rwanda established the world’s first nationwide system of medical drones. In that country, two-thirds of blood deliveries outside the capital are now delivered by drone. Recently, several co-authors and I have written on reasons to use medical drones in America. We focused on speedier deliveries over vast rural areas, traffic-clogged urban areas, and transport-disrupted transport routes (e.g., icy roads, hurricane-ravaged areas).
Now, there’s an additional argument — movement of medical supplies and even patients without putting medical-industry personnel at risk. In Hezhou, Guangxi, Chinese manufacturer eHang has used passenger drones — helicopters operated by remote pilots — to deliver medical supplies to hot zones. The same devices can pick up and deliver patients without requiring pilots or medical personnel to ride with the infected patients.
Artificial Intelligence and Contagion:
In 2015-2016, Zika virus spread across Brazil. Simultaneously, there was an upswing in babies born with microcephaly (a smaller-than-normal head and an underdeveloped brain). WhatsApp, a peer-to-peer messaging platform popular among Brazilians, played an outsized role in tracking the spread of Zika and in demonstrating the connection between the virus and the birth of microcephalic babies.
Epidemiologists and physicians were able to search for patterns in the queries, discussions, and comments across millions of Brazilians. This was a 21st-century version of the famous “Ghost Map” of 1854, in which John Snow (an anesthetist) and Henry Whitehead (a clergyman) identified the source of a horrifying cholera outbreak in London and terminated the outbreak by shutting down a community water pump.
As with the Zika outbreak, decentralized Internet data are being aggregated to track the spread of coronavirus and to predict its onset in other locales. Using artificial intelligence and machine learning, algorithms ply vast quantities of Google searches, social media posts, and other internet data to identify patterns than no human being would ever see.
Medical Regulation and Contagion:
The above accounts suggest that more flexible regulations for telemedicine, information systems and drones would be beneficial. Coronavirus should also raise questions about regulatory oversight over other areas of healthcare. Should it be easier for doctors licensed in one state to offer services in other states? Should non-physician providers (e.g., nurse practitioners, pharmacists) have greater latitude to offer unsupervised services — particularly where there are few if any doctors?
Should public and private insurers reimburse physicians for phone calls, emails, video conferences, etc.? Should hospitals and clinics have greater leeway to expand services without going through expensive, cumbersome certificate-of-need processes? Should the Food and Drug Administration’s drug and device approval processes operate more rapidly and less expensively?
“May you live in interesting times,” is allegedly a Chinese curse from antiquity. So far, 2020 looks to be quite interesting.
