The Increasing Importance of Remote Health Monitoring in Light of the COVID-19 Pandemic

The unexpected outbreak of the COVID-19 pandemic is undoubtedly a tragic and worrying global event.  Whilst the medical experts and organisations of the world, from the World Health Organisation to individual Governments to Hospitals and GP Surgeries, valiantly struggle to save as many lives as possible, they are also striving around the clock to find a cure.

Simon Eyre Director NewWave Health

By Simon Eyre, Director – April 2020

As a non-medical observer, I can see that the cure needs to be more that a vaccine and an antibody test for Coronavirus, the virus that leads to the deadly COVID-19 disease.  An cataclysmic shift-change in how individuals and their healthcare providers and practitioners prioritise and manage their health is needed.

COVID-19 has demonstrated to us all, the magnitude of the potential problem facing our healthcare services, and therefore facing us all, from the increasing number of the population with one or more chronic conditions.  For example, according to Diabetes UK[1] 3.9 million people are living with a diabetes diagnosis, 90% of those have type 2 diabetes. The organisation’s web-site (diabetes.org.uk) goes on to state – “More people than ever are at risk of type 2 diabetes. If nothing changes, more than five million people will have diabetes in the UK by 2025.”

Hypertension (high blood pressure) can lead to heart failure, coronary artery disease or stroke, all of which require medical intervention, often in the Intensive Care Units (ICUs) that the COVID-19 crisis has highlighted as being a scarce and valuable resource.  According to the UK Government[2] hypertension affects 1 in 4 people in the UK, that’s 12.5 million people, with little improvement in the last few years.  The global picture is even starker, The Lancet[3] suggesting that 57% of all deaths can be attributed to cardiovascular disease.

As we’ve seen with the COVID-19 virus, for the majority of people the symptoms are mild and many are also asymptomatic, but for those with underlying health conditions, the virus can become dangerous requiring intensive care and in many cases leading to death.  With so many people having underlying chronic conditions the burden of another pandemic could potentially be even more devastating.  Moreover, the chronic conditions themselves, and their resulting severe illnesses, will lead to a general pressure on healthcare services to meet demand.

A systematic review published by The Lancet in 2015[4] found that for evert 10mmHg reduction in blood pressure patients involved in the study experienced:

  • a 17% reduction in coronary heart disease;
  • a 27% reduction in strokes;
  • a 28% reduction in heart failure;
  • a significant 13% reduction in all-cause mortality.

According to the British Lung Foundation[5] 12.7m UK citizens (20% of the population) have a history of asthma, COPD or other longstanding respiratory illness.  Half of these are reliant on prescribed medication to keep their condition in check.  More than half a million people die of lung disease in the UK every year. Co-morbidity further exacerbates the impact of underlying health conditions, where co-morbidity is the presence of more than one condition in the same person – which often amplifies the risk of complications or death – the sum of parts.

It is therefore clear that the need for improving the general health of society has never been clearer to both clinicians and the general population.  Now is the time to do something, to make major changes to the way we address and manage chronic illnesses, before they too become the pandemic many experts predict. 

What we have learnt already from the COVID-19 pandemic is that those with underlying health conditions are more at risk, are more likely to suffer complications and death and put most strain on the health services. In Italy one of the initial epicentres for COVID-19 deaths, a survey by the Istitivo Superiore Do Santita[6] found that that almost 47% of patients who sadly died had 3 or more co-morbidities, 24% had at least one co-morbidity.  Over 73% of those who died had Hypertension.  The most common co-morbidities were a combination of Hypertension and Diabetes.

So how can we use technology such as SmartMed to learn from the lessons taught by this pandemic, and to help the healthcare industry prepare for any future one-off pandemics as well as the inevitable increased demand (some would say epidemic) from those with chronic conditions.

First of all, we need to empower patients to use technology to reduce and better and control chronic disease.  This means better education, tailored and personalised advice, exercise plans and diet regimes.  This needs to be done by making the patient feel more confident about their knowledge of their condition, symptoms when control is degraded and how to deal with these without stress or panic.

Secondly, we need to engender a culture of home monitoring to manage burden on GP surgeries and hospitals during peak demand.  Healthcare providers, such as GP surgeries, clinics and hospitals can remain focused on using scarce resources to treat those most in need. Patients become able to recognise changes in their own vital signs and when to seek further medical advice, knowing that the clinicians can also make use of this data to spot trends or anomalies from the norm that may need intervention, in the form of re-assurance, advice, medication (new or changed prescriptions) or medical procedures.  Virtual consultations, such as video or audio calls between the patient and their doctor can further improve the feeling of confidence and control in the patient, whilst being much more convenient and less costly than a face to face consultation.

The COVID-19 pandemic has, and still is at the time of writing, a concern for everyone around the world and has clearly had a major impact on healthcare systems both public and private.  However, it can be regarded as just a crystal ball glimpse of a future where the majority of the population have one or more chronic conditions.  A future where healthcare systems cannot cope. Unless we change the way we provide healthcare, with home monitoring and patient empowerment being necessary and effective solutions to avert this problem in the first place.

References

[1] https://www.diabetes.org.uk/professionals/position-statements-reports/statistics/diabetes-prevalence-2019

[2] https://www.gov.uk/government/publications/health-matters-combating-high-blood-pressure/health-matters-combating-high-blood-pressure

[3] https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)00128-2/fulltext

[4] https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(15)01225-8.pdf

[5] https://statistics.blf.org.uk/lung-disease-uk-big-picture

[6] https://www.epicentro.iss.it/coronavirus/bollettino/Report-COVID-2019_20_marzo_eng.pdf

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