Digital mHealth and Virtual Care Use in Pandemics: A Rapid Landscape Review of Interventions Used Internationally During COVID-19 in 4 Countries (Preprint)
Bibliographic record
Abstract
BACKGROUND As a result of the Coronavirus Disease-2019 (COVID-19) pandemic, providing health care while maintaining social distancing has resulted in the need to provide care remotely, support quarantined/isolated individuals, monitor infected individuals and their close contacts, as well as disseminate accurate information regarding COVID-19 to the public. This has led to an unprecedented rapid expansion of digital tools to provide digitized virtual care globally, especially mobile phone facilitated health interventions, called mHealth. To help keep abreast of different mHealth and virtual care technologies being used internationally to facilitate patient care and public health during the COVID-19 pandemic we did a rapid investigation of solutions being deployed and considered in 4 countries. OBJECTIVE To describe mHealth, and digital and contact tracing technologies being used in healthcare management of the COVID-19 pandemic among two high-income and two low-middle income countries. METHODS We compared virtual care interventions used for COVID-19 management among two high-income (HI) countries (the UK and Canada) and two low-middle (LMI) countries (Kenya and Rwanda). We focused on interventions used to facilitate patient care and public health. Information regarding specific virtual care technologies was procured from a variety of resources including grey literature, government & health organization website, and co-authors’ personal experiences as implementers of COVID-19 virtual care strategies. Search engine queries were performed to find health information that would be easily accessible to the general public, with keywords including “COVID-19”, “contact-tracing”, “tool-kit”, “telehealth”, and “virtual care”, in conjunction with corresponding national health authorities. RESULTS We identified a variety of technologies in Canada, the UK, Rwanda, and Kenya being used for patient care and public health. The aforementioned countries are using both video and text message-based platforms to facilitate communication with HCPs (ex. WelTel, Zoom). Nationally-developed contact-tracing apps are provided free to the public, with most of them using Bluetooth-based technology. We identified that often multiple complimentary technologies are being utilized for different aspects of patient care and public health with the common purpose to disseminate information safely. There was negligible difference among the types of technologies used in both HI and LMI countries, although LMI implemented virtual care interventions earlier during the pandemic’s first wave which may account for their effective response. CONCLUSIONS Virtual care and mHealth technologies have evolved rapidly as a tool for health care support for both patient care and public health. It is evident that, on an international level, a variety of mHealth and virtual care interventions, often in combination, are required to be able to address patient care and public health concerns during the COVID-19 pandemic, independent of a country’s economic standing. CLINICALTRIAL
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.021 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.006 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".