MedTech in fighting COVID-19

In no other time have we heard more about Medical Technology (MedTech) than now, with MedTech being deployed in fighting COVID-19. I used to imagine that MedTech companies consisted of super scientists working in an industry shrouded in mystery. To be sure, there are many cerebral minds in the MedTech industry, but we will try to demystify what it is, and how MedTech has been used in the battle against COVID-19.

What is MedTech

In 2014, when the Ebola epidemic ravaged West Africa, MedTech companies created new hospital sterilisation methods to work in portable field hospitals and medical tents. They developed mapping and geolocation software to track the disease’s spread, used messaging software to share real-time information, and delivered diagnostic tools to confirm an infection in less than an hour.

MedTech is with us even before birth, from pregnancy tests to ultrasound scans. When we get a cut, we put on a plaster. If our vision blurs, we get spectacles. If we are seriously ill, an MRI scan can find the cause. If our blood vessels become blocked, stents help clear the way. Digital health tools can check our health status and communicate vital data to health professionals. These diagnostics and medical devices help healthcare professionals restore us to good health as soon as possible and ensure that we get the care we need safely and in a minimally invasive way.

Advancements here are designed primarily to improve the overall quality of medical care by reducing diagnosis time, creating less invasive treatment options, or by lessening rehabilitation requirements and hospital stays. Many innovations within the MedTech industry has helped improve our general health, lengthen our lifespan, and bolster our quality of life.

The MedTech industry is currently booming and expected to grow at a compound annual growth rate of 4.1 per cent between 2014 and 2020 to achieve global sales of $514 billion in 2020, according to according to the forecasts from market intelligence firm Evaluate Ltd.

MedTech in the battle against COVID-19

With almost two million infected at the time of writing, the MedTech industry is challenged to re-imagine designs of mission critical devices, dramatically ramp-up production capacity, and get essential equipment such as ventilators and personal protective equipment (PPE) to clinicians and patients in short order. MedTech leaders are looking outside their normal sector boundaries to explore creative solutions to further supplement capacity. Innovative engineers and clinicians are retrofitting or reimagining products in limited supply for new and expanded use.

Crisis response and resilience

While the COVID-19 pandemic is an unprecedented global public health crisis, the outbreak is also serving as a catalyst for greater adoption of digital health. Stakeholders are implementing drastic measures, including swift deployment of digital health tools to curb the spread of the virus, ease the current burden on the healthcare system and maximise capacity.

MedTech crisis teams are focused on keeping employees safe, ensuring business continuity, and dealing with the rapid changes in the healthcare ecosystem and the macro environment. This includes rapidly scaling parts of the business to meet the increasing needs of the healthcare community, while adapting to the rapid shifts in patient behaviour and the location of care.

Medical technologies such as masks and gowns are helping prevent coronavirus transmission while respirators, catheters, syringes, and blood collection tubes help doctors provide the best treatment possible. Respiratory support equipment, accompanied by a range of equipment necessary such as infusion pumps, syringe pumps, pump consumables, IV access, ICU equipment, catheters, artificial feeding equipment and hospital beds need to be readily available and sufficient.

Additionally, diagnostic tests are needed to rapidly identify those infected to free up resources and increase medical care capacity. Diagnostics innovators are supporting the widespread availability of reliable testing. Telemedicine and remote care have seen more progress in just a few weeks than compared to all the preceding years. As various nations impose social distancing measures, the World Health Organization (WHO) on 1 April 2020, recognised telemedicine as an alternative model for delivery of care to ensure the continuous running of essential healthcare services.

Examples of MedTech uses against COVID-19

Worldwide, telehealth is a key digital tool to combat COVID-19 while maintaining safe distancing. The digital health landscape is changing beyond remote consultations and is one of the fastest-growing healthcare sectors. Contact tracing, early symptomatic and asymptomatic detection, and isolation, have also become key strategies in the COVID-19 crisis. In countries like the US and Germany, hospitals and clinics now offer virtual clinic sessions. In Asia, providers like China’s Ping-An Good Doctor and Indonesia’s AloDokter and Halodoc have reported huge usage increases.

We list below some of the known use cases of technology in the fight against COVID-19.

Prevention:

1. In China, users scan a QR code via popular apps e.g. WeChat and Alipay, to register and inquire if they were in close contact with someone who was infected.
2. Singapore’s contact-tracing app, TraceTogether, uses Bluetooth to identify close contacts of infected persons and saw more than 500,000 downloads in one day. It has since been integrated with SafeEntry, another system to monitor people’s movement in and out of certain locations.
3. South Korean district governments send out alerts when a resident tests positive, including a detailed information log about the resident’s day-to-day movements prior to diagnosis, traced using closed-circuit television or credit-card transactions.

Diagnosis:

In China, artificial intelligence (AI) tools conduct computed tomography (CT) lung scans without the aid of a health professional, speeding the diagnosis process and alleviating workload:

1. Beijing-based Infervision’s technology can diagnose a patient with COVID-19 in under 10 seconds.
2. Ping An’s smart image-reading system can analyse changes in lesions over multiple CT scans of COVID-19 patients during treatment on its own through its AI.

Treatment:

1. The Australian government introduced the COVID-19 Home Medicines Service, allowing vulnerable people to order prescriptions remotely without visiting the pharmacy.
2. Singapore now encourages the use of teleconsultations for chronic diseases such as diabetes, depression and bipolar disorder.

Rehabilitation/monitoring:

1. Philips is ramping up production of its VitalWatch eICU Program, which allows remote monitoring of intensive care wards from a central location so that hospitals can cope with the clinician shortage.
2. VivaLNK, a Chinese MedTech provider, deployed a remote patient monitoring tool that automates patient temperature tracking at the Shanghai Public Health Clinic Center (a primary care centre for COVID-19 patients).

Drug development:

• The Institute of Materia Medica in Beijing partnered with Canadian biotech firm Cyclica to identify and develop antiviral drug candidates for COVID-19 through its deep-learning machine MatchMakerTM

Digital engagement

Digital tools are increasingly employed to improve patient and physician engagement by:

1. Building digital patient pathways to enable patients’ access to physicians and drugs, from awareness and prevention, effective triaging, to diagnosis and treatment.
2. Improving digital engagement with physicians, e.g. through webinars, online scientific communities, or interactive clinical trial presentations.
3. Offering seamless delivery of crucial functions such as remote ordering/inventory stocking.

Other technology uses

1. Using cloud-based solutions to streamline inventory management and reduce cost inefficiencies (e.g. real-time updates of key metrics, 24/7 inventory visibility to anticipate stock shortages).

2. As care transitions out of the traditional hospital setting toward alternative sites to prevent overcrowding and provide better access to remote patients:

• Triaging and outpatient remote engagement tools alleviate load on the stretched healthcare services and resources.
• Increasing the use of electronic health records to allow clinicians better access to a patient’s medical history and provide more personalised care.
• Adopting interoperable clinical management systems to ensure seamless integration and more effective management of workload across different types of healthcare facilities.

3. Deploying standardised codes for different procedures to reduce administrative workload for healthcare providers during billing and claims reimbursement process.

4. Self-triaging digital tools for patients through a website or mobile app before seeking care.

Regulators’ role in MedTech adoption during the COVID-19 pandemic

China has been exploring telemedicine since 2014, including releasing mandates to provide clarity on telehealth regulations and on reimbursement coverage. Strong uptake followed with China’s health professionals (94 percent in 2019) adopting digital health tools, such as the use of electronic patient health records and telehealth in their practices. When it was clear that the COVID-19 outbreak was widespread, the central government began issuing regular “guidances”, and uptake followed, e.g. Ping An Good Doctor reported a 10x increase in newly registered users after COVID-19 started.

The Australian federal government lifted reimbursement restrictions on telehealth services, allowing Australia’s Medicare-subsidised telehealth access to general practitioners and some specialists. Japan’s Ministry of Health, Labor and Welfare eased regulations to allow online medical consultations and home delivery of prescription drugs. The U.S. Food and Drug Administration clarified that it does not intend to regulate mobile apps intended for public surveillance and communication related to COVID-19.

As a result of the crisis, patient centricity opened the way for greater adoption globally, and of more sophisticated digital health technologies.

Will we change?

The 2003 Severe Acute Respiratory Syndrome (SARS) epidemic showed Asian countries that a proactive approach was vital for future infectious disease outbreaks. Post-SARS, Taiwan set up the National Health Command Centre, a central command post for public health authorities to disseminate information directly and transparently. Singapore and Australia also realised the importance of streamlining exchange of information among different healthcare stakeholders.

The COVID-19 crisis, and the digital health acceleration that followed, offers a window into where key unmet needs lie for healthcare systems and consumers, and where the greatest value can be obtained through digital innovation. COVID-19 will force many countries to come to terms with the shortcomings in their healthcare systems, the accompanying costs, and the benefits for pushing for change after the crisis. There is already a slew of anecdotal stories of changing behaviours among healthcare providers, physicians, and consumers. Time will show if these changes remain, post-COVID-19.

Notes:

• https://www.universitylabpartners.org/medtech-all-about/
• https://www.mckinsey.com/industries/pharmaceuticals-and-medical-products/our-insights/reimagining-medtech-for-a-covid-19-world
• https://www.medicalplasticsnews.com/news/how-covid-19-is-impacting-the-medtech-industry/
• https://www.lek.com/insights/covid-19-and-acceleration-digital-health-apac
• https://www.weforum.org/agenda/2020/05/telehealth-could-be-a-game-changer-in-the-fight-against-covid-19-here-s-why/