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The Covid-19 pandemic has hit every aspect of society head-on: the economy, politics, consumerism... and, of course, the healthcare system. Few doubt that SARS-CoV-2 will mark a turning point in patient diagnosis, treatment and monitoring. Analyzing this evolution was the focus of the panel discussion "Transforming healthcare in challenging times", which was part of the Graduation Day event held for the seventh graduating class from the d·HEALTH Barcelona health innovation fellowship on October 29.

It is clear that times are tough. “It’s practically a miracle we’re even here today,” said Biocat CEO Jordi Naval while introducing the event. And the panelists in the discussion, who are working to fight the pandemic on the front lines, are more aware of this than anyone. The dialog, moderated by Dr. Daniel Moreno, head of the Innovation Program at Germans Trias i Pujol Hospital, featured Dr. Antonio Roman, director of healthcare at Vall d’Hebron Hospital; Dr. Antoni Rosell, clinical director of the Thoracic Department at Germans Trias i Pujol Hospital; and Dr. Rafael Máñez, head of Intensive Medicine at Bellvitge University Hospital. The three of them spoke from experience about the first wave and were certain we are currently in the second wave.

The first issue discussed was the use of imaging technology and artificial intelligence (AI) to diagnose Covid-19. Máñez spoke about their potential to determine which patients will develop acute respiratory failure, the type of respiratory support they need or the best moment to put them in the prone position (face down), to give just a few examples. “One of the main problems is distinguishing between patients. Computerized tomography scans are useful but it isn’t easy to move patients from the ICU to the scanner, or to disinfect the room after a Covid-19 patient has been scanned,” explained Máñez. Roman agreed in that AI will play a “huge role” in better predicting how patients will evolve, not only in terms of image diagnostics but also other parameters like risk factors and lab tests.

Towards consolidation of telehealth

Just as virtual alternatives have become part of how we shop, meet up, work and socialize, healthcare hasn’t been left untouched by this paradigm shift. “Telehealth has penetrated our system very deeply and very quickly. Could it be used to monitor Covid-19 patients?” Moreno asked. Roman noted its usefulness as a quick diagnostic tool. “We have the technology; you can even get a device to measure blood-oxygen levels at the supermarket. The problem isn’t receiving the signal; it’s educating the population so they know how to interpret it and transferring that data to the healthcare system. This part hasn’t been solved yet,” he admitted.

In the same line, Rosell said patients need to be more prepared in order to make decisions, and to do so he believes in devices that allow for a first exchange of information. “Instead of calling the ER or primary care center, having a highly interactive questionnaire to say whether the person should calm down or act quickly,” he explained. Máñez brought up another problem that arises in implementing this technology: “Young people are good at using it, but it’s hard for older people to manage. Education is a critical aspect,” he affirmed.

Early diagnosis, the best tool to gain control

To finish off the dialog, a wish list. What should the healthcare systems of the future be like, taking into account that restrictions and lockdowns aren’t sustainable in the long term? Rosell believes in remote patient-monitoring tools, the use of AI and non-invasive diagnostic and therapeutic systems.

For his part, Roman expressed his “doubts” that vaccines alone will be able to effectively contain the pandemic and gave the example of Chinese city Qingdao, which decided to test 9 million people when only 12 cases of SARS-CoV-2 had been detected. “The future is better testing and self-testing. Easy, early diagnosis is the best path to take,” he concluded.

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