E-Health: Two essential devices in telemedicine based on physical distancing

TELEMEDICINA
They have solidified themselves on the pandemic stage and are here to stay. These are two innovations that have a positive impact on the User Experience (UX) for both patients and medical personnel, one using Internet of Things (IoT) and the other with the drive-thru dynamics. Let's talk about Galeno_Sys and ATGen, and the health benefits that these solutions bring with them during and beyond the COVID-19 health emergency.

Usually, when we hear 'telemedicine,' the first thing that comes to mind is the image of a video call, and that's fine; consultations and patient monitoring through audiovisual platforms, whether on a mobile phone or a PC, are a significant part of this concept. However, the practice of telemedicine is even broader and involves all aspects of healthcare that are not dealt with in person. Telemedicine comes from the combination of the word 'medicine' with 'tele', which in Greek means 'distance'.

While solutions for telemedicine have been in development for years, in general, the primary goal has been to attempt to reduce costs or add an extra layer of service to what healthcare providers traditionally offered. 

But now we are immersed in a pandemic, and what used to be considered a differentiator has become vital due to the preventive need to maintain distance between people and, at times, to carry out home quarantine. The goal to curb the spread of the coronavirus is to prevent contagion as much as possible, and various projects framed in what is also known as mobile health, digital health, or eHealth are gaining momentum. These, in turn, encompass electronic health records, teleconsultation, telepharmacy, big data applied to data analysis, and more. 

Among the new ways to safely perform diagnoses, avoiding contact and gatherings when undergoing COVID-19 testing, we have the representative example of the drive-thru mechanism that the ATGen laboratory implemented since April 2020. Another essential aspect in this scenario is preserving the treatment and monitoring of high-risk patients, something that Galeno_Sys resolved by combining sensors, IoT, and the cloud, resulting in a system that enables continuous monitoring of cardiac patients with alerts issued from anywhere in the world.

Drive-thru mechanism for COVID-19 swab testing while maintaining social distancing, implemented by ATGen with an online scheduling system.

The new cases of coronavirus revealed by the thousands of tests are something we all keep a close eye on every day. We seek information, whether from the news or the daily updates on the CoronavirusUY app, to find out how many new positive cases there are or how many tests have been conducted. This helps us get a comprehensive view of how we are managing the pandemic. According to the map from the National Emergency System of Uruguay (SINAE), a total of 401,497 tests have been conducted in Uruguay since March 13th.

ATGen was the first private laboratory in Uruguay to have this test for COVID-19 detection, and they have analyzed around 148,000 studies, with more than 28,000 being conducted using the remote drive-thru mechanism.

The Auto-Test COVID-19, as can be found on the ATGen website for those who wish to undergo the study, incorporates the drive-thru system that was developed by fast-food chains and adapted for COVID-19 diagnosis. This adaptation was first implemented in South Korea, one of the countries with lower COVID-19 mortality rates, and then successfully replicated in Germany, the United Kingdom, and several states in the USA.

The system involves a person who needs to undergo a COVID-19 diagnosis driving to a sample collection center, where healthcare personnel, working with strict biosecurity measures, perform a nasal swab through the vehicle's window. The process takes less than 5 minutes and offers several advantages, as it minimizes contact and the risk of contagion.

The demand for public attention came from various sources, both public institutions and private individuals who wanted to undergo the test. Initially, to handle this high volume of requests, a chatbot system was implemented that connected to the web agenda of GeneXus Consulting, a solution that also allowed the development of the sample collection system at the LATU Event Center.

The electronic schedule integrated into the drive-thru sample collection system allows individuals or healthcare providers to coordinate the timing of the swab test. The primary goal is to prevent overcrowding by identifying users in advance when they arrive for testing. Test coordination can be done through various channels, including the web, healthcare providers, or it may be referred through the CoronavirusUY app, which centralizes diagnostic information.

At K2BHealth, we already had a scheduling system, which was adapted to ATGen's needs with the data required by the Ministry of Public Health (MSP) for swab testing. In addition, Mercado Pago was integrated as a payment gateway for private cases. All of this was built on the K2BTools backend within a period of 10 days.

"It was a solution to be able to serve all the people who needed to undergo the test in a quick, simple way, without leaving their vehicle and minimizing contact. Integrating the web agenda with a payment gateway allowed us to automate the entire process, making it very efficient, which made all the difference," says Ana Lockhart, Project Coordinator at ATGen.

Galeno_Sys Device: features, functions, and advantages of digital remote monitoring compared to analog

Any healthcare project, especially telemedicine, should always be centered on improving the patient's experience and enhancing their quality of life. 

When a person needs to monitor health parameters and indicators (blood pressure, blood sugar, heart rate, etc.) frequently, the traditional approach often involves visiting a healthcare center for periodic monitoring or tests. In other cases, devices may be surgically implanted to continuously record data, which is later analyzed in person. 

Currently, instead of implanting monitors, we can opt for wearable devices, which fall under the realm of telemedicine. These devices are based on IoT (Internet of Things) sensors that connect to the internet and send data to a cloud server. In case of a need, they can issue alarms for immediate patient care. In this sense, being non-invasive, they greatly enhance the quality of life for individuals, allowing them to be monitored and cared for from anywhere in the world.

It is estimated that the smart healthcare market has the potential to grow by USD 224.86 billion during 2020-2024, with a significant portion allocated to remote patient monitoring. Online healthcare and the ability to continue certain essential studies that cannot be suspended are crucial today, especially for patients whose conditions pose higher risks in the face of COVID-19. This is particularly true for individuals with heart conditions that require frequent electrocardiograms and cardiovascular function monitoring.

Galeno_Sys is a clear example of telemedicine applied to remote cardiac monitoring, preventing at-risk patients from being exposed in a hospital setting. How does it work? The medical device (wearable, not implantable), created by Electronics Engineer Hugo Articardi, is based on IoT and records up to 6 leads of ECG (Electrocardiogram) through disposable electrodes placed on the patient's chest.

The records are sent wirelessly to a cloud server, where the application analyzes them in real-time, and alerts are generated in the event of arrhythmias or abnormalities in the heart rhythm. This transmission takes place regardless of the patient's location or activity.

At GeneXus Consulting, we have been working alongside Hugo Articardi for the past year, implementing the software with all the necessary architecture and security requirements. The application primarily includes a backend for device management and general configurations. It detects signals and its main function is to visualize data to identify anomalies in the values, generating alerts for patient care. The solution was developed using K2BTools patterns and integrates accessibility and data security. Soon, it will also incorporate Artificial Intelligence projects to identify new arrhythmias and other research-related data generated.

With home hospitalization being a key component in the current situation, the significant advantage offered by this telemedicine tool is the ability to perform real-time monitoring with alerts. This ensures that the ongoing care of individuals requiring intensive attention is carried out fully and with quality.

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