The challenge of COVID-19 has accelerated the use of new data-sharing technologies.

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has vexed many healthcare providers, and the scale of disease and certain atypical characteristics have rattled confidence and inserted doubt into usual practices. As a result, uncertainty exists around optimal treatments and where to turn for answers. Prior to COVID-19, technology-based interventions remained largely untapped for several reasons. First, medical information required considerable time to navigate, including utilization of PubMed, EMBase and other databases not known for user-friendliness. Clinical decision support tools such as UpToDate (https://www.uptodate.com) and WebMD (https://www.webmd.com) were helpful but could not provide real-time updates. As information on COVID-19 continues to explode—since January 2020, the estimated number of papers exceeds 20 000 and doubles every 20 days1—new ways to digest these data were needed. Medical experts, who customarily shared and debated ideas at medical conferences, were now isolated as lockdowns took hold. Finally, state and federal regulations around the use of telemedicine continued to be quite restrictive, especially for in-hospital care. With current videoconferencing technology, point-of-care clinical evaluation and treatment is possible through mobile phones and devices without travelling, benefiting those with limited means. Clinicians unable to attend patients in person (due to disability, retiree status and/or risk of contracting COVID-19) may still participate in direct patient care via the telemedicine interface. Supporting such efforts, a global call to action embracing telemedicine has been made.5 Machine learning (ML) and deep learning are analytical techniques with rising applications in clinical medicine given enhanced outcome predictions6, 7 based on physiological perturbations that are commonly overlooked. Diagnosis and triage of patients with COVID-19 with ML currently involve advanced image analyses8 and methods previously used in predicting sepsis.9 Given the ubiquity of email, secure portals, online consents and other electronic methods over manual processes, researchers now conduct clinical trials with increased speed. Indeed, the World Health Organization (WHO) database now lists 1346 active COVID-19 trials underway.10 As a result, recruitment, enrolment and statistical analysis are no longer rate-limiting steps, and clinical trials can effectively inform providers about efficacy and safety of novel therapies. In the information age, technology-based solutions are increasingly powerful weapons in the war against COVID-19. Clinicians leverage technology not only via enhanced data analysis and telemedicine, but also by accelerating clinical trial execution that can broaden medical knowledge. Future technological directions include development of real-time patient registries that facilitate prospective observational cohort studies, implementation science that empowers clinicians to eliminate errors and enhance utilization of existing tools and virtual consults that deliver specialized expertise to under-resourced areas. The unprecedented nature of the COVID pandemic has demanded novel and creative embracement of technology that we hope will persist. A.M. is funded by the NIH and reports income from Merck and Livanova related to medical education. ResMed provided a philanthropic donation to UC San Diego.