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Telemedicine

COVID-19 could change the practice of healthcare forever

Sudha (name changed) woke up feeling fine on Wednesday, but just after breakfast, she suddenly started feeling chest pain, and difficulty in raising her left arm. Having had a history of hypertension, 60-year old Sudha knew she was at risk of an adverse cardiac event. However, she and her 32-yr old daughter also realised that making an unnecessary trip to the Hospital during the COVID-19 outbreak, could risk exposure to the deadly virus. So Sudha sent out an appeal for help on the whatsapp group comprising of residents in her apartment complex.

Luckily, one of her neighbors, who happens to be a Paediatrician by training, offered to lend her Frontier X device to Sudha. She explained to Sudha’s daughter that this device would not only continuously record her ECG but would allow her to quickly live-stream and generate a medical grade ECG strip which could instantly be shared with her Doctor.

Respecting the norms of social distancing her neighbor instructed Sudha’s daughter on a video call on how to quickly download the Frontier X app onto her phone following which she strapped the device across the chest and turned it on. Sudha’s daughter was now able to record her ECG and send it to two doctors within the same apartment complex over Whatsapp within 5 mins. The doctors who received Sudha’s ECG via Whatsapp, as well as the automated algorithms running on the Frontier X device, told Sudha that she had high Cardiac Strain (or ST-depression, in medical parlance). One of the doctors advised her to pop a Sorbitrate pill, and also go into the ER nearby, following which Sudha was rushed to a nearby hospital.

At the hospital, the resident Cardiologist again referred to the ECG acquired from Frontier X, and then ordered a 12-lead ECG to investigate the matter more deeply. After the 12-lead ECG reconfirmed a significant ST-depression, Sudha was sent for an Echocardiogram. Thankfully, the Echocardiogram showed hypertrophy, but no immediate risk of a myocardial infarction, so the Cardiologist gave her an additional medicine for controlling her high BP, and sent her home quickly in order to avoid the risk of infection with COVID-19. Sudha is now back home, having her newly prescribed BP medicines, and wearing the Frontier X, in order to monitor her Cardiac strain and arrhythmias, and preserve her peace of mind.
   



A SHIFT TOWARDS TELEMEDICINE

Sudha’s case is just one of the many examples of people with varying degrees of Cardiovascular disease, who are currently finding it difficult to monitor their health or consult their physicians in the coronavirus lockdown. Practo - India’s leading digital healthcare platform, has seen a 200% increase in the demand for teleconsultations since the beginning of March. While some may mistake this for a temporary blip, the truth is that a shift towards remote consultations with Doctors is likely to be a permanent one for several reasons.

Just like how demonetization in India, led to a permanent increase in the use of e-money, and coronavirus is leading to a boom in live-streaming and online co-working platforms all around the world, the shift towards remote healthcare has several factors propelling it along. Just like people have realized the advantages of using e-money and avoiding traffic jams on their way to work, they are also realizing the value of not having to visit a hospital if it can be avoided. Of course, just like many jobs can only be done in person, and many medical procedures require physical contact, this shift can never be complete, or even a majority. But the sentimentality of seeing your doctor in person is quickly being trumped by the fear of COVID-19, and people are thinking that if they can avoid traveling and visiting hospitals, then why indeed not?

Since the idea of telehealth and work-from-home have been around for decades, it is reasonable to wonder why the shift hasn’t happened till now, and why one might expect the shift in equilibrium to be permanent in the future. The answer is that necessity is not only the mother of invention, but is also the mother of behavioral change. Several studies examining behavioral change have shown that in most cases, the availability of a more attractive option is not enough to make society at large shift from one type of behaviour to another.

In most cases, society needs a big jolt to realize the value of an option that was available all along. And once society recognizes the value of the said option, there is no going back. Even before COVID-19, it has long been known that the risk of acquiring a new infection from a visit to the hospital is between 5-10% according to the CDC, and to add to that, Healthcare Acquired infections (HAIs), which cause 1.7 mn infections and 100,000 deaths a year in the US alone, are frequently resistant to antibiotics and very difficult to treat. Sadly, it has taken a global pandemic to bring this fact home to the public consciousness.

However, apart from reducing transport time, cost and risk of infection, the biggest factor mediating behavioral changes in the field of technology, has always been ease of use. Live-streaming, online co-working and chatting were available on PCs long before, but they permeated society in a big way only after the advent of smartphones and cellular networks with high bandwidth. Similarly, effective remote management of Cardiac health has not been possible until now because we did not have devices like the Frontier X, which can be used comfortably by anyone between the ages of 10 and 100 with equal ease. It does not require a nurse/doctor to come and shave your skin or plant electrodes at particular positions. Nor does it require any special router or network. It works with any smartphone on any cellular network, as long as the user is somewhat tech-literate.

In an unprecedented crisis like the present COVID-19 pandemic, it is important that we abide by the extreme regulations in place, and still maintain our personal health and well-being, with minimal exposure to risk. Frontier X is a small step in the direction of making this possible. We wish you and your family strength and safety in these trying times, and hope that we can help in any manner possible, to keep you safe.

Please reach out to support@fourthfrontier.com for further information.


Note: The use case described above is applicable only in India.

Disclaimers

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Frontier X is not intended to diagnose or monitor patients in critical care or any situation where the patient is in immediate danger. Fourth Frontier will not be liable for damages arising out of the use of Frontier X for unintended purposes. Information provided by Frontier X is not a substitute for medical advice. In the event of a medical emergency, contact a healthcare provider immediately.

RoW 
Frontier X is not intended to be used for diagnostic or treatment purposes. Fourth Frontier will not be liable for damages arising out of the use of Frontier X for unintended purposes. Information provided by Frontier X is not a substitute for medical advice. In the event of a medical emergency contact a healthcare provider immediately.

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