The United States is in immediate danger of being overwhelmed by the COVID-19 pandemic, but there’s still time to launch concrete initiatives to save lives. That’s the message from two MIT Sloan professors who have convened an alliance to rapidly develop, vet, and deliver policy proposals for use by state and federal governments.
Following the White House’s March 13 announcement allowing different agencies to take advantage of telehealth technology to combat the virus, the COVID-19 Policy Alliance released details of specific ways telemedicine can be deployed to deliver immediate value.
“We regard this moment as a moment of extreme national danger, and we are presenting specific, actionable steps that Congress can take today to lead us to a better place,” said professor during an online Congressional staff briefing hosted by the alliance, which includes experts in medicine, hospitals, telehealth, logistics, and cloud computing.
The Alliance also put online a set of data analytic tools to enable states to identify the highest risk facilities and localities — those with clusters of individuals over 65 or with relevant health issues.
“When you look on the countries that failed in dealing with this crisis, most of them failed at the moment when their hospital systems were overwhelmed by a flood of critically ill patients that essentially blocked every available capacity,” said professorIt’s still possible to avoid that situation in the United States, he said, but “there are still a lot of things to design, plan, and execute, and many of those are things that are not natural to how our systems operate under normal conditions in normal times.”
Levi highlighted three initiatives proposed in Emergency Operational Strategy to Reduce Deaths from COVID-19, the third part of its report, Creating a Coordinated Federal Telehealth Response to COVID-19:
Control the volume and pace of critically ill patients who require extensive hospital care. This can be achieved by identifying high-risk communities and individuals, extensively testing them, and ensuring their isolation, care, and access to food, prescription drugs, and routine medical care.
Government should lead this effort, the alliance said, with insurers, health systems, and other industry stakeholders providing operational expertise and logistics infrastructure (telehealth, ambulances, home care resources, home food delivery, online prescription fulfillment, and so on).
Divert as much testing, triage, and care management as possible from hospitals and clinics to people’s homes and or dedicated alternative facilities. This will minimize the load on hospital-based clinical teams and reduce their risk of exposure. Such care can be delivered via telehealth systems and apps, with support of appropriate logistics resources like ambulances as needed.
Federal government should work with health systems, including retail health systems, to develop unified guidelines and communicate aggressively to the public, the alliance report said.
Maximize capacity and deploy it dynamically across regions. “There will be states in which the outbreak is going to be far more advanced than others, and a key aspect will be, how are we able to utilize our capacity to the maximum?” Levi said. Telemedicine can play a big part in being able to allocate medical resources across states, including tapping the expertise of medical staff who are quarantined because of exposure to the virus, Levi said.
Data collection and analytics has a critical role to play as well, allowing entities to centralize national awareness of capacity and demand and then use data-driven risk analysis to dynamically deploy of capacity across regions and states. The federal government should form structured coordination channels to allow this data and information sharing, and federal and state command centers are needed as well.
A second paper, Urgent Problems to be Solved with State Telehealth Platform, offers detailed action items on:
1. How to implement mass testing without spreading the infection.
2. How to prevent hospitals from becoming infected.
3. What to do with thousands of mild-case infections.
4. How to prevent disastrous cluster of infections exceeding ICU capacity.