Applying software-defined networking to support telemedicine health consultation during and post Covid-19 era

Large-scale real-life implementation of technology-enabled care to maximize hospitals' medical surge preparedness during future infectious disease outbreaks and winter seasons: a viewpoint

Hospitals can be overburdened with large numbers of patients with severe infectious conditions during infectious disease outbreaks. Such outbreaks or epidemics put tremendous pressure on the admission capacity of care facilities in the concerned region, negatively affecting the elective program within these facilities. Such situations have been observed during the recent waves of the coronavirus disease pandemic. Owing to the imminent threat of a "tripledemic" by new variants of the coronavirus disease (such as the new Omicron XBB.1.16 strain), influenza, and respiratory syncytial virus during future winter seasons, healthcare agencies should take decisive steps to safeguard hospitals' surge capacity while continuing to provide optimal and safe care to a potentially large number of patients in their trusted home environment. Preparedness of health systems for infectious diseases will require dynamic interaction between a continuous assessment of region-wide available hospital capacity and programs for intensive home treatment of patients who can spread the disease. In this viewpoint, we describe an innovative, dynamic coupling system between hospital surge capacity and cascading activation of a nationwide system for remote patient monitoring. This approach was developed using the multi-criteria decision analysis methodology, considering previously published real-life experiences on remote patient monitoring.

Telemedicine in lung transplant to improve patient-centered care: A systematic review

OBJECTIVES

Long-term care combined with complex follow-up processes is among the essential needs of lung transplantation. Therefore, Telemedicine-based strategies can provide an effective approach for both patients and clinicians by applying remote patient monitoring. Hence, the main objective of this study was to investigate Telemedicine and telehealth usage in lung transplantation.

METHOD

A systematic review was conducted in four databases using keywords. Eligible studies were all English papers that developed Telemedicine-based programs to enhance patient care in lung organ transplantation. The interventions were analyzed analysis to determine the main descriptive areas. The quality of the included articles was evaluated using Mixed Methods Appraisal Tool (MMAT) tool by two authors.

RESULTS

Of the 261 retrieved articles, 27 met our inclusion criteria. Of these, 22 studies were devoted to the post-transplantation phase. All articles were published from 2002 to 2021 and the trend of publications has increased in recent years. Most of the studies were conducted in the United States and Canada. All eligible studies can be categorized into five types of Telemedicine interventions, 15 (55.56%) articles devoted to Telemonitoring, four (14.81%) for Teleconsultation, four (14.81%) articles for Telerehabilitation, three (11.11%) articles for Telespirometery, and one (3.70%) article were done regarding Tele-education.

CONCLUSION

This integrated review provides researchers with a new understanding of Telemedicine-based care solutions. Findings show that remote patient care in lung transplantation includes various aspects, especially self-care improvement.

Non-Pharmaceutical Interventions against COVID-19 Pandemic: Review of Contact Tracing and Social Distancing Technologies, Protocols, Apps, Security and Open Research Directions

The COVID-19 Pandemic has punched a devastating blow on the majority of the world's population. Millions of people have been infected while hundreds of thousands have died of the disease throwing many families into mourning and other psychological torments. It has also crippled the economy of many countries of the world leading to job losses, high inflation, and dwindling Gross Domestic Product (GDP). The duo of social distancing and contact tracing are the major technological-based non-pharmaceutical public health intervention strategies adopted for combating the dreaded disease. These technologies have been deployed by different countries around the world to achieve effective and efficient means of maintaining appropriate distance and tracking the transmission pattern of the diseases or identifying those at high risk of infecting others. This paper aims to synthesize the research efforts on contact tracing and social distancing to minimize the spread of COVID-19. The paper critically and comprehensively reviews contact tracing technologies, protocols, and mobile applications (apps) that were recently developed and deployed against the coronavirus disease. Furthermore, the paper discusses social distancing technologies, appropriate methods to maintain distances, regulations, isolation/quarantine, and interaction strategies. In addition, the paper highlights different security/privacy vulnerabilities identified in contact tracing and social distancing technologies and solutions against these vulnerabilities. We also x-rayed the strengths and weaknesses of the various technologies concerning their application in contact tracing and social distancing. Finally, the paper proposed insightful recommendations and open research directions in contact tracing and social distancing that could assist researchers, developers, and governments in implementing new technological methods to combat the menace of COVID-19.

STHM: A Secured and Trusted Healthcare Monitoring Architecture Using SDN and Blockchain

Healthcare professionals and scholars have emphasized the need for IoT-based remote health monitoring services to track the health of the elderly. Such systems produce a large amount of data, necessitating the security and privacy of that data. On the other hand, Software Defined Networking (SDN) integration could be seen as a good solution to guarantee both flexibility and efficiency of the network which is even more important in the case of healthcare monitoring. Furthermore, Blockchain has recently been proposed as a game-changing tool that can be integrated into the Internet of Things (IoT) to have the optimal level of security and privacy. However, incorporating Blockchain into IoT networks, which rely heavily on patients’ health sensors, is extremely difficult. In this paper, a secure Healthcare Monitoring System (HMS) is proposed with a focus on trust management issues. The architecture seeks to protect multiple healthcare monitoring system components and preserves patient privacy by developing a security interface where separate security modules can be integrated to run side by side to ensure reliable HMS. The security framework architecture we propose takes advantage of the blockchain technology as a secure and timely information back-end. STHM is a proposal that uses Software-Defined Networking (SDN) as the communication medium that allows users to access SDN’s different functional and security technologies and services. Simulation results show that the use of Blockchain for the SDN-based healthcare monitoring can ensure the desired flexibility and security for a very lightweight additional overhead.

The management of COVID-19 cases through telemedicine in Brazil

In Dec 2020 Brazil became one of the worldwide epicenters of the COVID-19 pandemic with more than 7.2M reported cases. Brazil has a large territory with unequal distribution of healthcare resources including physicians. Resource limitation has been one of the main factors hampering Brazil's response to the COVID-19 crisis. Telemedicine has been an effective approach for COVID-19 management as it allows to reduce the risk of cross-contamination and provides support to remote rural locations. Here we present the analyses of teleconsultations from a countrywide telemedicine service (TelessáudeRS-UFRGS, TRS), that provides physician-to-physician remote support during the COVID-19 pandemic in Brazil. We performed a descriptive analysis of the teleconsultation incoming calls and a text analysis from the call transcripts. Our findings indicate that TRS teleconsultations in Brazil experienced an exponential increment of 802.% during a period of 6 days, after the first death due to COVID-19 was reported. However, the number of teleconsultations cases decreased over time, despite the number of reported COVID-19 cases continuously increasing. The results also showed that physicians in low-income municipalities, based on GDP per capita, are less likely to consult the telemedicine service despite facing higher rates of COVID-19 cases. The text analysis of call transcripts from medical teleconsultations showed that the main concern of physicians were "asymptomatic" patients. We suggest an immediate reinforcement of telehealth services in the regions of lower income as a strategy to support COVID-19 management.

A Review of Mobile Applications Available in the App and Google Play Stores Used During the COVID-19 Outbreak

PURPOSE

The objective of this paper was to review the functionalities and effectiveness of the free mobile health applications available in the Google Play and App stores used in Saudi Arabia, Italy, Singapore, the United Kingdom, USA, and India during the COVID-19 outbreak.

METHODS

This study adopted a systematic search strategy to identify the free mobile applications available in the App and Google Play stores related to the COVID-19 outbreak. According to the PRISMA flowchart of the search, only 12 applications met the inclusion criterion.

RESULTS

The 12 mobile applications that met the inclusion criterion were: Mawid, Tabaud, Tawakkalna, Sehha, Aarogya setu, TraceTogether, COVID safe, Immuni, COVID symptom study, COVID watch, NHS COVID-19, and PathCheck. The following features and functionalities of the apps were described: app overview (price, ratings, android, iOS, developer/owner, country, status), health tools (user status-risk assessment, self-assessment, E-pass integration, test results reporting, online consultation, contact tracing), learning options (personalized notes, educational resources, COVID-19 information), communication tools (query resolution, appointments, social network, notifications), app design (data visualization, program plan), networking tools (location mapping - GPS, connectivity with other devices), and safety and security options (alerts, data protection). Also, the effectiveness of the apps was analyzed.

CONCLUSION

The analysis revealed that various applications have been developed for different functions like contact tracing, awareness building, appointment booking, online consultation, etc. However, only a few applications have integrated various functions and features such as self-assessment, consultation, support and access to information. Also, most of the apps are focused on contact tracing, while very few are dedicated to raising awareness and sharing information about the COVID-19 pandemic. Likewise, the majority of applications rely on GPS and Bluetooth technologies for relevant functions. No apps were identified that had built-in social media features. It is suggested to design and develop an integrated mobile health application with most of the features and functionalities analyzed in this study.