COVID-19 digital apps should be integrated with health systems response for maximum impact, says TGI study

NEW DELHI, MAY 26. A review of the mobile applications for COVID-19 response conducted by The George Institute for Global Health, India has recommended that with the growing number of COVID-19 cases in the country, there is an urgent need to create integrated teleconsultation options within these apps to assure quality healthcare services, including those with pre-existing conditions.  

The paper published in the latest issue of the ICMR’s Indian Journal of Medical Research highlights the need for coupling apps to health systems responses in order to maximize the impact of the app-based approaches .

The study found that most of the apps focussed on self-testing, quarantine monitoring, and contact tracing. “India’s response to COVID-19 can be strengthened by developing comprehensive mHealth solutions that address the needs of frontline healthcare workers, rapid response teams and public health authorities,” said Prof Vivekanand Jha, Executive Director, George Institute for Global, Health India.  

“Among this unprecedented global health emergency, the Governments must ensure the necessary but least intrusive measures for disease surveillance,” he added.

A number of bodies including the Government of India, State governments, and healthcare organizations have developed mobile apps for the containment of COVID-19. This study was aimed to systematically review COVID-19 related mobile apps and highlight gaps to inform the development of future mHealth initiatives.

A search of Google Play and the Apple app stores yielded 346 potential COVID-19 apps, of which 50 met the predefined study inclusion criteria. A list of COVID-19-specific functions was compiled based on the review of the selected apps, the literature on epidemic surveillance, and national and international media reports. The World Health Organization guideline on Digital Health Interventions was used to classify the app functions under the categories of the general public, health workers, health system managers, and data services.

The review found that 27 (54%) apps focussed on dissemination of untargeted COVID-19-related information on preventative strategies and 19 (32%) on monitoring the movements of quarantined individuals 27 (54%). Eight (16%) had a contact tracing and hotspot identification function.

On-demand information services through chatbots or telephonic helplines were available in 19 (38%) apps whereas 15 (30%) provided users with a self-risk assessment function based on a set of screening questions related to their symptoms, occupations, travel history, and contact history.

Information on the availability of Covid-19 testing facilities was available in six (12%) apps and only four (8%) apps had a provision for booking teleconsultation or testing appointments

 “While there is a huge emphasis on the use of these apps as self-protection tools there is little scientific evidence that these apps alone, without robust public health response linkages are likely to be beneficial,” said Dr Oommen John, the study co-author.

While valuable clinically relevant data are being collected through these apps, non-compliance to  standards and interoperability frameworks  result in these data residing in islands and do not translate into insights to inform policy decisions.

The government of India has launched Aarogya Setu mobile app—and made it mandatory in several cases-- for the containment of the infection, through contact tracing and information dissemination. Various State governments and healthcare organizations have also developed apps for lockdown enforcement, generating awareness, and monitoring of quarantined individuals in the country.

Another notable finding was that most of the apps did not have functionalities to assist the hospitals or healthcare workers. In contrast, frontline hospital workers were using mobile apps to compile clinical notes and track the use of protective equipment and ventilator in the United States.

“It would be ideal when digital health tools such as mobile apps take into consideration a comprehensive health system response approach for maximizing the benefits,” said Abhinav Bassi, Research Fellow, TGI, and a study co-author.