By Bettina Experton, MD, MPH, CEO of Humetrix
10 Essential Public Health Services (Revised, 2020)
Source: CDC
Public Health is no longer an unknown or discounted medical specialty. Day after day Public Health experts are sought after to explain, forecast, communicate about prevention and potential therapeutics, and debate public policies in the face of an ongoing pandemic taking lives and the life of our economies. Like any other physicians, Public Health specialists are here to diagnose, treat and help prevent disease progress or spread - but their mission doesn't rest with one patient but with millions at a time - for which the highly contagious COVID-19 virus and the pandemic it caused is a clear illustration.
While we have been relying on Public Health expertise, our existing Public Health infrastructure which has been minimized and underfunded for decades has struggled to respond to these pandemic challenges. Whether it is about contact tracing of fast spreading COVID-19, or testing and reporting, our Public Health system has been caught off-guard without the capacity to respond to the crisis. These infrastructure inadequacies cannot be fixed in time to address this pandemic. Public Health professionals and contact tracers cannot be hired and trained at the scale and pace required; and a brand-new IT infrastructure for more efficient COVID-19 data reporting will take years and not weeks to build. As Andy Slavitt has observed, real Public Health systems do exist in the US, and I had the privilege to train in one of them decades ago in California, but it will take time to emulate their model nationwide.
But are we left helpless, especially at a time when we have been able to rethink healthcare delivery with telehealth in just two months? Or when two competing tech giants - Apple and Google - have collaborated to develop mobile technologies to help solve contact tracing on a global scale? Or when individual mobility data can help monitor Public Health policies or power epidemic prediction models? These technology applications which can be deployed at scale show us the way to rethink Public Health – and fully adopt a shift to Public Health 2.0!
Preparing for this fall and another flu epidemic that threatens to compound the toll of COVID-19, the time has come to quickly capitalize on existing technology tools to get ready and be effective. From AI-powered backend systems, to consumer-facing and consumer-touching mobile technologies, especially these which can be applied at a population scale, by:
| 1. | having State Public Health agencies make use of and encourage public adoption of the Apple-Google Exposure Notification system, and |
| 2. | having government health agencies make use of other citizen/consumer-generated health data for earlier detection such as COVID symptom survey data, which are now made available to fuel the development of new predictive models, |
| 3. | having HHS leverage existing technologies and means of communication to reach out to its own beneficiaries when these are especially at risk for severe COVID infection, by: |
| ○ | having CMS communicate to its 60M Medicare beneficiaries and their family caregivers using its Medicare.gov website and beneficiary outreach email system. From Public Health prevention messaging, to specific alerts, to symptom surveys, to individual reporting of the results of soon to be deployed self-administered COVID-19 tests, to reporting drug or vaccine adverse events to complement the VSD provider-directed system. This will be especially useful when individual reporting can be tied to Part D or carrier claims which provide specific drug and immunization codes tying these products to their manufacturers. |
| ○ | having CMS communicate about and capitalize on its list of approved Medicare Blue Button mobile apps, so that Medicare beneficiaries can accurately share their medical history when having a telehealth consult with a provider with whom they don’t have an established relationship, or receive a location specific pandemic alert, or get personalized guidance about their specific risk for severe COVID-19 infection for them and their healthcare providers to take effective measures to prevent this disease. |
| ○ | capitalizing on the CMS claims data infrastructure to best monitor individuals at highest risk – to augment the ILINet or COVID-NET provider surveillance system which only touch 9 million patients. This is what Humetrix has been doing since late March in applying its analytics platform to support government efforts to map out COVID-19 for individuals most at risk, and which can also be applied to COVID-19 vaccine tracking to monitor both vaccine safety and efficacy. |
| ○ | Using existing claim data and EHR data systems along with consumer reported and sensor driven data to power AI tools for COVID-19 pandemic analysis to drive public policies, personalize treatment and help guide individual behavior. |
From mask wearing, to social distancing, to adoption of a safe and efficacious vaccine, it will take each of us, if not most of us - empowered with technology - to defeat a pandemic and move from the old Public Health model to a consumer-empowered Public Health 2.0!
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