Blog Post

The 5 types of data health care leaders are leveraging to answer key Covid-19 questions

By Madhavi KasinadhuniPamela Divack

April 17, 2020

    While randomized control trials are essential to provide robust data on treatment safety and efficacy, they also can take months—if not years—to conduct. But in today's Covid-19 world, clinical leaders need answers fast.

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    That's why many leaders are doubling down on investments in a wide array of data sources—such as EHRs, wearables, and tech platforms—to develop robust clinical evidence to answer critical questions regarding Covid-19. This evidence, sometimes called real-world evidence or RWE, is often defined as any evidence generated outside a randomized control trial.  

    While our research has shown that many clinical leaders were in the early stages of actually using this real-world evidence to inform their decisions about diagnosis and treatment before Covid-19, the diseases emergence is quickly accelerating that.

    Below we outline five new data sources that clinical leaders are turning to, to answer five key Covid-19 questions:

    1. The data source: Smartphone apps

    Key question it may help answer: What are symptoms of Covid-19, besides fever, cough, and shortness of breath?

    Stakeholders increasingly are looking to smartphone apps to surface and validate emerging clinical insights on Covid-19 that lack robust clinical evidence, such as reports that loss of taste or smell, cardiovascular events, or gastrointestinal issues can be symptoms of Covid-19.

    For example, researchers from Massachusetts General Hospital, in collaboration with the Harvard T.H. Chan School of Public Health, Stanford Medical, and Kings College London created a COVID Symptom Tracker app to track Covid-19's onset and symptom progression across the world. To date, they've analyzed data from more than 400,000 people who reported suspected Covid-19 symptoms to the app. They found that 60% of respondents who tested positive for Covid-19 experienced loss of smell and taste. The app already has nearly 2 million users who report their health status daily, providing critical information to researchers.

    Although these app-based research tools are in the early stages of collecting data, they're able to pool real-time data from patients around the world and speed time-to-insight. Additionally, because the apps reach a broad range of patients, their data may also help researchers understand Covid-19's impact on different sub-populations of patients with various demographics, pre-existing conditions, and co-morbidities.

    2. The data source: Online registries

    Key question it may help answer: Who else is vulnerable to Covid-19, besides the elderly and immunocompromised?

    To shed more light on potentially vulnerable populations, many disease-focused organizations are creating online registries to monitor Covid-19's impact on their patient populations. For example, the Crohns & Colitis Foundation partnered with other international groups that support patients with inflammatory bowel disease (IBD) to create SECURE-IBD, a registry to monitor and report on outcomes of Covid-19 occurring in IBD patients.

    Similarly, nearly 200 rheumatology organizations, including the American College of Rheumatology (ACR), created a Covid-19 Global Rheumatology Alliance registry to collect data on rheumatology patients with Covid-19. Newly created registries may help us understand and better predict Covid-19's impact on different disease states and patient subpopulations in the future, and thus and take necessary precautions.

    3. The data source: Wearable devices

    Key question it may help answer: Can our vital signs and biometric data help us identify and predict Covid-19 cases early on?

    Since many Covid-19 patients are asymptomatic, researchers are testing whether data from wearable devices (e.g. biometric data, vital signs) can detect and predict Covid-19 onset before more serious symptoms appear. For example, UCSF and Scripps are each launching studies to examine whether physiological data collected by wearable devices such as the Oura Ring, Apple Watch, and Fitbit can quickly detect the new coronavirus and other fast-spreading viral illnesses.

    While the use of wearable devices to collect data is not new, we anticipate Covid-19 will accelerate wearable adoption and use across the industry in the future.

    4. The data source: Location data from Big Tech companies, like Facebook, Google, and Apple.

    Key question it may help answer: How can we track Covid-19’s spread and predict the next hotspots?

    In absence of robust data on Covid-19's spread between communities, tech companies like Facebook, Google and Apple in addition to the federal government, are looking to analyze user’s location data to detect population movement and track the spread of coronavirus. Although user safety and privacy is of paramount concern, it appears that Covid-19 is accelerating the rate at which users—and tech companies—may be comfortable sharing personal data to advance health care.

    5. The data source: EHRs and claims data

    Key question it may help answer: What is the safety and efficacy of drugs that are approved to treat Covid-19, but with limited evidence?

    As the FDA allows the emergency use of drugs to treat Covid-19 (e.g. chloroquine, hydrochloroquine) in absence of robust clinical evidence, stakeholders are struggling to understand drugs' safety and efficacy. To gain more insight into the risk/benefit profiles of different treatments, researchers are accelerating the use of existing, clinically rich data sources, such as EHRs and pharmacy and claims data, to more quickly uncover clinical insight in absence of robust trials.

    Columbia University and ODHSI, for example, launched a virtual study-a-thon to see if data from EHR and claims data from 600 million patients can help "examine the safety of proposed drugs and the effects of various treatments on historical viral diseases as well as predict outcomes for patients with viral symptoms or complications." While EHR-based data analysis are an area of focus for many cross-industry health care leaders today, Covid-19 is shining light on the necessity of this data to understand treatment value. 

    With the number of patient deaths related to Covid-19 climbing daily in the United States, time is of the essence to answer these critical care questions. If the Covid-19 related studies mentioned above are successful, we should expect to see increased comfort with non-traditional data sources like wearables, registries, and tech giant data in the future. The terms “real-world data” and “real-world evidence” may become just a core piece of how we generate evidence and make decisions.

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