With the Covid-19 pandemic very much in the rear view mirror, the use and effectiveness of digital technologies during the health crisis and what we can learn moving forward has been analysed in a report by the Ada Lovelace Institute, providing us with a framework for evaluating the growth of health technology and in turn highlighting that there are lessons to be learnt.

The Ada Lovelace Institute set out to look at the use of digital technologies during the Covid-19 pandemic by reviewing evidence from 34 countries to see how efficient they were, what the evaluation and regulation was like at the time and the legacy of the technology today before generating some key government recommendations.

Visiting senior researcher and lead author of the report Melis Mevsimler told Digital Health News that the Ada Lovelace Institute “wanted to put all of [their] work in one report to say that at the emergence of these technologies, these were the risks and challenges we identified and based on these findings and reflections, these are our recommendations for using technology in future pandemics”.

The key findings of the report are summarised under four main themes: effectiveness, public legitimacy, inequalities and governance.

“In terms of effectiveness we think that these technologies show that definitely digital technologies can be of use and can definitely have a positive impact,” Mevsimler said.

However, “they have to be deployed in a timely manner and also with serious consideration on how they should be governed and how they should be used and monitored”.

The Institute’s research found that there was a lack of understanding about how to define and evaluate the effectiveness of Covid-19 technologies, with limited evidence available to developers and decisionmakers.

When it comes to inequalities, “the monitoring was really poor in the UK and across the world”, according to Mevsimler.

“Experts we have engaged with always highlighted that they think a lot of financial resources and time went into building these technologies, but not so much consideration was given to non-digital interventions such as manual contact tracing.

“I think technology in a way was seen as a silver bullet and this might have amplified health inequalities and other societal inequalities,” she added.

The acceleration of virtual wards

The Covid-19 pandemic highlighted the role that virtual wards and remote monitoring can play in a health crisis when hospital beds are at capacity. One business that was transformed because of the pandemic was Doccla, now the UK’s leading virtual hospital ward.

Doccla’s platform integrates seamlessly with existing healthcare systems, enabling real-time access to patient data and facilitating efficient communication between healthcare providers. Personalised care coordination is offered, ensuring that patients receive the right interventions and support at the right time.

Founder of Doccla Martin Ratz told Digital Health News of the impact the pandemic had on the business and its technology.

“It was transformational for us as a business. We would never have grown the way we have and the adoption of our services would never have happened if it wasn’t for Covid; it was extraordinary,” Ratz said.

“From a business perspective it helped us scale this trajectory, but from a societal perspective it is a step change in terms of behavioural adaptation to new technology.

“If you asked me if I looked back on those times [the pandemic] as something good, clearly the personal tragedies were horrific but from a behaviour change, we proved that the seemingly impossible is possible and we can do so much,” he claimed.

Doccla’s growth and the acceleration of virtual ward and remote monitoring technology in general demonstrates a positive impact that the pandemic had in that it was a catalyst for new technology, embracing innovation and behavioural change.

As a result of the success of the technology seen during the pandemic, the UK government announced in January its plans to expand the use of virtual wards, with the goal of treating up to 50,000 patients a month.

Governance and regulation

Several concerns were raised at the time of the pandemic and subsequently about the governance and regulation of the technology used, particularly due to the speed in which some technologies were implemented.

The Ada Lovelace Institute report highlights the glaring issues with the lack of regulation of this technology, including “the lack of robust data governance frameworks, regulation and oversight mechanisms” which “led to lack of clarity about who was accountable for misuse or poor performance of Covid-19 technologies”.

However, Mevsimler was quick to point out that “governments had to roll out these fairly quickly, so I don’t want to be overly critical because none of us expected to have the first global health crisis of the algorithmic age. It is to an extent understandable that they didn’t have adequate regulations in place”.

Ratz argued that there was no alternative to rolling out technology quickly and there would not have been time for vigorous governance and regulation slowing down the rollout during the pandemic peak.

He said: “The heroic work of our NHS colleagues and people connected to that ecosystem wouldn’t have happened if people weren’t very pragmatic about some of the information governance.

“I think one has to take the view that what is the alternative? If you have patients that are potentially dying in the community, do we then opt for providing them with some monitoring or do we opt for not doing that because a certain set of forms haven’t been signed off?”

Recommendations and looking ahead

All of the research by the Ada Lovelace Institute was built towards providing the UK government, and governments across the world, with some key learnings and recommendations so that we are better equipped to deal with pandemics in the future.

“One key recommendation would be to make sure that the regulations both to use health data in an emergency context but in general too are in place along with our oversight mechanisms as well,” said Mevsimler.

The report also highlights the needs to “build public trust by publicly setting out guidance and enacting clear law about permitted and restricted uses and mechanisms to support rights, and redress and tackle legal issues”.

Mevsimler confirmed to Digital Health that the Ada Lovelace Institute are also publishing a policy briefing that specifically takes the UK case into account by evaluating its use of digital technologies during the pandemic and what the UK government can learn.

In terms of the international report already released, it is aimed at helping to play a role in eliminating mistakes and positioning the world in a better place to cope if another pandemic of this scale was to occur.

Andrew Strait, associate director at the Ada Lovelace Institute, said: “It is important that policymakers look back and learn the many lessons we have identified in our research.

‘We hope that our report will guide governments, policymakers and other international organisations when deploying data-driven health technologies in the future.