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Supporting frontline health workers using digital technologies during COVID-19

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With more than 5.1 billion unique mobile subscribers on the planet, access to a mobile phone now outstrips access to essential health services. Digital technologies—and mobile phones in particular—have potential to dramatically alter how healthcare is delivered and received.

In fact, digital health is a key lever for progress towards all three of the new Johnson & Johnson Center for Health Worker Innovation goals. Technologies can:

  • Reduce the health worker coverage gap by extending the reach of frontline health workers into communities that lack sufficient care through virtual health services, and increasing efficiency and productivity so that fewer health workers are needed.
  • Improve quality of care by supporting the performance of individual health workers and the functioning of distributed health worker teams.
  • Strengthen primary and community health systems by increasing the availability and flow of data.

By connecting health workers to each other, to communities and to health systems, digital technologies can amplify frontline health worker voices—empowering them to be leaders, innovators, and agents of change within health systems.

For this reason, Johnson & Johnson has been investing in digital health programs for a decade and has worked with partners to develop tools to help large implementers and national governments scale up their use of technology for community health.

However, despite the potential of digital health, it has been slow to deliver the disruptive gains in healthcare that seemed possible.

Until now.

In many ways, the COVID-19 pandemic seems to be a watershed moment. Faced with social distancing measures that limit face-to-face care, a need to educate large swathes of health workers and citizens on a new disease in record time, and an urgent requirement for accurate data to enable rapid detection and tracking of disease, healthcare is going digital at an unprecedented pace.

As part of the $50 million commitment from the Johnson & Johnson Family of Companies and Johnson & Johnson Foundation to support frontline health workers in the global fight against COVID-19, we are harnessing this momentum to help build the connected health systems that the world needs now, and in the future.

Health in Your Hand

Faced with an epidemic of misinformation that has been spreading as fast as the disease itself and disruption of many routine health services, it has never been more important to ensure that the public has access to accurate, up-to-date information to empower them to make informed decisions. Mobile platforms – including interactive chatbots, helpdesks, apps and websites – can provide real-time information and virtual services at a time when health workers are overburdened, and in-person consultations are challenging. These tools can also provide health workers with their own two-way communication channels for accessing official COVID-19 information, receiving updates, and submitting feedback and reports.

We are partnering with programs that are using readily accessible platforms with widespread community use like WhatsApp, SMS, and automated voice messaging, typically in partnership with national governments. These programs are also exploring frontier technologies like natural language processing and artificial intelligence to cope with the growing volume of user queries and feedback, while maintaining quality.

  • Praekelt.org has partnered with nine national governments and the World Health Organization to launch interactive WhatsApp chatbots in 18 languages reaching over 20 million people. The bots provide quality information to health workers and citizens and a symptom checker to screen for cases of COVID-19.
  • IntraHealth and UNICEF are working to expand mHero, a two-way mobile communication system linking frontline health workers to Ministries of Health. Originally deployed in Liberia during Ebola, mHero remained in use even after the outbreak ended and is now being utilized by several national governments to rapidly relay information on COVID-19.
  • CareMessage is providing free messaging support to Federally Qualified Health Centers and free clinics in the US to ensure that vulnerable communities are supported with quality information.
  • Organizations are using digital tools to help maintain routine maternal and child health services, such as mothers2mothers’ ‘Virtual Mentor Mother’ program and ARMMAN’s ‘Virtual OPD’, which connects pregnant women to specialist obstetricians to answer queries and offer advice.

Mobile services can drive healthy behavior change and support patient monitoring across a diverse range of health conditions and patient groups, including maternal and child health, non-communicable diseases, mental health, and HIV. Our hope is that post-COVID-19, many national governments will continue to leverage these innovative technologies to expand access to health care in the face of health worker shortages.

Digital Learning Platforms

Health workers around the world require urgent information on COVID-19 – what it is, how to manage it, and how to prevent its spread. They also need information on how to keep themselves safe and how to cope with the psychological toll of serving at the frontlines of this deadly disease.

We are partnering with organizations that are using digital channels to educate health workers at scale. These platforms allow rapid content updates in response to changing needs and health worker feedback and engagement.

Tech-supported Teams

Community health workers operate in distributed teams, often across large distances and with limited face-to-face supervision. Now, more than ever, they need support to perform with maximum safety and efficiency.

In response to COVID-19, we are partnering on programs that scale up effective digital technologies for disease surveillance, contact tracing, case management and referral. We believe that technology tools can support and reinforce performance management, supportive supervision, and clear processes of communication, referral and accountability to promote high-functioning teams in a time of increasing burden on health systems.

  • Partnerships to support community health teams with digital tools include Dimagi, Reach52 and Penn IMPaCT
  • Dimagi’s app templates for COVID-19 response now cover contact tracing, facility tracking, port of entry screening, health worker support, and community-based monitoring. There have been over 1,000 downloads of these apps by organizations around the world.

Building for the long-term

While these platforms are valuable during the current pandemic, they also serve as a powerful example of how mobile technologies can be used to build a bridge between communities and health systems, empowering communities to be active participants in their own health in partnership with trusted frontline health workers.

Whenever possible, our approach has been to avoid duplication and fragmentation by investing in global digital goods and mature platforms rather than one-off solutions to strengthen digital health for the long-term.

Our vision for the future is that connected frontline health workers will be equipped to deliver care that is efficient, patient-centered, and responsive to data, trends, and community feedback, improving the accessibility and quality of health services while helping health workers to thrive.