Is there a silver lining to the COVID-19 pandemic? A recent article by UMass Chan Medical School and UMass Lowell researchers in Humanities & Social Sciences Communications, a Natural portfolio magazine, reports that interest among healthcare professionals in point-of-care technologies (POCTs) has increased during the pandemic, with perceived applications of easy-to-use at-home, mobile or bedside devices in a wider range of ailments.
Health care professionals also view the adoption of POCT as facilitating the humanization of epidemiology—in other words, sharing control over diagnosis and disease management with patients, rather than continuing to be managed by the provider.
So-called “grey swan events,” which are expected but unpredictable, can change attitudes and behaviors, such as about how societies administer and provide access to health care, and offer unique opportunities to drive innovation, the authors write. COVID-19 has provided one such gray swan opportunity.
“I was trying to figure out if there was any positive trajectory that happened as a result of COVID,” said senior author Denise R. Dunlap, PhD, associate professor of global strategy, entrepreneurship and innovation at UMass Lowell’s Manning School of Business. “Fortunately, we had collected data before COVID hit. And subsequently we had another study that was coming out during this time period of the pandemic. So it provided a unique opportunity to explore trends before and after COVID.”
Relatively few other studies have examined the factors influencing the adoption of POCT among healthcare professionals, according to the paper’s authors. COVID-19 has provided an opportunity to highlight weaknesses in health care delivery systems, including reliance on laboratory diagnostic technologies, and to rapidly develop new technologies to meet patient needs.
Dr. Dunlap and her colleagues worked with UMass Chan researchers David D. McManus, MD, Richard M. Haidak, Professor of Medicine and Chairman and Professor of Medicine; Nathaniel Hafer, PhD, assistant professor of molecular medicine and lead investigator of the National Institutes of Health (NIH) Rapid Diagnostics (RADx) Core Logistics Team; Craig M. Lilly, MD, professor of medicine, anesthesiology and surgery; and TH Chan School of Medicine fourth-year student Sean Teebagy.
“The service center was really a dead end for a long time,” Dr. Hafer said. “Now, after the experience of COVID, everyone knows what a test at home is and the advantages of being able to test yourself. So the conversation has changed from “What the hell is this all about?” to “How do we apply this now to cancer or other infectious diseases, etc?”
In the present study, the researchers conducted identical surveys among a network of healthcare professionals, researchers, and medical device developers. The first survey was distributed from October 2019 to the end of March 2020. The second was distributed from the end of October to November 2020.
Respondents were asked to name up to five conditions for which POCT could assist in the diagnosis of disease; name up to five conditions for which POCT can help them monitor or manage disease; and which features of POCT are most important when incorporating it into their regular practice.
Before the COVID-19 pandemic, health professionals identified 18 categories of medical conditions for which POCTs could be used to diagnose disease. Endocrine diseases, including diabetes mellitus, are prominent among them, followed by infectious diseases, cardiovascular and hematological diseases.
Since the designation of COVID-19 as a pandemic, health professionals have identified 20 medical conditions for which POCTs can be used to diagnose disease. Infectious diseases and medical conditions related to the cardiovascular system moved towards the center of this network, followed by endocrine, respiratory and hematological conditions.
The perception of POCT for disease management or monitoring has also changed. Before the pandemic, health professionals identified cardiovascular disease as the category for which on-site technology was most useful for monitoring or management. After COVID-19 was designated as a pandemic, endocrine diseases were identified as the condition for which POCT is most useful. However, the greatest increase in interest is in metabolic diseases.
“I believe there are many different reasons why healthcare technology has become more important since COVID; because the more you get used to using a technology, the more you see the benefits of having that technology,” Dunlap said.
Dunlap suggested that during the pandemic, many people with heart disease or cancer went undiagnosed because they were afraid to go to the hospital or their health care provider canceled routine checkups.
“Covid has made it so that not only are field tests needed for COVID research, but field technologies are needed because healthcare is becoming more decentralized,” Dr. McManus said. “There is no doubt from our paper that you can see changes in terms of the adoption of these technologies and their integration into mainstream healthcare. People used to think of them as extras, but now it’s a staple in healthcare.
The project was developed by the UMass Center for Advancing Point of Care Technologies (CAPCaT), a member of the NIH Point-of-Care Technology Research Network, co-led by McManus and co-author Bryan Buchholz, PhD, chair and professor of biomedical engineering at UMass Lowell. Supported by a $7.9 million grant from the NIH, CAPCaT is part of the Massachusetts Center for Medical Device Development (M2D2), managed by UMass Chan Medical School and UMass Lowell, to help biotech and medical device startups to bridge the gap between the idea and the market.