A Saint John-based researcher is teaming up with a local health-monitoring company to develop ways to screen and treat COVID-19 — all from the comfort of a patient's home.
Keith Brunt, a transactional medicine researcher at Dalhousie Medicine New Brunswick, is working on a pilot project that would tweak existing technology to allow it to pick up warning signs of COVID-19.
"We've had the technology for over a decade, we've just never had the political will to use it," said Brunt.
"COVID is the catalyst. Sometimes it takes a crisis to commit to the innovation."
Brunt and his team have partnered with Routinify, a remote health-care monitoring company with a Canadian headquarters in Quispamsis.
The company's Colorado-based CEO said its goal is to ensure that adults can live safe and healthy lives as long as possible in their own homes.
Pat Kelly said the company already has the technology and infrastructure in place to remotely monitor the well-being of people — and not just the usual vital signs.
While each customer's plan is created to address their unique needs, the system can remind people about appointments and when to take their medications. Wearable sensors can keep track of sleep patterns and activity levels. They can also consistently monitor key vital signs, like blood pressure, blood sugar, and oxygen levels in the blood.
The results can automatically trigger a response from the system, explained Kelly.
Depending on the nature of the person's unique plan, alerts could be sent to family members or a medical professional for follow up.
For example, a low number of steps could trigger a call to a family member to check on the person's mental well-being, while elevated blood pressure would lead to a call from one of Routinify's on-staff nurses.
All that is already in place, said Kelly.
The pilot project will refine the existing technology for COVID-19 detection — and potentially for post-infection care, as well, explained Brunt.
The project is one of several in the province to receive money for COVID-19-related projects.
In March, the New Brunswick Innovation Foundation, in partnership with the New Brunswick Health Research Foundation launched a COVID-19 Research Fund and invited researchers to apply — which they did in droves.
They received 60 applications and requests for $2.3 million in funding, which was more money than they had available.
That's when the Atlantic Canada Opportunities Agency stepped in to provide more funding. In total, 27 projects across the province have been approved — to the tune of $846,707.
Brunt said the money received from the New Brunswick Innovation Foundation will help pay for the work to integrate the systems and run a pilot project.
The good news, he said, is that Routinify already has the ability to collect all the relevant data to screen for symptoms of COVID-19.
One of the first signs is an elevated body temperature, followed by shortness of breath.
Routinify can track those things constantly. It can also monitor lung sounds for congestion and the level of oxygen in the blood, he said.
"What follows from that is an increase in blood pressure and heart rate, and collectively, that should then trigger us to ask case history questions."
While all of those things can be monitored, Brunt said they're trying to determine what thresholds have to be reached in order to flag a potential problem.
And all of that can be done constantly, for countless numbers of patients.
"There aren't enough caregivers on the planet to take care of everyone," said Kelly, but technology can help monitor them and interpret the data.
And potentially, the early physiological signs could help lead to a quicker diagnosis of COVID-19 -— perhaps even before a patient notices any symptoms, said Brunt.
"These instruments are sensitive enough if we couple them with machine learning algorithms, we can actually say, 'It looks like there's an early sign of an infection here. Start self-monitoring for symptoms,' maybe even cue them to isolate and take precautions."
And discovering a possible case early on can trigger earlier self-isolation, which reduces the possible spread to other people, he said.
Peace of mind
Robert Snow said Routinify has already changed his life.
Since being hit by a drunk driver 30 years ago, the Fredericton resident has struggled with some of life's simplest things, such as knowing when to eat.
One of the effects of his traumatic brain injury is that he doesn't experience hunger. He also has significant memory problems, so he can't even remember to eat, let alone take his 10 daily medications.
He started Routinify a year ago.
"It has completely changed my life," said Snow.
Tablets deliver reminders about when to take his mediation and when to eat. It also reminds him about medical appointments that he could never remember.
Says said pop-up messages wouldn't have worked, because he has trouble understanding the text reminders. So, audio reminders are called out to him on the tablet and are accompanied by pictures. To make sure he's received the alerts, he has to respond by touching the screen, otherwise the reminders will continue.
Snow said he would welcome the ability to screen for COVID-19 from the safety of his own home.
"It has me worried that if I went to a doctor's office and somebody didn't quarantine themselves for 14 days and went in there and all of a sudden I got it. I wouldn't really know how to assess that I have it."
With all of his underlying health issues, his chronic pain, and his smoking habit, he worries that he wouldn't be able to detect symptoms early enough to protect those around him, including the support workers who come regularly to help him maintain his independence.
"It would make me feel at ease," he said, to know that his vital signs were being constantly monitored for signs of COVID-19.
Brunt said the pilot project is also exploring how the system would help monitor patients who have tested positive.
He said the remote-monitoring system could be prescribed to patients upon their release from hospital — or even for those who weren't hospitalized but who require further monitoring as they recover from the disease.
"Not everybody follows a linear course where they get infected, they show their peak symptoms, and then it goes away. Sometimes there's a bit of a bounce that comes back as a virus kicks back into gear."
He said the goal is to enable patients to go back home while being able to closely monitor their vitals for a resurgence.
"So having a system like this, recruiting people into a trial using this equipment, I think gives us the opportunity to say, 'Look, when we discharge you to home, we're going to keep following your care. We're going to keep an eye on you. We're going to keep track of how you're doing.'
"If I was a patient, I would find that very reassuring."