Adoption of Digital Technologies in Health Care During the COVID-19 Pandemic: Systematic Review of Early Scientific Literature

BACKGROUND: The COVID-19 pandemic is favoring the digital transition in many industries and in the society as a whole. Healthcare responded to the first phase of the pandemic through the rapid adoption of digital solutions and advanced technology tools. OBJECTIVE: The aim of this study is to describe which digital solutions have been reported in the early scientific literature to mitigate the impact of COVID-19 on individuals and health systems. METHODS: We conducted a systematic review of COVID-19 early literature (from January 1, 2020 to April 30, 2020) searching MEDLINE and medRxiv with terms considered adequate to find relevant literature on the use of digital technologies in response to the pandemic. We extracted study characteristics such as paper title, journal, publication date, and categorized the retrieved papers by type of technology, and patient needs addressed. We built a scoring rubric by cross-classifying the patient needs with the type of technology. We also extracted information and classified each technology reported by the selected articles according to healthcare system targets, grade of innovation, and scalability to other geographical areas. RESULTS: The search identified 269 articles, of which 124 full-text articles were assessed and included in the review after screening. Of selected articles, most of them addressed the use of digital technologies for diagnosis, surveillance and prevention. We report that digital solutions and innovative technologies have mainly been proposed for the diagnosis of COVID-19. In particular, within the reviewed articles we identified numerous suggestions on the use of artificial-intelligence-powered tools for the diagnosis and screening of COVID-19. Digital technologies are useful also for prevention and surveillance measures, for example through contact-tracing apps or monitoring of internet searches and social media usage. Fewer scientific contributions address the use of digital technologies for lifestyle empowerment or patient engagement. CONCLUSIONS: In the field of diagnosis, digital solutions that integrate with the traditional methods, such as AI-based diagnostic algorithms based both on imaging and/or clinical data, seem promising. As for surveillance, digital apps have already proven their effectiveness, but problems related to privacy and usability remain. For other patient needs, several solutions have been proposed using, for example, telemedicine or telehealth tools. These have long been available, but perhaps this historical moment could actually favor their definitive large-scale adoption. It is worth taking advantage of the push given by the crisis and important to keep track of the digital solutions proposed today to implement tomorrow's best practices and models of care, and to adopt at least some of the solutions proposed in the scientific literature, especially in those national health systems which in recent years proved to be particularly resistant to the digital transition.CLINICALTRIAL: