JMIR MEDICAL INFORMATICS

Ye

Viewpoint

The Role of Health Technology and Informatics in a Global Public
Health Emergency: Practices and Implications From the COVID-19
Pandemic
Jiancheng Ye
Feinberg School of Medicine, Northwestern University, Chicago, IL, United States

Corresponding Author:
Jiancheng Ye
Feinberg School of Medicine
Northwestern University
633 N Saint Clair St
Chicago, IL
United States
Phone: 1 312 503 3690
Email: jiancheng.ye@u.northwestern.edu

Abstract
At present, the coronavirus disease (COVID-19) is spreading around the world. It is a critical and important task to take thoroughefforts to prevent and control the pandemic. Compared with severe acute respiratory syndrome and Middle East Respiratory
Syndrome, COVID-19 spreads more rapidly owing to increased globalization, a longer incubation period, and unobvious symptoms.
As the coronavirus has the characteristics of strong transmission and weak lethality, and since the large-scale increase of infected
people may overwhelm health care systems, efforts are needed to treat critical patients, track and manage the health status ofresidents, and isolate suspected patients. The application of emerging health technologies and digital practices in health care,such as artificial intelligence, telemedicine or telehealth, mobile health, big data, 5G, and the Internet of Things, have become
powerful “weapons” to fight against the pandemic and provide strong support in pandemic prevention and control. Applications
and evaluations of all of these technologies, practices, and health delivery services are highlighted in this study.
(JMIR Med Inform 2020;8(7):e19866) doi: 10.2196/19866
KEYWORDS
health technology; health information system; COVID-19; artificial intelligence; telemedicine; big data; privacy

Introduction
In December 2019, an emerging infectious outbreak was foundin Wuhan, Hubei Province, China, and it was caused by thenovel coronavirus (2019-nCoV) [1,2]. At present, the pandemicis spreading across the whole world [3]. There has been
human-to-human and health care worker transmission, but thesource of the coronavirus disease (COVID-19) has not beenfound; the route of pandemic transmission has not been fully
understood. The virus may mutate, and further spread is almost
certain. 2019-nCoV has a long incubation period and strong
infectivity; therefore, the prevention and control of the
COVID-19 pandemic faces great challenges. Compared withsevere acute respiratory syndrome (SARS) and Middle East
Respiratory Syndrome (MERS), COVID-19 has some new andhttp://medinform.jmir.org/2020/7/e19866/

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different features; it has spread more rapidly due to increased
globalization, a longer incubation period, and hidden symptoms[4].
Integrating novel health technologies and practices such as
artificial intelligence (AI), big data, 5G mobile networks,
Internet of Things (IoT), mobil health applications, telehealthservices, and health information exchange (HIE) services [5]into health care systems can aid in the following ways: reportingand monitoring human transmission information, data assortment
and analysis, tracking and sending alarms, etc. All of thesefunctions are helpful to provide strong support in pandemic
prevention and control. Figure 1 demonstrates a framework ofhealth technologies, informatics, and digital services following
a modified fit between individuals, task, and technology (FITT)
framework [6].

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Ye

Figure 1. Modified fit between individuals, task, and technology (FITT) framework for health technologies, informatics, and digital services. HIT:
health information technology.

Roles and Capabilities of HealthTechnology and Informatics in the
COVID-19 Pandemic
Taking advantage of health technologies in assisting theinvestigation and judgment of the pandemic will innovate
diagnosis and treatment, improve service efficiency, andstrengthen the capacity of information technology to support
pandemic prevention and control. The specific schemes aredescribed in the following sections.

Health Information Acquisition and Data Analysis
Application
To carry out the real-time development of pandemic tracking,key screening, and effective prediction, we should make fulluse of disease prevention and control information systems, andactively adopt the method of online pandemic information
reporting. Big data technology will provide support for scientificprevention and policy development. The health care systems
need to form a multisource platform that integrates data
monitoring, exchange, convergence, and feedback mechanisms
for road, railway, civil aviation, communications, medical, andother pandemic-related parties. The integrated platform will
enhance the information linkage with public security,transportation, and other departments. COVID-19 diagnosis
and suspected medical record collection need to be used tohttp://medinform.jmir.org/2020/7/e19866/

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conduct analysis and application from the regional and national
health information platform, which aids in the pandemic
prevention and control, clinical treatment, and scientificresearch.

Telehealth Services
With the assistance of health information technology (HIT),
major hospitals, along with designated hospitals, can provide
services such as remote consultation and prevention and control
guidance. This will improve the ability of elementary healthinstitutions to deal with the pandemic situation and relieve thepressure of designated hospitals.
Moreover, internet hospitals or internet diagnosis and treatment
platforms have their advantages. They can provide online
rediagnosis of some common and chronic diseases and drug
distribution services, and reduce the risk of cross infection ofpatients’ offline visits. Public and standardized platforms should
be adopted to gather the service links of registered and approved
internet hospitals and internet diagnosis and treatment websites.
This adoption would make it more convenient for people toobtain timely information on pandemic prevention and control,and diagnosis and treatment services. Organizing health careinstitutions at all levels to provide online compulsory counseling,home medical observation, and guidance for pneumonitis
infected by COVID-19 will expand the online medical service

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space, guide patients to seek medical treatment, and relieve thepressure of offline clinics.

Scientific Popularization and Real-Time Information
Disclosure
COVID-19 knowledge popularization and prevention oftransmission is critical to facilitate timely access to authoritative
information, and assist in understanding the diseases andself-protection scientifically. Adopting national integrated online
service platforms and official websites of health administration
departments at all levels will be helpful to carry out pandemic
information inquiries.
Social media and other popular platforms should be employed
to carry out training on self-protection and for providing
COVID-19 diagnosis and treatment education. This will improve
the health care services and personal protection capabilities ofprimary care institutions.

Health Information System Deployment
To ensure the smooth operation of the pandemic prevention andcontrol system, an upgrade and transformation of the network
should be accelerated. Where appropriate, information
technology such as 5G should be applied to improve the stability
and transmission quality of the designated hospitals’ network
to meet the needs of patient treatment.
On the other hand, pandemic monitoring and analysis, virus
tracing, patient tracking, personnel flow, and community
management are important tasks during the pandemic. Healthtechnologies such as big data, cloud computing, and AI can beapplied to develop scientific strategies for precision prevention
and control of the pandemic. Internet platforms can help tomatch the supply and demand of medical and pandemic
prevention materials precisely. In this way, coordinateddeployment and recycling management can be achieved.
Information technology enterprises and medical research
institutions should work jointly to tackle key problems,
accelerate the detection and diagnosis of COVID-19 infection,and conduct research and development of new vaccines.

Health Technology Applications andDigital Service Practices
Artificial intelligence (AI)As 2019-nCoV has the characteristics of strong transmission
and weak lethality, the large-scale increase of infected people
may drag down the medical system, so the pandemic prevention
and control needs to track and manage the health status ofresidents and isolate suspected patients. AI’s capacity of in-depth
mining and processing massive information has been used todetect and predict the spread of viruses in pandemic situations[7,8] by building intelligence monitoring platforms anddeveloping advanced algorithms such as neural networks, thesusceptible-exposed-infectious-removed (SEIR) model, andlong short-term memory (LSTM) networks [9-12]. For instance,data from social media, contact tracing, surveys, etc [13] could
be applied to various machine learning or deep learning models
to predict the course of COVID-19 and potential reappearances[11].
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Ye
After the outbreak of COVID-19, the false negative outcomeof the kit test increased the difficulty of diagnosis. AI has
become a powerful supplement to kit detection. The increasingly
mature AI medical imaging technology [14], through tagging
a large number of medical image samples and applying themto the algorithms for training, learning, and understanding, could
effectively assist doctors in decision making. Furthermore, AI
is also on the frontlines of the pandemic. For instance, intelligent
robots are collections of integrated multi-sensor fusion, path
planning, robot vision, intelligent control, and human-computerinterface technology. They can provide diverse services suchas disinfection, food delivery, and medicine delivery. In thesituation of scarce protective clothing, the pressure on thefrontline health care workers to diagnose and treat can berelieved to a certain extent, and the chance of cross-infection
can be reduced.

Telemedicine, Telehealth, and Telecommunications
Technology
Telecommuting has been widely used in industries andbusinesses by replacing traditional commuting with digitaltechnologies [15,16]. In the health care domain, telemedicine
has been leveraging telecommunications technologies to makeuse of HIT and medical information such as video imaging,
thus, allowing health care providers to work remotely [17,18].
Telehealth has been interchangeably used with telemedicine[19,20], but as an umbrella term, telehealth incorporates thefunctions of telemedicine and a variety of nonclinical services
like tele-pharmacy and tele-nursing [21]. The emergence of
telehealth in the coronavirus pandemic dates back to SARS in2003 [22]. During the SARS period, to reduce people’s mobility
and cross infection, a lot of work was conducted through theinternet, telehealth began to show its usefulness. However, due
to the network quality and technical level at that time, telehealthwas limited to simple online or telephone consultation, which
was relatively elementary.
Relying on the rapid development of the telecommunication
technologies, video imaging, 5G, and other technologies inrecent years, telehealth has developed rapidly. At present, thescenarios of remote expert consultation and remote medical
education have been widely applied. Telehealth can solve theproblem of unbalanced development of medical resources among
regions. Through the internet, experts can organize remoteconsultation in remote areas and resource-deficient areas.
Textbox 1 presents two basic models of telehealth.
Telehealth has brought the benefits of high-quality medical
resources from superior hospitals to the community-level healthinstitutions, and it has greatly improved health quality, efficacy,
efficiency, and saved expenses.
Remote diagnosis through internet technology and big data
enables patients to perform imaging and electrocardiogram
examinations at township-level hospitals, and doctors at
grassroots hospitals can transmit information to their superiors
via the internet. The regional diagnosis center and experts will
issue a timely diagnosis report, which is convenient for doctors
at the elementary hospital to provide patients with targeted
treatment.
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During the COVID-19 pandemic, telehealth systems can assist
and support health care professionals to conduct remoteconsultation so that doctors from different regions can converge
together to discuss the diagnosis and treatment of patients [23].
The system will connect the remote mobile workstation besidethe patient’s bed, and real-time video meetings can be carriedout so that the experts can observe the actual situation of thepatient. During the process, patients have interactions throughvideo [24] or telephone [25] with health care providers [26].
The history of symptoms and exposure risk will be obtained
through an observational assessment. Based on this information,
doctors can make judgments on whether the patient has been
infected or needs further testing. Telehealth has also been used
to help manage the patients with suspected symptoms of
COVID-19 and provide virtual medical services for chronic
diseases [27,28]. The image diagnosis system digitizes theresults generated by the examination equipment (x-ray,ultrasound machine, etc) in the medical institution; health careproviders can access the electronic health records (EHR)

Yeremotely through the network to realize remote diagnosis. For
patients who are critically ill, telehealth intensive care equipment
transmits the physiological information and medical parameters
to the monitoring center through the telecommunication
network, and real-time detection and further analysis can be
conducted. The systems can realize interoperability of automatedhealth data through HIE [5] and the sharing of medical
information with participating hospitals. Telehealth shortensthe distance between doctors and patients, and helps doctors
provide timely medical services based on physiologicalinformation transmitted from distant places [29]. Experts fromother places remotely access the EHR of patients in theinsulation ward, discuss the treatment plan and effect in realtime, and give professional opinions.
Given the shortage of medical protective material and personal
protective equipment (PPE), the use of remote consultation
reduces the occurrence of on-site diagnoses, which also saves
PPE, and reduces the risk of infection spread caused by thetransfer of diagnosed patients to the superior hospitals.

Textbox 1. Basic models of telehealth.
Direct docking mode
If the inviting medical institution finds the invitee on its own, then telehealth can be carried out directly between the medical institutions.
Platform matching mode
If the inviting medical institution cannot find the invitee by itself, it can publish the requirements on the remote medical service platform establishedby the inviting medical institution or a third-party institution. The platform can match the invitee’s or other medical institutions’ initiative to theinviter’s needs of health response.

5G
The fifth generation mobile networks, or fifth generation
wireless systems, is the latest generation of cellular mobile
communication technology. It provides at least 10 Gbit/s peakrate and millisecond-level transmission delay [30]. The network
enables a new kind of network that is designed to connect
everything together virtually, including human and machines,
objects and devices with high reliability and capacity. Compared
to prior generations, 5G has larger bandwidth, higher rate, lower
delay, and larger connection. 5G communication technology
can not only achieve high-quality transmission of 3D images
but also provide services such as data acquisition, real-time
positioning, remote diagnosis and treatment, and other fusion
functions in addition to information communication [31].
In a prior generation of wireless systems such as 4G, network
bandwidth was limited, only meeting the transmission of small
volumes of medical information. For medical images likecomputed tomography scan images [23], real-time remoteconsultation, and telemedicine meetings, the network must havehigh transmission speed and low latency. The COVID-19
pandemic is a global emergency; saving time means saving
patients’ lives.
In the medical industry, communication is one of the importantfactors that impact the development of medical rescue. The
high-speed communication capacity of 5G can effectively
improve the efficiency of medical emergency rescue and the
response ability at public health events.

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Remote diagnosis and treatment based on 5G between doctors
and patients can be realized through real-time high-definition
audio and video connection. Medical data transmission canpromote the transition from “face-to-face” consultation to video
remote consultation, which further improves efficiency andprecision. Under the current situation of the pandemic, 5G andtelehealth can make diagnosis and treatment more efficient,convenient, and safe. The high-speed, large-capacity, andlow-latency of the 5G network accelerate achieving the needsof real-time, high efficiency, and stability of the remoteconsultation.
5G telecommunication technologies also improve the healthcare accessibility. Health information systems gather clinicaldata from various locations such as hospitals, community healthcare organizations, and physician practices. 5G supports
real-time health data exchanging so that health care professionals
can get access to patients’ diagnosis records, medical history,
and lab results without delay and information transmission
barriers. Prior generation of wireless systems could not provide
such capacities for HIE [32] and may cause health care
workforce burnout [33]. With the implementation of 5G, thetraditional medical workflow will be improved dramatically,
and the unnecessary contact between health care providers andpatients may be reduced. The electronic health information
system can track the whole process of the medical order, which
decreases the risks of medical errors and improves the qualityof health care and system management.
In the prevention and control of COVID-19, it is essential to
make full use of 5G communication technology, linking doctors
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JMIR MEDICAL INFORMATICSand experts across the country and even around the world;
actively taking advantage of online diagnosis and treatment;
carrying out online consultation, health science popularization,
psychological assistance counseling, and home isolation
guidance services such as delivery of medicines for chronic
diseases; and enabling patients to receive health care withoutleaving home, all of which will reduce the risk of being exposedto the virus.

Internet of Things (IoT)
IoT is a novel paradigm of interrelated digital machines,
mechanicals, computing devices, and other objects [34,35].
Based on the communication protocols, it combines with theinternet to realize the intelligent management of information.
By taking advantage of communication technologies such as
networks or the internet and sensors, everything could be linked
together to realize the connection between people and objects
or objects and objects. At the same time, people-oriented
information, remote monitoring and control, and intelligent
management are realized. Remote monitoring [36] based on
IoT is an effective way to assist in achieving real-time,
continuous, and long-term monitoring of patient vital signs andtransfers the acquired health data or critical alarm information
to health care professionals. Remote monitoring can also achieve
real-time data acquisition and analysis of patients in isolatedareas. Heart rate, breathing, and other physiological indicators[37] of patients with COVID-19 can be collected in the isolatedzone through smart devices [38], electrocardiographs,
ventilators, and sphygmomanometers; data can then be sent
back in real time through Bluetooth [37] or the network. The
collected data of patients’ physiological signs can be analyzed
and processed intelligently in the clinical decision support
system. Once the system finds abnormal data, it will send an
alarm [39] in real time, and doctors will investigate and judge
the situation according to the alarm information.

Mobile Health Apps
Patient-generated health data (PGHD) are becoming more andmore important in health care, especially in the COVID-19
pandemic. Coronavirus tracking apps on smartphones areplaying critical roles as a mobile technology to collect, gather,and share PGHD during the pandemic. Users can check whether
they have had contact with patients who are infected by entering
personal information. When registering, users are required toenter their name as well as age, zip code, and other relevant
information. Phone numbers are also recorded, so users will be
notified once the system identifies contact with patients whoare infected. Most trace tracking apps use network or Bluetoothtechnologies. When other users get close to a certain social
distance range, the app will perform digital handshakes withthem; this “interaction” will be recorded and encrypted [40].
This information is useful to identify high- and potential-risk
groups, which further accelerates conducting accurate
investigations, prevention, and monitoring [41]. During the
pandemic, apps for tracking, tracing, and early warning havebeen successfully implemented in many countries to control the
spread of the coronavirus. Tracking the flow of personnel helped
predict the spread trend of the pandemic and improved theefficiency of prevention and control work.
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However, ethical and legal issues [42] are raised with thewidespread use of contact tracing and monitoring technologies[43]. The pressure to protect personal information is higher thanever. User data is a “disaster area,” as privacy can be leaked.
Some apps claim that data will be encrypted on the user’s mobile
phone for a few days and then permanently deleted if users havenot been exposed to patients who are infected. Some apps need
to obtain the user’s consent on two aspects: user’s agreementwith data being collected while using the app and agreement
on releasing relevant personal data once they are found to havecontact with patients who are infected.
Data opening and sharing in the context of pandemic prevention
and control cannot exceed the reasonable limits. The disclosureand use of data need to protect the rights and interests of citizens
to achieve a dynamic balance between public governance andcitizen protection. On the one hand, making good use of datatechnology has been proven to optimize the governance of the
public health emergency; on the other hand, personal
information and privacy data protection boundaries should bestrictly guarded to avoid unnecessary and irreparable damage.
Technical tools such as data desensitization and blockchain
technologies should be applied along with detailed personal
information classification standards, strict privacy regulations,and policies.

Big Data
With the threat of the COVID-19 pandemic, an urgent publichealth crisis that produces massive data from multiple sources,
the use of big data technology can provide the public anddecision makers with more complete, continuous, accurate, andtimely pandemic prevention information and traceable diseasesource-based methods [44].
Through big data technology along with geographic locationand time stamp information, it is possible to analyze themovement trajectory of affected persons [45]; comprehensively
track the movement trajectories of patients who are infected,
suspected patients, and related contacts; and accurately describe
the cross-regional infiltration. The health care database could
be integrated with immigration and customs data to generate
real-time alarms during clinic visits to assist in identifying
infected cases [46]. Movement tracking has provided powerfuldata support for the prevention and control of the pandemic.

Conclusion
Currently, the prevention and control of COVID-19 is in a
critical period. The construction of integrated intelligent healthcare systems through novel health technology applications plays
a vital role in blocking the spread of the pandemic. The
intelligent health care system integrates strategic emerging
health technologies and health care delivery services andpractices, such as AI, big data, 5G, IoT, cloud computing
technology, sensor technology, telehealth service, mobile healthapps, and HIE practices. This system will form a new mode ofinnovation and upgrading of traditional medical and healthinformatization.
Meanwhile, it is also critical to establish security and privacy
protecting systems to enhance the infrastructure, medical data,
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and management system. It is important to prevent patient
information leakage, create a safer and more convenient medical
treatment environment, and provide a strong security guarantee
for the intelligent health care system.
Through combining health technology and health care systems,
diagnosis efficiency and patients’ medical experiences can be
improved, and remote sharing of high-quality medical resourcesYe
and real-time information interaction can also be achieved. The
integrated system can effectively alleviate the problems of
medical resource shortages, uneven distribution of health carequality, and shortages of health care workers. The establishmentof an integrated intelligent health care system for COVID-19
pandemic prevention and control will also provide a positivereference for the design and development of subsequent
intelligent health care platforms for other public health crises.

Conflicts of Interest
None declared.

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Wang CJ, Ng CY, Brook RH. Response to COVID-19 in Taiwan: big data analytics, new technology, and proactive testing.
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Abbreviations
AI: artificial intelligence
COVID-19: coronavirus disease
EHR: electronic health record
HIE: health information exchange
HIT: health information technology
IoT: Internet of Things
LSTM: long short-term memory
MERS: Middle East Respiratory Syndrome
PGHD: patient-generated health data
PPE: personal protective equipment
SARS: severe acute respiratory syndrome
SEIR: susceptible-exposed-infectious-removed
2019-nCoV: novel coronavirus

Edited by G Eysenbach; submitted 04.05.20; peer-reviewed by E Chukwu, E Da Silva; comments to author 21.05.20; revised version
received 22.05.20; accepted 21.06.20; published 14.07.20
Please cite as:
Ye J
The Role of Health Technology and Informatics in a Global Public Health Emergency: Practices and Implications From the COVID-19
Pandemic
JMIR Med Inform 2020;8(7):e19866
URL: http://medinform.jmir.org/2020/7/e19866/doi: 10.2196/19866
PMID: 32568725©Jiancheng Ye. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 14.07.2020. This is an open-accessarticle distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/),
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR
Medical Informatics, is properly cited. The complete bibliographic information, a link to the original publication on
http://medinform.jmir.org/, as well as this copyright and license information must be included.

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