Among the many effects and side-effects of the pandemic, recent weeks have tested our perception of time to the very limit. As the days and weeks go by, it seems an eternity since the ‘before’ time.
Even in the context of these extraordinarily fast-moving times, however, certain accomplishments stand out. This is one of them.
Professor Richard Costello is a senior respiratory consultant at Beaumont Hospital in Dublin, Ireland. As the crisis deepened this spring, he watched his hospital’s caseload increase in dramatic fashion, pressure building in spite of his team’s unstinting efforts.
“Irish hospitals are working tirelessly and doing a stellar job at looking after coronavirus patients,” says Prof Costello. “However, with the number of cases rapidly increasing, I knew we urgently needed to find a solution that enabled our hospital teams to cope with the crisis by optimizing and scaling acute respiratory care delivery for all affected patients.”
He gathered a group of fellow senior respiratory consultants to exchange ideas and discuss ways of dealing with the unprecedented health crisis.
“With additional clinical staff being pulled in from other departments to boost our respiratory care teams, we knew we also needed something that would provide clinicians less experienced in this area with the critical knowledge and decision support to care for patients,” adds Prof Costello.
With cases continuing to stack up, the team worked around the clock, collaborating with the Dublin-based digital health solutions provider S3 Connected Health and with the support of The Royal College of Surgeons in Ireland and The Royal College of Physicians in Ireland.
Together, they came up with a new clinical support tool designed to give healthcare professionals the support they needed in the triage, monitoring, and treatment of Covid-19 patients. They named the tool ACORRD, which stands for the Assessment of COVID-19 Risk of Respiratory Deterioration.
Concept to deployment in just 10 days
Remarkably, the tool – a CE-marked, class 1 medical device – went from concept to deployment in a staggering 10 days.
“In normal service, creating ACORRD would take up to a year, from developing the concept through to deployment,” says Jim O’Donoghue, President of S3 Connected Health. “However, as these are critical times, we managed to expedite the process – by building upon our existing Affinial platform, which underpins all our digital health solutions – and delivers it in less than two weeks, thanks to our outstanding partners.”
ACORRD has been designed to enable clinicians to quickly, and appropriately, triage Covid-19 patients using a web-based application on their smartphone. The tool defines a novel measure of patient status called the COVID Critical Care Index (CCCI), and helps determine the best course of treatment based on:
- The mode of oxygen delivery
- Key patient vitals, including respiratory rate and oxygen saturation levels
CCCI assessments are repeated on an ongoing basis, allowing ACORRD to visualize trends, track disease progression, assist in the early identification of patient deterioration, and provide rapid advice to the care team on the appropriate clinical considerations.
Developing the tool required a special derogation from the Health Products Regulatory Authority and the Irish Department of Health (HSE), which saw ACORRD reaching doctors at Beaumont Hospital in record-breaking time. A further three major hospitals in Ireland are now also using the tool, with more than 1000 patients benefiting from a pilot scheme.
“An exemplar for agile development”
“The development of ACORRD and the speed of collaboration on this project is testament to the team of clinicians and developers from RCSI, RCPI, and S3 Connected Health,” reflects Martin Curley, Director of Digital Transformation and Open Innovation at Ireland’s Health Service Executive. “All parties answered the emergency call to action and this project is an exemplar for agile development.”
Now that it has been deployed, ACORRD is supporting vital functions including helping specialist respiratory clinicians to identify and triage patients who are most in need of attention. The tool also prompts non-respiratory clinicians in the delivery of respiratory care with appropriate data and recommendations to support clinical decisions
At a senior level, meanwhile, ACORRD provides respiratory team leaders with instant oversight of the condition of patients, helping to treat them, and both optimize and forecast resource requirements including staff and equipment.
The rapid development of the tool is part of a wider effort by the Irish tech sector, which has responded to the pandemic with an unprecedented show of innovative solutions. A recent survey conducted in association with the UN-backed Health Innovation Index (HIEx) places Ireland sixth in a worldwide ranking of countries responding to Covid-19, with medtech at the forefront of the Irish effort.
“Digital health solutions are becoming a vital part of today’s healthcare system,” says Jim O’Donoghue of S3 Connected Health. “The COVID-19 crisis has underlined the importance of embracing digital solutions to improve patient outcomes and facilitate more efficient care.”