What has inspired us

Pandemics, like the one we are going through with COVID-19, lead to a rapidly increasing service demand that can overwhelm the functional capacity and safety of hospitals and the healthcare system. Pandemics can also cause severe disruption to health care services, particularly in hospitals, with the consequent risk of amplifying the disease and neglecting the care for non-infected patients.

Resilient and well-prepared hospitals can resist, absorb, and respond to the shock of a pandemic while maintaining critical functionality, and then they can recover to their original state or adapt to a new one.

Besides looking for a new treatment and vaccines, a cornerstone strategy for the management of the COVID pandemic is that hospitals are ensuring:

  • Continuity of essential services
  • Well-coordinated implementation of hospital operations
  • Clear and accurate communication
  • Swift adaptation to increased demands
  • Effective use of scarce resources
  • A safe environment for patients and healthcare workers
  • Infection prevention and control

Hospitals are among the healthcare centres whose prompt and efficient services can play a significant role in decreasing pandemics mortality rate, so responding and effectively adapting is crucial

What we propose

Our proposed solution is called I-HEAL, a Hospital Preparedness and Resilience Network as a web-based platform focused on tackling the impact of pandemics in hospitals.

The ambition of I-HEAL is to enhance hospital resilience and preparedness for COVID-19 and future pandemics by:

  • Assisting hospitals in responding effectively to pandemics in all their stages
  • Providing evidence-based resources for self-evaluation and development of action plans
  • Creating awareness of the importance of good planning and preparedness
  • Collaborating with healthcare professionals from other hospitals addressing similar problems and challenges
  • Considering all hospital-based emergency management principles and best practices
  • Reducing time investment by networking and shared solutions

What I-HEAL does

I-HEAL, the Hospital Preparedness and Resilience Network, offers healthcare professionals working across the EU and worldwide three key elements:

Self-evaluation preparedness and resilience tool that automatically suggests tailored action plans

In this section, the users are guided through a questionnaire to assess the resilience and preparedness of their organizations.

The users would have two outputs:

  • Colour-coded assessment signalling the weaker and stronger areas of their organization.
  • Match of possible solutions to apply to the weaker areas.

For example, if the hospital does not have a protocol on how to handle COVID-19 infected patients in operating rooms, our platform highlights that as a weakness and it then suggests relevant protocols that other users have shared, or that have been already published in peer-reviewed literature.

Solutions can include training materials, protocols, reported experiences by other users and scientific papers. I-HEAL identifies solutions through both artificial intelligence (AI), for published materials and inputs from other users.

For the tailored report, our algorithm browses through the complete database of solutions and matches those that are relevant for the particular domain of resilience and that have been tested in similar settings.

I-HEAL also offers a catalogue of solutions. This way, the user can directly browse the different solutions, filtering by the clinical department, domains of resilience and countries where they have been implemented.

Trusted network of peers to exchange questions and potential solutions

Users are able to quickly introduce specific questions or concerns they have in a Forum. Then, they are able to crowdsource possible solutions.

The forum has the following characteristics:

  • Users are identified by their trust level. Each user is assigned a trust level for each clinical domain, based on the ability to confirm their healthcare background and their contributions to the network as rated by other users.

  • Users are able to browse previous conversations through keyword search and threads.

  • Users get suggestions on potentially relevant solutions. Depending on the keywords, threads that a user enters, the web would automatically suggest some potentially relevant solutions, highlighting the top-rated solutions for these topics.

Resilience and Preparedness Mapping

As a result of all the individual self-evaluations, I-HEAL is able to generate mappings of resilience and preparedness by geographical area.

The mapping includes:

  • The colour-coded overall level of preparedness and resilience by geographical area.

  • Filter by domains of preparedness.

  • Identification of the most searched keywords by geographical area.

In order to maintain privacy, a hospital would never be publicly identified, so only aggregate information would be provided for a region or country.

What is the impact of I-HEAL

Hospital preparedness and resilience is about saving lives and reducing the long-term health and social consequences of pandemics.

The number of people killed in pandemics depends not only on the severity of the event itself but also on the ability to respond effectively and treat the ill.

In theoretical terms, Risk = Threat × Vulnerability × Consequence. Thus, even if we are not successful in reducing the threat of disasters or our vulnerability to them, it is possible to reduce the risk by mitigating the consequences and preparing hospitals to treat the sick and protect the well.

Therefore, our goal is to develop a multi-language platform to facilitate and accelerate the resilience and preparedness of hospitals during the COVID-19 pandemic and beyond addressing different challenges:

Challenges

How I-HEAL tool helps

Activities to facilitate resilience and preparation of hospitals are partially carried out, without taking into account all relevant aspects.
  • Providing a self-evaluation tool to identify the most important issues that should be covered during pandemics including structural and functional requirements
  • Adapted to any type of hospital in different languages
To tackle a pandemic episode, hospitals face similar challenges for preparedness, outbreak response, and recovery.
  • Connecting managers, healthcare professionals, researchers and experts to share problem-solving strategies, resources and relevant tools for each stage of pandemics
  • Creating a catalogue of solutions, including tools, papers, best practices and solutions that can be screened by different variables (e.g.type of hospitals, clinical department, country, language)
Investment in healthcare preparedness has positive results, although if tackled individually managers and professionals might feel overwhelmed.
  • Facilitating collective actions and reducing duplicate efforts on preparing documents, looking for up-to-date evidence and creating solutions from zero
  • Suggesting tools and action plans tailored to their own needs and gaps
  • Creating awareness about resilience and the critical elements to be addressed

Who should use I-HEAL

The main target users of I-HEAL are hospital managers, hospital emergency committees and staff who have the responsibility for establishing and maintaining the preparedness and resilience of hospitals for pandemics and other emergency disasters.

I-HEAL is relevant for both public and private hospitals.

The wider target users are stakeholders across many sectors including governments, health authorities, financial institutions, disaster management organizations and local suppliers which support and contribute to hospital preparedness and resilience, for example through policy guidance and health sector and intersectoral coordination for provision of medical supplies and equipment.

Why should hospitals use I-HEAL

I-HEAL provides a picture of the status of a hospital on preparedness and resilience against a pandemic.

Hospitals which have already drawn up plans for managing the COVID-19 pandemic should use I-HEAL to review their preparedness and resilience and, if necessary, to update their pandemic response plans and their capacity to implement them.

Hospitals which have not developed response plans should use I-HEAL to make a start in the planning process and in adjusting their plans to respond to the pandemic.

How we built it

Through Collaboration:

  • An international and interdisciplinary team across Europe (Spain, Germany and Poland)
  • Domain-specific know-how within healthcare and software development industries
  • Using Microsoft Teams as the main platform for collaboration

By Preparing the deliverables:

  • Architecture
  • Using a variety of tools
  • Writing the concepts
  • Developing personas
  • Developing storyboards
  • Developing the mocks

Using IT infrastructure / backend/ frontend concepts for:

  • Database usage (system DBs and knowledge database)
  • AI/machine learning (ML) topics
  • Data security (e.g. GDPR, etc.)
  • Web and mobile app considerations

Challenges we ran into

Trust network

One of the most important pillars for providing medical data and research data is trust. For traditional data – published in papers and magazines – peer reviews are an established way to verify papers and their inherited data. A pillar of trust is in this case the magazine, distributing data/pre-published papers to qualified and authenticated reviewers.

As there is no international – or even national – registry of qualified reviewers available, they built their own network of trust to get qualified and proper review results.

As the proposed tool provides sensitive data about healthcare and structural health care system data, we also must ensure that only healthcare professionals are enabled to contribute to our platform. Due to the fact that there is no registry/database available that might be used to identify those professionals, ensuring the profession of registered users is an important task for this tool.

To establish this, an approach for building and providing a “medical trust network” was taken, which is described in the appendix.

Building a knowledge base for best practices

The use of AI and ML is becoming more prominent within the health sector. Recent advances in drug discovery, patient diagnosis and treatments are just a few examples where AI / ML technology was successfully used. In our project, we are also planning to use these concepts - there are several use cases where this could prove to be valuable. For example, we would like to find out:

  • What is the best evidence for a given set of criteria such as infection control and prevention, supply use, etc.
  • What are the best processes, procedures and tools that could be deployed quickly to improve the resilience of a medical facility
  • What are the trends or patterns regarding general healthcare topics that could be observed considering the wealth of available information online

Our approach consists of gathering various data sets on which we will then run custom machine learning algorithms. The data sources for our algorithms would be peer-reviewed medical journals, news publications, etc. which can be scraped from websites, stored locally, analyzed and categorized by natural language processing (NLP) algorithms. As an implementation stack, we envision using Python with the standard libraries (e.g. Scrapy, Pandas, etc.) as well as the Keras framework.

Accomplishments that we're proud of

I-HEAL is a scalable solution. By its own nature, it can have a global reach from the get-go. I-HEAL is also adapted to the local context. Despite its global reach, I-HEAL always keeps track of the local context, for example by recommending solutions that have been tested in similar settings. This implies that these solutions have been implemented with similar resources, in similar cultural backgrounds, etc. Therefore it already guides the user to implement solutions easier. I-HEAL will be open to all healthcare professionals and managers across the globe by at the same time having a credible business plan to generate a return for investment.

What we learned

Building and developing a complex idea from scratch has been possible even in 48 hours.

Creating a new team to make an idea come true was totally feasible by being determined to get through it with cooperation and innovation!

Geographical boundaries are no barriers to achieving a common cause and we have confirmed that different settings and disciplines have synergistic effects.

What's next for Hospital Resilience and Preparedness Tool

I-HEAL will be useful not only for the COVID-19 pandemic but also for future pandemics or healthcare crises. It could also potentially be extended to other organizations of the health and social care systems such as primary care centres and nursing homes.

This entails that I-HEAL can outlast this particular moment and therefore create a higher return for investment.

To attract investors we plan to develop some additional features that would strengthen the business plan for I-HEAL.

We envision a PRO version addressed to institutions and healthcare corporations. For a given fee they could access the following features:

  • Institutional management area that would enable the user to set automatic alerts to professionals, tracking progress at the department level, communication information, etc.

  • Corporation internal network, where one could compare across their hospitals, generate their own resilience mappings reflecting the level of their hospitals and comparing it to the average of the region/country/world.

  • Allow for adaptation of indicators to tailor them to their specific internal protocols.

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