The Present: As of April 19, 2020, there are over 2,000,000 confirmed cases and 1,000,000 survivors of COVID-19 . Right now, resources are being used for tracking, containment, and treatment of the acutely ill patients. With health care systems worldwide being chronically understaffed, underfunded as well as overwhelmed by the sheer number of acute infections, who will take care of recovering patients after their discharge from the hospital?
The Need: Recovery data currently are not being collected because there is no standardized system in place. Healthcare workers are overburdened, and follow-up data that missed to be recorded now canno’t be used for global analysis. Any data that might be collected is fragmented, unstructured and not standardized. Around the globe, many people are trying to solve important problems regarding COVID but very few focus on recovered patients whose numbers will keep increasing.
The Past: Data from pandemics, most importantly SARS and MERS shows us that it’s not over when the virus is managed. The vast majority of patients from those outbreaks suffered long-term adverse effects, such as avascular necrosis, PTSD syndrome, and depressive disorders.
The Future: Gathering data now, and for the next several years, will have a huge impact on how we respond to the next pandemic. A better understanding of the recovery phase of COVID-19 will be invaluable to inform policy making, improve resource allocation, and modify treatment. If we act now, we will thank ourselves in the future.
What It Does
The Survivors App is an adaptable application which provides the solution to the above: Our two-part solution takes the burden off of healthcare professionals. It gathers recovery data from patients and makes it available for global analysis, providing invaluable insights to the patient, the scientific community and the public health systems.It can be used also to track survivors of any pandemic wave or virus.
The Survivors App: Upon registration, the user completes an anonymous survey, which collects demographic data, past and current medical information, and COVID experience and treatment. Then, users can self-report any symptoms as frequently as they want, and will be asked to complete periodic WHO validated surveys to track the evolution of health-related problems over time.
The Dashboard: Users’ anonymous recovery data is immediately available on a publicly accessible dashboard providing insights for doctors, governments, and researchers on a worldwide scale. The database structure was built to be future-proof. Our solution is focussed on the current pandemic, but can easily be adapted to future ones. The collected data could reveal targets of improvement for our current management practices, could identify signs to alert the patient to seek professional help whether for relapse or for the development of psychiatric conditions. Data analysis on a large scale and by geographic location can also provide information needed for the educated decision making of allocation of resources. Overall, this tool can provide invaluable insights to the patient, the scientific community and the public health systems
How We Built It
The design, app, and APIs were all designed and crafted in the technologies listed. To speed up the process, the app set a data structure which was then passed through the design, to the database, then to the analysis team with changes proposed at each step and then the final structure was reflected back up that chain to create the final design. This allowed the app development to start early and progress while the design and analysis methods were finalised. The app was then adapted to the design
Creating the Questionnaire for the App: The questionnaire was created by our team’s medical professionals, who researched literature from previous pandemics as well as recent literature on COVID-19 and SARS-CoV-2 and considered what information would benefit patients, public health, and the scientific community. A concise representative view of collected data can be found here:link
Overview of Data Collected:
1. Data Collected upon Registration - Collected Once: Users provide anonymous data regarding their demographic and socio economic situation, current medication, medical history, and their COVID-19 infection and treatment period. We are very interested in the type and results of tests used for diagnosis, symptoms experienced, when and if they went to the hospital, and any treatment received.
2. Data Collected on a Daily Basis - User’s Choice: Patients can enter symptoms, vitals, and record new tests taken. These are selected from a wide range of symptoms organized per anatomic region (head, chest, gastroi ntestinal, etc.) for easier and more intuitive search. Additionally temperature and blood pressure can be entered as well.
3. Data Collected Periodically - Prompted Surveys: Every 30 days, users are prompted to take the WHODAS (World Health Organization Disability Assessment Schedule 2.0). The survivors’ overall disability over 6 Functioning Domains (cognition, mobility, self-care, getting along, life activities, and participation in society) and its changes will be assessed over time. The answers are then summed and scored according to WHO methodology.
Challenges We Ran Into
Scope of the App: This app has the potential to be used in so many different scenarios, and help so many different parties, that keeping the scope clear was a challenge at times.
Communication: Our team is a multidisciplinary and multicultural. Communication between disciplines and collaboration between cultures can be problematic. In working together, we developed a common language and had patience to overcome misunderstandings.
Questionnaire: Creating a concise and clear questionnaire that translates to many languages proved to be challenging
Accomplishments That We’re Proud Of
During Greek HackCorona:
Teamwork: The idea, the team, and the design was born during the weekend of April 10-11, during the Greek HackCorona. We competed against well-established teams, and among 55 teams, our newborn team placed 4th out of the 5 winning places.
App Design: Initial wireframes of the mobile app
Data Structure: We used data related to previous pandemics
Front End: We created a first draft of our mobile app
Back End: Creation of the database and the integration with the mobile app and the dashboard.
Dashboard: 1st draft of dashboard (Streamlit)
Research: Best-practices for the questionnaire and follow-up execution
Prototype: A working prototype of the mobile app
Video Pitch: A complete 3 minute pitch, detailing our progress
After April 11:
Development: Initial version of app submitted for testing to the Apple Store---
UX Design: The flow of the app re-evaluated
Branding: A new logo and brand identity implemented
Marketing: Created target personas and identified motivators
Marketing: Continued market research and identified competitors
Content: The medical team continued to refine the questionnaire
Legal: The development members researched ‘terms and conditions’
Translations: The questionnaire was translated to several languages (English, Greek , German and Italian)
During EU vs. Virus:
Content: Continued refinement of the questionnaire
Front End: We created an android version and we finalize the app accorind the design.
Video Pitch: Creation of new video pitch and presentation deck created
Technical Protocol: Creation of a technical protocol link
Dashboard: Implementation from scratch a new dashboad using Dash-plotly
What We Learned
Working effectively as a team creates momentum, improves morale, wins contests, and can even save lives.
Multidisciplinary teams and multicultural teams can have a more holistic understanding of a problem set in different settings and can provide a more well-rounded solution.
What's Next for Survivors
The data-collecting Survivors App and website will be ready for rollout on May 1st 2020. We always aim for improvement, and are actively looking for ways to improve the app.. New features are already being worked on, such as an export function to allow easy data sharing between patients and their trusted doctor.