Real-Time Digital Contact Tracing: Development of a System to Control COVID-19 Outbreaks in Nursing Homes and Long-Term Care Facilities.

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can spread rapidly in nursing homes and long-term care (LTC) facilities. Symptoms-based screening and manual contact tracing have limitations that render them ineffective for containing the viral spread in LTC facilities. Symptoms-based screening alone cannot identify asymptomatic people who are infected, and the viral spread is too fast in confined living quarters to be contained by slow manual contact tracing processes. OBJECTIVE: We describe the development of a digital contact tracing system that LTC facilities can use to rapidly identify and contain asymptomatic and symptomatic SARS-CoV-2 infected contacts. A compartmental model was also developed to simulate disease transmission dynamics and to assess system performance versus conventional methods. METHODS: We developed a compartmental model parameterized specifically to assess the coronavirus disease (COVID-19) transmission in LTC facilities. The model was used to quantify the impact of asymptomatic transmission and to assess the performance of several intervention groups to control outbreaks: no intervention, symptom mapping, polymerase chain reaction testing, and manual and digital contact tracing. RESULTS: Our digital contact tracing system allows users to rapidly identify and then isolate close contacts, store and track infection data in a respiratory line listing tool, and identify contaminated rooms. Our simulation results indicate that the speed and efficiency of digital contact tracing contributed to superior control performance, yielding up to 52% fewer cases than conventional methods. CONCLUSIONS: Digital contact tracing systems show promise as an effective tool to control COVID-19 outbreaks in LTC facilities. As facilities prepare to relax restrictions and reopen to outside visitors, such tools will allow them to do so in a surgical, cost-effective manner that controls outbreaks while safely giving residents back the life they once had before this pandemic hit.

Artificial Intelligence-Powered Digital Health Platform and Wearable Devices Improve Outcomes for Older Adults in Assisted Living Communities: Pilot Intervention Study.

BACKGROUND: Wearables and artificial intelligence (AI)-powered digital health platforms that utilize machine learning algorithms can autonomously measure a senior's change in activity and behavior and may be useful tools for proactive interventions that target modifiable risk factors. OBJECTIVE: The goal of this study was to analyze how a wearable device and AI-powered digital health platform could provide improved health outcomes for older adults in assisted living communities. METHODS: Data from 490 residents from six assisted living communities were analyzed retrospectively over 24 months. The intervention group (+CP) consisted of 3 communities that utilized CarePredict (n=256), and the control group (-CP) consisted of 3 communities (n=234) that did not utilize CarePredict. The following outcomes were measured and compared to baseline: hospitalization rate, fall rate, length of stay (LOS), and staff response time. RESULTS: The residents of the +CP and -CP communities exhibit no statistical difference in age (P=.64), sex (P=.63), and staff service hours per resident (P=.94). The data show that the +CP communities exhibited a 39% lower hospitalization rate (P=.02), a 69% lower fall rate (P=.01), and a 67% greater length of stay (P=.03) than the -CP communities. The staff alert acknowledgment and reach resident times also improved in the +CP communities by 37% (P=.02) and 40% (P=.02), respectively. CONCLUSIONS: The AI-powered digital health platform provides the community staff with actionable information regarding each resident's activities and behavior, which can be used to identify older adults that are at an increased risk for a health decline. Staff can use this data to intervene much earlier, protecting seniors from conditions that left untreated could result in hospitalization. In summary, the use of wearables and AI-powered digital health platform can contribute to improved health outcomes for seniors in assisted living communities. The accuracy of the system will be further validated in a larger trial.