The numbers

The statistics we have until now don’t paint a very pretty picture.  At the time of this writing on april 5th, there are over 1.2 million cases worldwide with the death toll reaching a little under 65 thousand. Out of the total cases, 5% are in serious or critical condition. But bear in mind, this percentage is calculated taking into account the number of cases that had an outcome, not the total number of active cases right now, so it might be subject to change.

According to one source at the beginning of the outbreak in Italy, 9 in 10 people of those that didn’t make it, died before ever reaching an intensive care unit in overcrowded hospitals. These numbers will most surely rise as healthcare units become more and more crowded, medical supplies run out and doctors get sick, all parts of beseiged medical systems worldwide.

There have been large debates about the accuracy of the death tolls and accuracy of official numbers. China was accused of downplaying numbers, along with North Korea, and and […]. There have also been disputes about the actual cause of death in people in the most affected age groups. The Coronavirus affects people with underlying conditions more seriously, of which the ones with heart conditions or diabetes are most vulnerable. We see from statistics that the 60+ age group is the most hardly hit, but this is mainly due to other co-morbidities. The argument has been that if an elderly catches the virus and doesn’t survive because of other health problems, can be COVID-19 listed as a cause of death?

The global media environment and all the public attention the pandemic has right now is not going to help data scientists trying to get a grasp of the numbers. Compared to the regular flu that also kills hundreds of thousands every year and doesn’t get listed as a cause of death because it’s much more common, when someone dies of Coronavirus infection, almost surely the disease gets listed as the primary cause of death and all other comorbidities fade in the background.

What we know for sure

Taking into account all these factors, we need to understand that numbers are going to constantly change, might not be true in the first place and can be ultimately biased.

But there are things that we know here at Medicai based on our practical on-going experience and partnerships in the medical sector that don’t make it to the statistics. Because of all the media coverage, news, laws and political fighting the pandemic has sparked, patients with serious conditions don’t get the attention and assistance they so desperately need because of overwhelmed medical systems, shortage of personnel or social distancing measures put in place almost everywhere in the world.

Think cancer patients. Many of them don’t have 3 months to ’postpone’ their treatment until this crisis is over. They have their own crisis and their own battle to fight in which three months of social distancing measures or unavailable medical services can drastically influence its outcome. To top it off, they’re in one of the most vulnerable co-morbidity groups because of the toll their illness already had on their bodies to start with.

At Medicai, because of our business model, we are constantly surrounded by chronic patients and this is just one example of a category of highly impacted patients that don’t show up in any official statistic regarding the Coronavirus pandemic. To be completely honest, it’s probably impossible to measure all these implications, but that doesn’t mean it’s not actually happening.

Online means social distancing, collaboration, efficiency and comfort

Our main focus at Medicai has always been on chronic patients. We know from our research that they’re one of the most overlooked category of patients and one of the most vulnerable at the same time. Using our platform, doctors can receive medical documents and communicate with their patients, thus the latter don’t need to expose themselves unnecessarily just to deliver an MRI, they can just upload it online.

Doctors receive medical imaging data that they can use for triage without the patient needing to come personally to the hospital or clinic.  Specialists can collaborate with fellow doctors and share knowledge and insight on specific cases, ultimately improving patient outcome. We have been focusing our developments on key features that we know are going to help during times when it feels daunting for patients and doctors to implement proper treatments. Overall, if we can contribute even just a little to the wellbeing of chronic patients in these hard times, we will consider our job well done.

Use case: How Neuroaxis is using Medicai

Dr. Dan Mitrea is a neurologist and co-founder of Neuroaxis

Mr. Mitrea, thank you for joining us! Please tell us more about yourself, why did you choose to become a doctor and how did you decide to found Neuroaxis?

Thank you for the invitation.
Why did I decide to become a doctor… Well I believe that that there are 2 reasons why. The first one is that I always liked people, being around and listening to their stories and mostly see how I could help those that needed a hand. The second reason is linked to my family which is made by medical professionals. Both grandparents and parents are medical doctors, so you can imagine that most of the stories in the house were related to patients, cases, hospitals and clinical work.

Neuroaxis came to my mind while i was in residency. It was an observation that most of the people we were treating in the hospital were not necessarily “stationary”, on the contrary, around 80% of this patients needed ambulatory care. So I discussed this idea with my friend, Mr. Dragos Tudorache. We immediately started working on market research and a business plan. After one year we had a pretty good idea on what and how we were going to do this. We needed a partner to help us with the financial aspects of the business and also be interested in developing it along with us. That is how Mrs. Cristina Patrascanu came into our team.

How is the current COVID-19 pandemic affecting you and your staff right now?

This situation is new to everybody in the world, so I guess that this is affecting all of us. The medical sector is now being stretched beyond it’s limits and is so because there are a lot of lives to be saved. Unfortunately this is happening because we did not prepare for such a situation. The WHO is now overwhelmed and I do believe that what is now happening will definitely change the way we organize our healthcare systems and even our economy.
Our staff is very supportive, everybody understood the situation and working along our medical team to insure patient safety and access to all the Medical services we offer.

What do you think should be done at a central level, what should the government do to help doctors today?

I believe the government is doing all it can now to insure less speeding of the SARS-CoV-2 virus. By limiting people’s physical interaction will help diminish the spread of the disease and buy us time to be able to treat infected patients that are in need of intensive medical support. If this measures are not respected, there will be a spike in people needing intensive medical support and unfortunately there is not enough staff nor places to care for this cases.
For the medical perspective the government should ensure that the hospitals are properly supplied with materials that protect the medical staff and the their patients.

Tell us how your recent partnership with Medicai fits into this puzzle

The partnership with Medicai started 1 year ago, when Mr. Mircea Popa approached us with his idea of building an online PACS system. We were one of the few pilot clinics that started implementing Medicai since it’s early development. Right now it’s one of the central points in our patients care and helping our business have more fluid workflow within the medical team.
The possibility to exchange medical imaging files (big size files) with the team or with another healthcare professional from another clinic, to discuss the case exclusively online has helped us win a lot of time and of course cut costs on what it meant to install a local PACS server. Basically our workflow related to patient imaging files and interactions within the team improved due to the use of Medicai.

Can you give us an example of a case that you managed through Medicai?

We do this every single day. We even organize our weekly reports around the imaging data that we collect from patients during a week and then discuss in Medicai all the cases.
We are currently working on a case of a male patient that has paraparesis probably due to white matter disease. He sent us his medical and imaging files, was clinically examined by one of our colleagues and has now shared his files with the all our neurology specialists. We will discuss his case this week during the weekly report and offer a pathway for his diagnostic and treatment.

Another interesting case was of a female patient, diagnosed with a very large meningioma (brain tumor). With Medicai we managed to collaborate with colleagues from Lyon, France. We discussed her imagining and clinical status and agreed that she needed surgery to remove the tumor. So she went to Lyon, in the beginning of this year, had the surgical intervention and is now back in Romania, in our care. We share her status with our friend from Lyon via Medicai.

These workflows would have been possible in the meantime, why do you think it’s only now they’re beginning to get

We all know that access to high quality health-care means collaboration between medical teams (shared knowledge). There was a need to have a simple system with which colleagues could share medical files and talk. The system needs to be secure and easy to use, available everywhere and on any device.
In our particular case workflow improvements came quickly.  Medicai offers both PACS storage/viewing solutions combined with the possibility to talk and share the files with other colleagues. The amazing thing is that all is online, cloud-based, so no data needs to be downloaded, all the information is securely stored and registered in the platform. This is what Medicai brought to our business.

What do you think will happen with the healthcare industry once the pandemic is over, is telemedicine here to stay?

Yes, telemedicine is a great solution to improve our healthcare system. It will first take off some of the  burden from hospitals and patients that need to walk from their home in order to see a specialist, or visit multiple teams in a timely manner. It will help us better monitor our patients at home or anywhere they want to relocate. It will help us manage our time better and it will definitely help us communicate better within our professional community.

This pandemic will help us better see the benefits of this form of medicine and will definitely have a long term impact on how we do our profession.