Implementation of a novel digital diagnostic tool to support the assessment of respiratory disease in a COVID-19 fever clinic

Abstract

© Author(s) (or their employer(s)) 2022. Reuse permitted under CC BYNC. No commercial reuse. See rights and permissions. Published by BMJ. INTRODUCTION Following its first detection in Wuhan, China, in December 2019, the speed at which SARSCoV2 spread around the globe took many countries and their health systems by surprise. The coronavirus pandemic presented three major difficulties, namely a surge in SARSCoV2 infections, high mortality associated with COVID19 disease and large patient numbers overwhelming emergency departments and intensive care units. In March 2020, the Australian government responded by establishing standalone fever clinics to assess patients experiencing symptoms possibly related to COVID19. At a macro level, these clinics helped Australia manage many aspects of the pandemic; however, at a micro level, the clinics encountered various challenges. First, SARSCoV2 spread through the population alongside other winterassociated respiratory illnesses causing a surge in the volume of individuals experiencing COVID19like symptoms, and thus presenting to the clinics. Second, the precautionary requirement for clinicians to don and doff personal protective equipment between patient encounters reduced patient assessment speed and efficiency. Finally, given that the symptoms of respiratory illnesses—including fever, cough, sore throat and shortness of breath—can be related to a number of different diseases such as COVID19, chronic obstructive pulmonary disease (COPD), asthma, pneumonia and upper respiratory tract infections, there is diagnostic complexity in distinguishing patients with a particular respiratory disease and even more so for those with concurrent infections. This final challenge is exaggerated in highthroughput clinical environments, such as COVID19 fever clinics. A single Federal Government funded COVID19 fever clinic in Queensland, Australia, looked to virtual health technologies as a potential way to alleviate these problems. One technology in particular—ResAppDx (‘the device’)—offered noticeable value to the COVID19 fever clinic due to its ability to rapidly identify Summary box