The new healthcare: from eHealth to CoronaCheck

How do we keep healthcare affordable for everyone? Can an app ensure fewer hospitalizations? How do we know if the official CoronaMelder app helps to curb the spread of the virus? Behavioural scientist and epidemiologist Esther Metting aims to answer all of these questions. In addition to her research at the University of Groningen, Metting is also in high demand as a media expert in the public debate on issues relating to the coronavirus pandemic. Recently she also started working as a figurehead for eHealth at DASH (Data Science Centre in Health) at the UMCG.

Text: Merel Weijer/department of Communication

As human beings, we are living longer, which also means that more people are suffering from chronic illnesses than ever before. The workload in the health care sector is very high and costs are on the rise. This may affect how easy access to good and affordable health care becomes in the future. According to Esther Metting, technology in health care (eHealth) could serve as a solution to this problematic situation, resulting better health, lower healthcare costs and support for both doctors and patients. ‘As an epidemiologist and behavioural scientist, I look at both the clinical outcomes of eHealth and at changes of behaviour on both the part of the patient and the health care provider. One of my research areas is investigating whether or not applications can result in lower hospitalizations and a better lifestyle and how people who are less digitally literate could also access this technology. My research serves to provide more knowledge about this target group, for example by ensuring that all patients can benefit from the advantages eHealth has to offer.’

Struggling with digitization

In recent years, Metting has actively volunteered at multiple societal organizations, where she observed that a large group of people struggle to keep up with the digitization of society. This group also includes highly educated people and young people. In Metting’s opinion, developers and policy officers should pay more attention to this group. ‘Two million Dutch people are not digitally literate and struggle to keep up with the many technological developments taking place in modern society. A serious issue, resulting in limited access for this group to both eHealth and the health care of the future. With the outcomes of scientific research, we can develop methods to help include this group.’

Effects of the CoronaMelder app

Esther Metting is also involved in the evaluation of the CoronaMelder and CoronaCheck apps as a scientific advisor. Over the last year, she has conducted research for the Ministry of Health, Welfare and Sport with a focus on the opinions and behaviours of users, the effects of the apps on the spread of the virus, and accessibility for people lacking digital skills. Research into the CoronaCheck app is ongoing, but the study on the CoronaMelder app has since been completed. Over five million Dutch people have downloaded the app, and the app appears to have a limited but noticeable effect on curbing the spread of the virus. The app also ensures that people who have been in contact with an infected person are warned faster than through standard contact tracing. The results from the study have been used to inform the House of Representatives and to improve publicity campaigns. Metting: ‘Apparently, lots of people believe that the app tracks your location. This is not the case and more attention has been paid to this in recent communications. Now that society is opening up again, the app can have tremendous added value by allowing infected individuals to quickly warn those who were in their vicinity.’

The scientist in the public debate

Metting is often asked to share her opinion on current coronavirus policy. She believes that contributing is important. ‘As a researcher, I can provide a nuanced reflection on government measures using my knowledge of scientific literature and the results from my studies.’ The researcher has recently become more aware of the role that she and her colleagues have in the public debate. ‘As researchers, we are used to looking at our research data with an open and unbiased view. Statements in scientific publications are based on results from other studies, while opinions in the media are often polarizing and unfounded. It is important that well-substantiated and nuanced opinions are also heard.’ As a new member of the Young Academy Groningen, she believes that she has an important role to play in this regard as well. ‘As a YAG member, I aim to bridge the gap between academics and non-academics by sharing the results of scientific research in a clear, comprehensible and accessible way.’

Concerns about the health of teaching staff

The University has once again opened its doors to students and staff. Metting also has a nuanced opinion on this decision. On the one hand, allowing students and staff back on campus is a positive step. ‘Last year’s teaching was almost entirely held online. Unfortunately, this negatively affected the wellbeing and motivation of many. Setting up remote teaching was hard on teaching staff as well. And, of course, teaching students remotely is a lot less satisfying.’ All of the above are reasons to reopen the University as quickly as possible. ‘But on the other hand, many students are not or not yet vaccinated, and this is a group experiencing a high number of infections. Our research into the rapid testing centre showed that lecturers often worry about their own health when offering in-person teaching. One infected student on campus can infect many others. Finding a worthy alternative to in-person teaching so that those with symptoms, those who have tested positive, and vulnerable individuals can provide or follow remote teaching is very important.’

The future of health care

Metting expects that eHealth will continue to play an increasingly important role in health care. Partly due to this, there will be more emphasis on preventive and personalized health care. Nowadays, people have a lot of tools at their disposal to help monitor their health care, such as a pedometer, a digital food diary, or a blood pressure monitor. She believes that these developments can motivate people to live a healthier lifestyle. These tools can also help to detect issues at an earlier stage, which also allows interventions to occur sooner. In addition, the large amount of anonymous digital health data serves to better predict in which situations and for which patient a specific treatment would be most useful, further individualizing health care. ‘I am convinced that eHealth, used appropriately, will lead to better health care and better health.’