How to Manage Your Stress When the Sky Is Falling

Executive Summary

In these uncertain times, as an invisible virus spreads across the globe, we need to  manage our stress more than ever. Like the elite athletes the author works with, who can control their physiological and mental arousal, we need to employ psychological skills to move into our activation sweet spot to perform well and live well. Those who understand how to use their mind to manage stress look for the optimal state where they are “switched on” but not too tight. We may not have control over our circumstances, but we do have control over our minds. So we should all be employing mental skills and practices to get us through this trying time. Things you can do include a morning mediation routine, establishing a repeatable sleep and wakeup routine, connecting with others, and establishing a higher sense of purpose.

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It’s natural to feel stressed right now. As we try to navigate our new normal, we’re worried about getting sick or losing our jobs, we’re inundated with news about death tolls and an economic recession, and we’re isolated from coworkers, friends, and family.

Stress helps prepare us to meet the demands and challenges of our environment — up to a point. The chain of rapidly occurring neuro-chemical and neuro-electrical reactions can sharpen attention and our ability to assess our surroundings, motivate us, and even briefly boost our immune system. But it’s designed to be a short-term response to last for minutes or hours, not days and weeks.

When our stress system stays activated for a prolonged period of time, it can suppress our adaptive immune systems and make us more vulnerable to viral infections.

Further Reading

That’s why we need to manage our stress more than ever. Like the elite athletes I work with, who can control their physiological and mental arousal, we need to employ psychological skills to move into our activation sweet spot to perform well and live well. Those who understand how to use their mind to manage stress look for the optimal state where they are “switched on” but not too tight.

We may not have control over our circumstances, but we do have control over our minds. Even if you think you’re relatively calm, know that stress is a stealth and powerful adversary. It can hit you out of nowhere. So we should all be employing mental skills and practices to get us through this trying time.

Breathe

A mindfulness practice allows us to have space from our cognition and emotion so we can see things as they really are. Rather than being anxious, we can see that we’re experiencing anxiousness. There’s a big difference.

Start from the moment you wake up. In a recent video, my colleague at Compete to Create and former Olympian Courtney Thompson offered advice on how to set our minds right each and every morning. Instead of reaching for your phone, checking the news, or scrolling through social media, try this:

  1. Take one really long deep breath — more than ten seconds — and try to exhale longer than you inhale. Express one thought of gratitude. Don’t just check a box. Are there people in your life that are stepping up? Is your family healthy? Try to really feel it. It’s not an exercise in thinking, it’s an integration between thinking and feeling.
  2. Set your intention for the day. I don’t mean your goals or to-dos. I mean, what type of person are you going to be today? An intention represents a commitment to carrying out an action in the future. Are you going to show up for others? Be calm and controlled for family, friends, strangers, and colleagues? This is an exercise in imagery, seeing yourself at your best.
  3. Pull off the sheets and put your feet on the ground. Take a moment to feel your feet on the floor. Be where your feet are. This is a primer to mentally and physically start your day in the present moment.

No matter what’s happening, remember that you’re in control of your thoughts (well, at least the one’s you’re aware of). You can decide what you’d like your first thoughts each day to be. Choose well.

If you’re feeling unfocused or anxious during the day, take eight minutes and just breathe, observing your passing thoughts without judgment and bringing your attention back to your breath when those thoughts grab your attention. If you become distracted, re-focus back to your next breath. Try it. There’s no right or wrong way to practice.

Eat and Sleep Well

Self-care, during times of high-stress, is essential. It sounds simple and obvious, but, when we’re in survival mode, many of us don’t take good enough care of ourselves

Great sleep is crucial. Recently, on my podcast Finding Mastery, I spoke with Matthew Walker, a sleep expert and Professor of Neuroscience and Psychology at the University of California, Berkeley. For optimal sleep, he suggests going to bed at the same time each night. Your brain thrives on regularity — not Netflix.

But, if you’re stressed out, you may have trouble falling or staying asleep. If you run into trouble, Walker suggests “walking it off.” I suggest one of these three tactics. Brush your teeth — to re-ignite a Pavlovian, it’s-time-to-go-to-sleep response — read a book (the more boring the better), or jot down your thoughts on a pad of paper (not your phone!) until you feel sleepy.

Try to wake up at the same time each morning, too — even if you had a bad night’s sleep. Regularity will keep your circadian rhythms in check.

Eat and hydrate well, too. In times of high-stress, our bodies crave sugar, starches, and salt. But research has found that people who have a healthy diet are less prone to infections. Eat colorfully. Dark and leafy vegetables (sorry, candies and chocolate don’t count) are an efficient way to feed the energy needs of your immune system.

And drink plenty of water. It flushes toxins from your body.

Create Connection

In times of uncertainty, we typically gravitate toward our tribe for comfort and support. In this instance, we are being asked to separate from the community, to shelter in place, to keep our social distance. But, if left unchecked, social isolation can lead to loneliness, which can have drastic effects on our mental and physical health.

Separation doesn’t have to mean isolation. Take this time to really connect with others. Tell them how valuable they are to you. Send messages of praise to your coworkers. Tell your family how much you love them. Make a list of people you want to call, to thank them for making a difference in your life. And don’t only broadcast your own concerns. Be curious about how others are doing — and truly listen. Do it today.

This is a time to practice compassion. Almost everyone will be affected by the social, physical, and economic dislocation of the pandemic. Recognize we are all in this together. There is no “other.”

Shake things up. Partake in Instagram dance parties. Sing. Or make music together. Italy offers a beautiful example of creating joy and connection while in lockdown. People have started singing from their balconies, out their windows and across rooftops at appointed times, coordinating their efforts via social media. Viva l’Italia!

This isn’t the time to be overly worried about what others think of you. We’re all in this—together—and if there were ever a time to let loose, this is it. Connecting with others, and being open and vulnerable, is what’s going to get us through.

Find Purpose

As the news gets worse, and we go about our everyday routines, you may find yourself thinking that your life and work lacks fire. So try anchoring this remarkable period in purpose larger than yourself. You get to decide the story you tell yourself. When we have an orientation beyond ourselves, it makes us more resilient in the face of challenges.

Victor Frankl, the Austrian neurologist and psychiatrist, survived four concentration camps, an experience that profoundly deepened his understanding of man. Frankl learned that our main drive or motivation in life is neither pleasure nor power but meaning. Frankl wrote, “Life is never made unbearable by circumstances, only by lack of meaning and purpose.” In his experience at the camps, he wrote, “Those who (were) oriented toward a meaning to be fulfilled by them in the future were most likely to survive.”

For inspiration, take note of the people who are serving the greater good in response to the crisis. Some are helping the less fortunate in their communities. Others are using this as a teaching moment for their children.  That’s living — and leading — from a place of purpose. You can do the same.

As you forge ahead, and things get tough, remember that your most significant ally lies inside you: your mind. So take care if it — for your own health and the health of others, too.

Are You a Small Business Owner by Accident?

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Many entrepreneurs become small business owners by accident. I never wanted to have my own company. When I graduated from college, I wanted to be president of IBM. But then I got tired of my boss. He kept promoting incompetent people over me. As a result, I struck out on my own. But I failed to understand the kind of journey I was really starting.

On the Small Business Radio Show this week, Marcus Babcock, now a sales manager at business management app, vcita,  started out as a personal trainer at a big box gym when he was 20. This eventually led him to striking out on his own and starting a mobile workout “studio” with other trainers. It all happened by the time he was 24.

The Accidental Entrepreneur

Marcus got laid off from a big gym. Then entrepreneurship got “forced on him.” He started to take on clients on his own. He liked the idea of having his own business. Where he exercised “control.” It allowed him to work with anyone he wanted. And gave him more free time. Marcus soon realized that he was working more hours for less pay and spending less time doing what he loved- training clients.  He began to work mostly on marketing, scheduling clients and making sure he got paid. This was “very humbling” and he started to question why he was in his own business!

Marcus realized how to scale his company. He knew he couldn’t keep track of everything on an excel spreadsheet. He explains it this way. “I was working 12 hours a day training clients and another 12 hours managing the business. I had to remember who the people were, if they paid, when their next appointment was, how many sessions they had left and remind them to come again”. Marcus says he even forgot to charge them for their training service!

The Lessons of Growing a Company

Next, Marcus started to “hoard applications.” They performed specific functions in his company. But the information failed to transfer easily from one application to the other. As a result, he spent a lot of time on data entry. Or he coped with incomplete information about his customers. This hurt his relationship with them.

He now uses vcita. It works as an end to end business management app. And it takes customers from a marketing prospect to scheduling. Then from scheduling it takes this to billing to collection to contacting them again automatically. It manages the entire life cycle of the customer. Marcus believes in the analytics. He understands the activities of your customers and prospects. And he understands how an all in one system gives you the key to profitably growing your business.

With the cloud, this seems a small investment per month. You start with the functions you need right now. And then expand to other areas to match growth. Marcus encourages all small business owner to think about the value of their time. “What is it worth if your clients show up to your appointments on time, what is it worth if they pay on time, what is it worth for them to come again?”

Listen to the entire interview on the Small Business Radio Show.

Image: vcita.com


How Hospitals Can Manage Supply Shortages as Demand Surges

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As everyone has become painfully aware, acute shortages of materials like masks, ventilators, intensive care unit (ICU) capacity, and staff are hamstringing the heroic efforts of health care professionals around the world to address the pandemic.

Now, more than ever, the right supply-chain strategies and management practices are urgently needed to optimize scarce resources, alleviate shortages, and expand capacity quickly. While good management can never be a substitute for dedicated and skilled medical practitioners, improving the management of supply chains is crucially needed to ensure that these professionals have the resources to do their jobs.

Further Reading

This article, which draws from the best practices in supply chain and operations management, can help struggling hospitals and other care providers increase the odds they will have those resources. It is based on a central reality: Tackling shortages and supply constraints requires a comprehensive strategy aimed at both the demand- and supply-side roots of the problem.

Managing Demand

A pandemic generates an enormous demand shock for health care systems already running at close to full capacity. While social-distancing measures, travel restrictions, and shelter-in-place orders are effective in dampening demand, they are only part of the solution. It is still necessary to manage the way patients enter and proceed through the various nodes of the health care delivery system.

Managing flow means proactively shaping how, when, and where among these nodes patients (both infected and uninfected) receive care. During the Covid-19 outbreak, hospitals have been forced to redesign patient flow in real time, grappling with such issues as: Which care can be moved from a hospital to an alternative setting (even the home)? Which procedures for which patients can be safely postponed? What policies do we put in place to determine how long patients (those with and those without Covid-19) need to stay in the hospital or utilize an ICU?

To help alleviate system congestion, health care managers should follow two principles:

1. Be aware of systems interdependencies and unintended consequences.

Health care systems are composed of many interconnected points of care, and the demands across them are not independent. For example, demand for baby delivery rooms spurs demand for postpartum and neonatal care. System interdependencies mean that changes in one part of the system can generate unintended consequences.

For instance, a study of ICU care by Diwas Singh KC and Christian Terwiesch found that as ICUs reached full capacity utilization, physicians responded by shortening lengths of stay for patients. This “early” discharge strategy indeed worked to open capacity in the short term, but there was an unintended consequence: It increased the “bounce-back” (re-admission) rate to the ICU, thus increasing demand for the ICU (and effectively reducing peak ICU capacity). The general implication of this study is to be careful not to inadvertently make a bad capacity situation worse by diverting patients from specific points of care. Postponing broad swaths of routine care — a strategy being pursued by many hospitals today — could create similar false economies if some patients will then require more intensive care later as a result of the postponement.

The lesson here is to carefully stratify patients by the risk of postponement to manage not only their current health, but also their future demand for the scarcest health resources. In the context of the Covid-19 pandemic, for instance, we should be very careful about postponing care that increases the risks a patient will require ICU or ventilator capacity a few weeks down the road. The acute shortages of ICU capacity and ventilators due to Covid-19-relared demand is a big enough problem; we should not make it worse by making poor choices about how to treat patients who aren’t infected by Covid-19.

Taking a system perspective also means that providers should consider available resources, bottlenecks, and capabilities outside their own walls. Hospitals under stress quite naturally focus their attention on hospital resources (like beds and medical staff). But in doing so, they risk neglecting the constraints faced by providers of community and home health care whose personnel and infrastructure capacity is already stretched. Yes, diverting non-critical patients from hospital settings to home care helps free up hospital capacity for the critically ill and reduces the incidence of contagion. But this strategy needs to be complemented with the appropriate infrastructure and technology (e.g., mobile care units and telemedicine capabilities) to monitor and coordinate such care. If it isn’t, more home-bound patients may end up requiring hospitalization or intensive care later on than otherwise would be the case.

2. Forecast short-term demand.

When demand is exploding and systems are overwhelmed, it may seem futile to make the effort to forecast demand a week or two out. After all, what difference does it make if a system is overutilized by 25% or 50%? Both seem dire. But when systems are overloaded, small week-to-week differences in caseloads can have a big impact on a hospital’s utilization of its resources. Therefore, while no forecast is perfect, having some visibility into short-term future demand provides hospitals and other care sites the opportunity to plan patient flows proactively (e.g., pursue preemptive diversionary strategies).

There is now enough data from around the world on Covid-19 infection rates and their impact on care providers for local providers to make perhaps rough but sufficiently useful short-term forecasts, taking into account population density, social distancing policies, the daily testing rates that can be achieved, the time it takes to process the tests, and so on.

As we discuss below, good forecasting also becomes critical for managing supply shortages and bottlenecks.

Managing Supply Problems and Shifting Bottlenecks

Managing demand needs to be complemented with effective strategies for managing the supply of resources needed to care for patients — obviously, not an easy task when dealing with a highly contagious disease like Covid-19. But it’s crucial since not doing so can trigger vicious cycles, as we’re already seeing.

Covid-19 cases increase demand for tests and for staff. The increase in demand for tests initially results in test shortages (and thus testing backlogs). Staff need protective gear both to perform tests and to treat patients. So, not surprisingly, increases in patient flows creates shortages of masks and other protective equipment.

Shortages of both testing and protective equipment leave staff vulnerable to infection. In Italy, health care practitioners constitute 9% of all Covid-19 cases. In Spain, the figure is 14%. And there is now a significant infection rate among health care workers in the United States, according to reports in The New York Times and The Boston Globe. High rates of infection among health care workers not only make already bad staffing shortages worse, they also can increase demand if infected staff become a vector for transmission to patients who don’t have Covid-19.  The key challenge in dealing with supply shortage is to break these vicious circles.  There is no one way to do this, but applying some of the principles below should be helpful.

Engage in systematic de-bottlenecking. This means not just focusing on existing bottlenecks, but also identifying future potential bottlenecks (in other words, forecasting them) and addressing them before they materialize or become acute.

Dealing with acute shortages means identifying the root source of the shortage and focusing efforts there to expand or leverage available supply (which we discuss later). Because staff is a critical resource of almost every phase of health care delivery, protecting their health should be the number one priority. Increasing ventilator production or creating new ICU beds is helpful only to the extent that there are staff available to operate that new equipment and care for the patients.

In highly interdependent supply chains, bottlenecks will shift. For instance, if testing capacity is limited by the availability of cotton swabs, it does little good to increase the availability of testing kits or to increase laboratory capacity to process tests. Getting ahead of supply shortages requires forecasting the next bottleneck in the system, which requires excellent information about the inventory available in the entire supply chain (not just one’s own inventory), the capacity of suppliers, demand patterns, and rates of consumption.

Like demand forecasting, supply forecasting is not a precise science. But supply forecasts provide important visibility into the future state of the supply chain and enable organizations to proactively identify potential shortages in advance — when there is time to resolve the issue. In health care organizations right now, it is natural to focus on the shortage of ventilators, masks, protective gear, and swabs — those shortages must be addressed urgently. However, hospital managers should be aware that future shortages in other commodities and resources are lurking. The sooner they are identified, the better the chance to resolve them before they become acute.

Pool and coordinate resources across organizations. It is a well-known principle in supply-chain management that the amount of inventory required to meet a given level of demand decreases as the number of places holding inventory shrinks. Centralization reduces inventory requirements because of the beneficial effects of pooling uncorrelated demand from different locations (that is, while some places might be experiencing higher-than-expected demand and requiring more inventory, this would be balanced out by places experiencing lower-than-expected demand, which require less inventory). This is an area where territorial behavior concerning supplies by states, hospitals within states, or even departments within a hospital may significantly exacerbate shortages.

A critical part of pooling is not just sharing physical inventory but also sharing information about inventory: What is available, in which quantities, and where it is located? Good information cannot magically make shortages of physical materials go away, but bad information can certainly make shortages worse. Lack of information creates uncertainty, and uncertainty can lead to “just in case” hoarding.

As a first step, it is absolutely essential to break down departmental barriers and to optimize inventory within a hospital. However, during a time of crisis, hospitals should think about going one step further: pooling and managing inventory (including sharing information) within their health care system and even across health systems within the same region. This means sharing inventory across hospitals that may compete for patients in normal times. But if hospitals try to preemptively procure materials to gain an advantage over their rivals, it simply makes shortages worse.

Pooling of resources does not just apply to materials inventory. It should be used for equipment that can be easily moved from hospital to hospital. Staff could potentially be pooled across hospitals. In the Netherlands, ICU bed availability is managed nationally, and in other services, such as obstetrics, as many as 10 hospitals that are competitors in normal times now report their bed availability regionally, so that beds can be managed as a single resource and allocated through one call center.

Technically, none of this is particularly difficult. A ventilator or ICU nurse employed in Hospital X presumably would be just as effective in Hospital Y across town. The difficulty is getting hospital leadership to change their thinking. There is a time for competition and a time for cooperation. A pandemic is a really good time for cooperation.

Innovating and learning in real time. Attacking a shortage requires creative technical and organizational solutions. In response to the short supply of masks (especially N95 masks), many hospitals have been developing and producing alternative designs that may be suitable for interacting with non-Covid-19 patients. Repurposing post-anesthesia care units (PACUs) into ICUs is another example of innovation occurring in some hospitals.

Human assets can also be repurposed. In the United Kingdom, for instance, generalist nurses are being trained to manage a ventilator under the supervision of a specialist critical care nurse, thus effectively increasing the number of ventilated patients each specialist nurse can care for.

Some of the challenges of repurposing are more institutional or organizational than technical. For instance, most countries or professional societies require certification for health care specialists to perform certain tasks. Relaxing these requirements can help alleviate staff shortages.

Any kind of innovation involves risks. Are the makeshift masks really safe? Are repurposed PACUs really as effective as regular ICUs? Is the quality of care harmed by having generalist nurses operate ventilators under the supervision of specialists? Under intense pressure, hospitals simply do not have time to wait for definitive answers to these questions or to follow the traditional approach to implementing new practices (e.g., long clinical trials). What is needed is data — collected, analyzed, and shared in real time — to provide insights about what is working, what is safe, and what is not.

Hospitals and providers need to experiment with new approaches, but they also need to share information candidly so that others can learn and that everyone can make the right mid-course corrections. Good information and fast feedback loops can accelerate the learning needed to identify, implement, and diffuse innovative approaches.

Focus on Information, Fast Decision-Making, and Learning

The Covid-19 crisis is testing the both the medical and managerial competencies of health care systems throughout the world. Dealing with the operational strains created by this crisis requires coherent, comprehensive, systematic efforts that span both demand and supply forces.  To implement these efforts, health care managers need to focus on information, fast decision-making, and learning.

Information is everything. Every practice we’ve recommended above hinges on having high-quality and high-velocity information. You cannot forecast patient flows without excellent information on things like how many tests have been conducted, how many people are infected, where are they, where have they been, with whom have they been in contact, and so forth. You cannot predict the consequence of new approaches to patient flow without good information about current demand and supply in different parts of the system. You cannot predict the next bottleneck without information on future demand, usage rates, and current stock levels. Testing capacity and turnaround matters not only for the clinical reasons, but because it provides information needed to proactively make and adapt operating plans.

Fast decision-making. Covid-19 attacks at a pace determined by nature, not by government regulations, bureaucratic rhythms, political machinations, management systems, or institutional rules. Having high quality and timely information does little good if managers running health care systems are unwilling and unable to respond quickly to that information.

The challenge facing health care managers is balancing the value of centralized coordination and information-sharing with the need for flexibility and responsiveness by clinicians and nursing staff working on the front lines. Hierarchical structures, which tend to be slow under the best of times, are totally inadequate during a fast-moving crisis. Good leadership in a crisis focuses on providing those on the front lines the resources and decision rights they need to solve problems quickly and learn.

Focus on learning. Almost by definition, a crisis brings an organization into uncharted territory. The existing playbooks have to be rewritten on the fly and under enormous strain.  Everything we discussed above requires grappling with questions for which answers are not fully know or for which the answers are changing by the day. Waiting for perfect information is not an option.

Under these situations, execution is a series of experiments and failures. Failures (or “mistakes”) are an inevitable consequence of doing something new, not a sign of incompetence. Learning from experiments, including what hasn’t worked, is critical, but that can only happen if the leadership of the organization creates a psychologically safe and transparent environment. The health care organizations that will battle best against Covid-19 are not necessarily the ones with the right answers, but those that can learn fastest.

How and Why to Use Social Media for Marketing During the COVID-19 Pandemic

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The unprecedented COVID-19 outbreak has holed up a huge chunk of the global population in their homes.

What does this mean for the billions of economic engines scattered around the world? How are businesses to sustain themselves? If these questions are haunting you, you’re not the only one.

Fortunately, this problem has a solution:

Social media marketing.



Why is Social Media Marketing the Answer?

Let’s look at the main reasons why you should take your marketing online now:

There’s a Sharp Rise in Demand for Online Content

In the quest of killing time, seeking information, and calming ourselves, more and more people are turning to online content. In fact, a report by Facebook revealed that there’s been about a 70% increase in time spent on the application in Italy.

Influencers Make for Budget-Friendly and Effective Partners

Most influencers have it all—a steady following, great expertise, and the resources required to self-create content (even from home). Plus, they have a way with online marketing and know exactly what will work when.

Also important to note is that influencers are not spared from the effects of a slowed-down economy. In this light, they may be more open to negotiating and accepting deals that they perhaps wouldn’t on a normal day.

Small Efforts and Big Results

If you think about it, online marketing doesn’t require much effort. You don’t need big bucks or a lot of resources.

All you need to do is understand the need of the hour, and create content that there’s a demand for. Moreover, a little wit and humor could be an added advantage!

How Can You Leverage Social Marketing During COVID-19?

You’ve been sold on amping up your online marketing efforts. But, how?

Focus on Growing your Accounts, Not on Conversions

We’re living in times where consumer spending has limited itself to the very essentials. So, expecting your online marketing to boost sales right now would be unfair. However, now’s a great time to build your online following, and put out content that’s needed.

For instance, share tips to increase productivity while working from home. Alternatively, share light-hearted content like dog videos and memes.

Partner with Influencers

These are social media personalities that can influence the buying decisions of consumers – even in gloomy times like these. Reach out to them, and step up your online marketing.

This pandemic has forced businesses to look for alternate solutions. If you’re convinced that online marketing is the way to go, check out this infographic by HireInfluence.

How Can You Leverage Social Marketing During COVID-19?

Image: Depositphotos.com

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How Hospitals Are Using AI to Battle Covid-19

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Executive Summary

The spread of Covid-19 is stretching operational systems in health care and beyond. The reason is both simple: Our economy and health care systems are geared to handle linear, incremental demand, while the virus grows at an exponential rate. Our national health system cannot keep up with this kind of explosive demand without the rapid and large-scale adoption of digital operating models.While we race to dampen the virus’s spread, we can optimize our response mechanisms, digitizing as many steps as possible. Here’s how some hospitals are employing artificial intelligence to handle the surge of patients.

HBR Staff

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On Monday March 9, in an effort to address soaring patient demand in Boston, Partners HealthCare went live with a hotline for patients, clinicians, and anyone else with questions and concerns about Covid-19. The goals are to identify and reassure the people who do not need additional care (the vast majority of callers), to direct people with less serious symptoms to relevant information and virtual care options, and to direct the smaller number of high-risk and higher-acuity patients to the most appropriate resources, including testing sites, newly created respiratory illness clinics, or in certain cases, emergency departments. As the hotline became overwhelmed, the average wait time peaked at 30 minutes. Many callers gave up before they could speak with the expert team of nurses staffing the hotline. We were missing opportunities to facilitate pre-hospital triage to get the patient to the right care setting at the right time.

The Partners team, led by Lee Schwamm, Haipeng (Mark) Zhang, and Adam Landman, began considering technology options to address the growing need for patient self-triage, including interactive voice response systems and chatbots. We connected with Providence St. Joseph Health system in Seattle, which served some of the country’s first Covid-19 patients in early March. In collaboration with Microsoft, Providence built an online screening and triage tool that could rapidly differentiate between those who might really be sick with Covid-19 and those who appear to be suffering from less threatening ailments. In its first week, Providence’s tool served more than 40,000 patients, delivering care at an unprecedented scale.

Further Reading

Our team saw potential for this type of AI-based solution and worked to make a similar tool available to our patient population. The Partners Covid-19 Screener provides a simple, straightforward chat interface, presenting patients with a series of questions based on content from the U.S. Centers for Disease Control and Prevention (CDC) and Partners HealthCare experts. In this way, it too can screen enormous numbers of people and rapidly differentiate between those who might really be sick with Covid-19 and those who are likely to be suffering from less threatening ailments. We anticipate this AI bot will alleviate high volumes of patient traffic to the hotline, and extend and stratify the system’s care in ways that would have been unimaginable until recently. Development is now under way to facilitate triage of patients with symptoms to most appropriate care setting, including virtual urgent care, primary care providers, respiratory illness clinics, or the emergency department. Most importantly, the chatbot can also serve as a near instantaneous dissemination method for supporting our widely distributed providers, as we have seen the need for frequent clinical triage algorithm updates based on a rapidly changing landscape.

Similarly, at both Brigham and Women’s Hospital and at Massachusetts General Hospital, physician researchers are exploring the potential use of intelligent robots developed at Boston Dynamics and MIT to deploy in Covid surge clinics and inpatient wards to perform tasks (obtaining vital signs or delivering medication) that would otherwise require human contact in an effort to mitigate disease transmission.

AI Initiatives are Already Emerging

Several governments and hospital systems around the world have leveraged AI-powered sensors to support triage in sophisticated ways. Chinese technology company Baidu developed a no-contact infrared sensor system to quickly single out individuals with a fever, even in crowds. Beijing’s Qinghe railway station is equipped with this system to identify potentially contagious individuals, replacing a cumbersome manual screening process. Similarly, Florida’s Tampa General Hospital deployed an AI system in collaboration with Care.ai at its entrances to intercept individuals with potential Covid-19 symptoms from visiting patients. Through cameras positioned at entrances, the technology conducts a facial thermal scan and picks up on other symptoms, including sweat and discoloration, to ward off visitors with fever.

Beyond screening, AI is being used to monitor Covid-19 symptoms, provide decision support for CT scans, and automate hospital operations. Meanwhile, Zhongnan Hospital in China uses an AI-driven CT scan interpreter that identifies Covid-19 when radiologists aren’t available. China’s Wuhan Wuchang Hospital established a smart field hospital staffed largely by robots. Patient vital signs were monitored using connected thermometers and bracelet-like devices. Intelligent robots delivered medicine and food to patients, alleviating physician exposure to the virus and easing the workload of health care workers experiencing exhaustion. And in South Korea, the government released an app allowing users to self-report symptoms, alerting them if they leave a “quarantine zone” in order to curb the impact of “super-spreaders” who would otherwise go on to infect large populations.

Digital Transformation Now

The spread of Covid-19 is stretching operational systems in health care and beyond. We have seen shortages of everything, from masks and gloves to ventilators, and from emergency room capacity to ICU beds to the speed and reliability of internet connectivity. The reason is both simple and terrifying: Our economy and health care systems are geared to handle linear, incremental demand, while the virus grows at an exponential rate. Our national health system cannot keep up with this kind of explosive demand without the rapid and large-scale adoption of digital operating models.

While we race to dampen the virus’s spread, we can optimize our response mechanisms, digitizing as many steps as possible. This is because traditional processes — those that rely on people to function in the critical path of signal processing — are constrained by the rate at which we can train, organize, and deploy human labor. Moreover, traditional processes deliver decreasing returns as they scale. On the other hand, digital systems can be scaled up without such constraints, at virtually infinite rates. The only theoretical bottlenecks are computing power and storage capacity — and we have plenty of both. Digital systems can keep pace with exponential growth.

Importantly, AI for health care must be balanced by the appropriate level of human clinical expertise for final decision-making to ensure we are delivering high quality, safe care. In many cases, human clinical reasoning and decision making cannot be easily replaced by AI, rather AI is a decision aid that helps human improve effectiveness and efficiency.

Digital transformation in health care has been lagging other industries. Our response to Covid today has accelerated the adoption and scaling of virtual and AI tools. From the AI bots deployed by Providence and Partners HealthCare to the Smart Field Hospital in Wuhan, rapid digital transformation is being employed to tackle the exponentially growing Covid threat. We hope and anticipate that after Covid-19 settles, we will have transformed the way we deliver health care in the future.