Comparison with existing literature
infection
REGRESSION, INFECTION, CHRONIC DISEASES
The COVID-19 pandemic promoted a surge in digital health applications for population-level public-health responses: a recent review identified 247 distinct initiatives, ranging from artificial intelligence and big data to diagnose and screen for COVID- 19 infection, to the provision of telehealth for healthcare access.The study presented here shows that innovative methods of data analysis can be used to extract signals from administrative claims databases, in particular those containing therapeutic information (medicines and services). Access to detailed claims data was key to make possible the identification of high-risk patients and their primary care providers. Claims data have also been successfully used to detect high-risk groups during the COVID-19 pandemic in South Korea.Further, the study presented here demonstrated that secure-messaging infrastructure can be used to quickly reach primary providers, and digital interventions influenced by behavioural theory are effective in promoting care by the primary provider. Such systems could be used to: guarantee the supply of medicines use for chronic diseases; promote support for patients with mental health conditions; maintain care for persons with time-critical illnesses, such as persons in active bouts of chemotherapy and those undergoing dialysis or requiring home-delivered oxygen; and maintain care of older patients.An interesting and unexpected finding was the difference in the number of appointments in the year prior to the COVID-19 pandemic between the digital and postal groups. The only criteria separating both groups was access to secure-message delivery. As no other differences between groups were identified, it is possible that the access to technology itself is promoting care provision; however, as shown by the Cox regression and the partial-effect plots, the digital intervention retained its effect even after adjusting for the number of appointments in the previous year. Both findings suggest that access to technology and secure-message delivery should be promoted to clinicians as ways to promote care coordination.