The staff and patients at Montreal’s Jewish General Hospital will use a powerful new smartphone app that will allow users to monitor their vital signs by simply staring into their phone’s screen. The information that the “first of its kind” medical-grade app provides is a potentially powerful new tool in the fight against COVID-19.

The app’s developers did not specifically design it for COVID-19 and it cannot diagnose someone. However it does measure important indicators that typically serve as warning signs that a person has the virus.

The app measures three vital signs: heart rate, respiratory rate and oxygen saturation in the blood.

A resting heart rate above 100 beats per minute, a respiratory rate higher than 30 and an oxygen saturation level below 93 per cent can signal that a patient is at risk.

Dr. Lawrence Rosenberg, executive director of the health authority in charge of the Jewish General, told the Montreal Gazette the app has the potential to be what he called a game-changer.

“It should allow us to pick up people who are virus-positive but who have subtle or early symptoms that we wouldn’t be able to pick up previously until they came to an emergency room,” Rosenberg said.

In fact, the app’s developers are saying that had the app could have slowed the spread of the novel coronavirus if it had existed widely before the pandemic struck. That’s because some infected users would have known to self-isolate at home.

The underlying tech

Fitness trackers like Fitbit rely on light pulses against the skin to monitor heart rate using PPG or photoplethysmography.

But Binah.ai, the Tel Aviv company that developed the underlying technology, uses remote PPG (rPPG). The app uses a smartphone’s camera to capture the light on a person’s cheeks below the eyes.

“We are not a screening tool for COVID,” said Sheldon Elman, a staff physician at the Jewish General and the chairman of Carebook Technologies, the Montreal company providing the app. “We are a screening tool for vital signs, which then in certain situations can tell you whether a change in your vital signs could indicate a deterioration that could be very much COVID-related.”

Carebook fine-tuned the app in collaboration with the Jewish General. The company has already applied to Health Canada for approval of the technology. However, given the exceptional circumstances of the pandemic, the Jewish General will roll it out shortly anyway for its purposes.

According to the Gazette, senior officials in the government, including Health Minister Danielle McCann, are interested in the app. They are poised to make a decision on its widespread use in the coming days.

The app does not take a person’s picture or use facial recognition. The vital-sign measurements are revealed only with the consent of the patient.

Photo: Binah.ai (Carebook app may not appear identical)

Hospital will use ‘COVID-19 app’ in one of three ways

According to the Gazette, the Jewish General will use the app in three ways.

As early as next week, triage nurses will use the app to screen arriving emergency-room patients for telltale symptoms. Without having to touch a patient, a triage nurse will hold a smartphone in front of a patient’s face. In less than a minute the app will measure heart rate, respiratory rate and oxygen saturation in the blood. Patients with abnormally elevated heart, respiratory rates or a low oxygen-saturation reading will be isolated immediately for further investigation.

Second, the Côte-des-Neiges hospital will use the app in its COVID-19 wards, so patients can monitor their vital signs. Nurses may need to enter the rooms less frequently. This will help conserve gloves, masks and other protective equipment worn by medical staff.

Third, some vulnerable patients in Montreal’s heavily-affected west end will use the app. The app will let people monitor their symptoms at home.

The hospital is testing of the app’s accuracy on-site. Given the early positive results, it has shared it with the Quebec Health Ministry. The provincial government is considering introducing the smartphone technology across the province. The goal is to reduce the size of a possible second wave in the next few months.

Is the solution in our pockets?

In a blog post by Binah.ai the company details how smartphone-based digital health tools could play a role in limiting outbreaks. This applies from travel checkpoints to at-home screening.

“One of the strongest weapons we have to fight the spread of an outbreak is one we carry around every day — our smartphones,” wrote CEO David Maman. “We have the opportunity to unleash remote healthcare solutions like never before.”

And for those itching to get back on a plane?

“Imagine a completely noninvasive, zero-touch, one-minute scan upon arrival from a new country into any airport, where digital technology can scan for specific markers of a current epidemic,” writes Maman.

It’s a dose of news that many of us likely have been hoping for. Particularly, as the Gazette reporter Aaron Derfel noted, “The current strategy of locking down entire cities cannot go on indefinitely.”

Quebec Premier François Legault extended the closing of non-essential businesses until May 4. But Dr. Rosenberg said eventually, people will need to come out of their homes.

“That will be a time when having the app widely available will be useful because people can then start screening themselves for things like O2 saturation and their respiratory rate. Then (some) will either go back into isolation or go to the emergency room. But it will keep them off the street and should mitigate the second wave, in principle.”