Facing illness or death alone is a fate that no human should have to endure. Yet as the tidal wave of COVID-19 drenched the world in fear and forced people apart, for many this was a sad reality.

On 13 March 2020, the UK government ruled out hospital visits to stop the spread and protect the vulnerable, leaving sick people to suffer without the love and support of family or friends.

Professor of Critical Care Nursing at King’s College London, Louise Rose, and Dr Joel Meyer, a critical care consultant at Guy’s and St Thomas’ hospitals, watched in dismay as isolated patients in their ICU wards died unconscious on ventilators.

They realised the devastating impacts restrictions on hospital visits were having on patients, families and NHS staff. They also knew that the road to consolation began with IT.

Professor Louise Rose

Professor Louise Rose (photo: Sunnybrook Health Sciences Centre)

'We needed a solution that would enable family members to say goodbye to someone who’s dying but also to spend time at a bedside with their relative, albeit virtually,' Professor Rose said.

'Our patients in ICU are generally sedated and unconscious. When they wake up, not being able to speak with the people who they love is exceptionally distressing. And when they can’t tell the staff much about themselves, we need the family there to bring a patient to life in terms of their story.

'Telephone calls are one thing, but seeing is so important.'

To achieve this, Professor Rose and Dr Meyer needed fit-for-purpose software, hardware and implementation, and they needed it fast.

Professor Rose remembered a man who she had met only the month before who could offer some hope.

Michel Paquet

Michel Paquet

We need it yesterday

Michel Paquet, CEO of Canadian digital health company Aetonix, had paid a visit to St Thomas’ Hospital in February to showcase his aTouchAway app, then a two-way virtual communications tool designed to connect patients living at home with their clinician.

Professor Rose quickly got back in touch. 'She called and said, "this is happening and this is new. We think you could actually do something for us, because we saw what you could do"', Mr Paquet said.

A meeting was called and in the space of two hours, Professor Rose, Dr Meyer and Mr Paquet discussed how to redesign and reprogram the app to function as a secure cloud-based virtual visiting platform. It had to be simple to use in a busy ICU ward, completely secure and reliable, and able to support texts and three-way video conversations between loved ones.

The Life Lines initiative was born.

Inside, Mr Paquet was panicking. His job as an IT professional is to find rapid solutions, but the speed required for Life Lines was breathtaking.

'Dr Meyer told me, "we’re doing this and we need it yesterday"', he said.

Of course as an entrepreneur, you say yes. But then you go home and think, I'm only going to sleep for one hour over the next three months.

He was also driven by his own experience; when his own father had died, he’d had the chance to be with him.

Like many IT professionals across the world in 2020, Mr Paquet met the challenge. Within days of the government’s announcement, rapid testing of aTouchAway had begun.

'Within two weeks, we had developed the bespoke virtual visiting solution, we had secured a tablet supply, secured a one-million-pound charitable donation to pay for the tablets and the software, and started to distribute to hospitals across the UK', Professor Rose said.

The first virtual visit took place for an ICU patient at St Thomas’ Hospital on March 25.

And then, Mr Paquet said, 'it spread like wildfire'.

Global reach for the first wave of virtual visits

True partnership based on altruism

That fire was a guiding light amid the COVID darkness. Soon, Life Lines had the logistical and financial support of NHS organisations, clinical networks, philanthropic organisations and industry partners such as British Telecom and Google.

In the first month alone, in excess of 1,000 Android devices were delivered to around 150 NHS hospitals. To date, these tablets have made more than a million minutes of calls from 180 UK hospitals to loved ones around the world, carrying love, hope and connection.

Mr Paquet is still catching his breath.

'It’s been quite a ride to be able to achieve this. Aetonix usually onboards one or two clients a week, but we had to onboard 172 organisations within weeks. It was absolutely crazy.'

Having managed IT projects for nearly 35 years, he had never seen a team mobilise so quickly. He says that he’s bowled over by the power of a diverse team with a clear goal.

'That to me has been spectacular. IT professionals know that typically things take months.'

You start to realise that the world could change and do this in hours when it’s really required.

King's College Hospital

Security, simplicity and scalability

But, as with any large-scale IT rollout, there were challenges.

ICU wards have specific needs, explains Professor Rose.

'Our patients cannot talk, they’re generally unconscious, they can’t use their own devices and our staff are exceptionally busy and decked out in PPE. We needed an out-of-the-box solution, something that could be delivered to the ICUs and they could literally turn it on with a four-pin code and their virtual visiting solution was ready to go.'

Overnight, Mr Paquet had to cultivate the Aetonix team to do what IT professionals the world over do every day: perform complicated feats of engineering to ensure a product is easy for people to use.

aTouchAway was adapted quickly to allow each patient one or more secure family contacts who could receive a video call on their own smartphone after having registered as aTouchAway user. Meanwhile busy ICU staff were able to operate the application via a one-touch solution enabled by Android devices.

For privacy reasons, Mr Paquet had to source UK servers and then collaborate with hospital IT departments country-wide to ensure that the tablets would work without compromising security.

For additional peace of mind, aTouchAway messages were encrypted, and any images, videos and documents were set to expire within 72 hours to protect patient confidentiality.

And to keep connections reliable, all tablets were 4G-enabled.

While IT solutions had been found, Mr Paquet still worried if his product would cope as COVID-19 spread, ICUs became packed and demand for video calls skyrocketed.

'The servers' memories were reaching top levels … that was scaring us like crazy', he said.

'But we had good infrastructure in place. And there was a point where we were doing 5,000 calls a week.'

Within four weeks, more than 1,000 tablets were provided to over 150 hospitals

‘Out of this world’

Stories of connection blossomed.

'We heard how people opened their eyes when they heard their grandchildrens’ voices or how they got to see their dog on the screen, which reassured them. We heard of virtual marriage proposals, we heard songs and prayers around the bedside', Professor Rose said.

Lisa Anne Fowler

'For some families, they had so much stress going on in their lives, they were so distraught. To reconnect, to see their loved one even at the end of life, was absolutely out of this world for them.'

Before the pandemic we had never had the capacity before to bring patients back into their homes. For many, it really was a lifeline.

Lisa Anne Fowler was one of these people.

Just before Christmas 2020, she received a phone call saying her brother had fallen down the stairs of his London home and broken his neck, leaving him paralysed. From his ICU bed at London’s St George’s Hospital, he was forced to confront his new reality alone.

Ms Fowler was neither able to travel to London or visit her brother in hospital. While she was able to speak to doctors over the phone, she says it was 'upsetting' not to be able to see him.

Then she was told of the aTouchAway app. The first time that she saw her brother was 'shocking', but over time, as he improved, she looked forward to their conversations and could even book a timeslot in advance to talk to him.

'Even though he was under a lot of medication, he could still talk to me and I could see how he was and it made a massive difference', she said. 'I’m so grateful to have had this technology to be able to make video calls with him in this awful time for our family. I can’t express my thanks enough.

'It was incredible because a few years ago you couldn’t do this.'

Messages

Emma (not her real name), who spent six weeks in ICU after contracting COVID-19, believes that the virtual visiting app saved her life.

'It was like living a nightmare', she said. 'I was scared when I woke up from the coma,and all I wanted was my family to be by my bedside. Life Lines gave me some peace because it was the only line of communication I had with my husband and sister', she said.

'I had some dark moments and felt like I didn’t want to carry on, I didn’t have the strength. When I spoke to my husband and sister they were saying "do it for us". It gave me the strength to carry on fighting for my life.'

Future focus

Future focus

The pandemic’s stranglehold on UK hospitals may be easing but the Life Lines project is only just beginning.

All tablets donated to ICU wards will remain in place, continuing to connect loved ones who, for whatever reason, are unable to be together.

The aTouchAway platform is also being expanded to other wards and palliative care settings, and is being researched as a tool to help ICU survivors through physio, rehab and recovery in their homes.

The pandemic demanded a technological leap and IT professionals responded. Their expertise has enabled Life Lines to change thousands of lives around the world.

Mr Paquet describes the experience as a privilege that’s also left him and his team irrevocably changed.

People in my team are extremely proud of what they have accomplished and that will remain forever.

'It takes effort. It takes coordination. It takes patience. And it takes putting frustration aside to just make it happen.'

On a personal level, Mr Paquet says that he’s happy to have shown a good example to his four children.

'When you ask me what I'm most proud of, it’s to show this to my children. It’s to tell them, there’s no limit to what you can do.

'It's not about money, it's about doing the right thing.

It's really the accomplishment of my career. I have changed the lives of people. That will remain forever.'

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