Background As a result of the COVID-19 pandemic, providing health care while maintaining social distancing has resulted in the need to provide care remotely, support quarantined or isolated individuals, monitor infected individuals and their close contacts, as well as disseminate accurate information regarding COVID-19 to the public. This has led to an unprecedented rapid expansion of digital tools to provide digitized virtual care globally, especially mobile phone–facilitated health interventions, called mHealth. To help keep abreast of different mHealth and virtual care technologies being used internationally to facilitate patient care and public health during the COVID-19 pandemic, we carried out a rapid investigation of solutions being deployed and considered in 4 countries. Objective The aim of this paper was to describe mHealth and the digital and contact tracing technologies being used in the health care management of the COVID-19 pandemic among 2 high-income and 2 low-middle income countries. Methods We compared virtual care interventions used for COVID-19 management among 2 high-income countries (the United Kingdom and Canada) and 2 low-middle income (Kenya and Rwanda) countries. We focused on interventions used to facilitate patient care and public health. Information regarding specific virtual care technologies was procured from a variety of resources including gray literature, government and health organization websites, and coauthors’ personal experiences as implementers of COVID-19 virtual care strategies. Search engine queries were performed to find health information that would be easily accessible to the general public, with keywords including “COVID-19,” “contact-tracing,” “tool-kit,” “telehealth,” and “virtual care,” in conjunction with corresponding national health authorities. Results We identified a variety of technologies in Canada, the United Kingdom, Rwanda, and Kenya being used for patient care and public health. These countries are using both video and text message–based platforms to facilitate communication with health care providers (eg, WelTel and Zoom). Nationally developed contact tracing apps are provided free to the public, with most of them using Bluetooth-based technology. We identified that often multiple complimentary technologies are being utilized for different aspects of patient care and public health with the common purpose to disseminate information safely. There was a negligible difference among the types of technologies used in both high-income and low-middle income countries, although the latter implemented virtual care interventions earlier during the pandemic’s first wave, which may account for their effective response. Conclusions Virtual care and mHealth technologies have evolved rapidly as a tool for health care support for both patient care and public health. It is evident that, on an international level, a variety of mHealth and virtual care interventions, often in combination, are required to be able to address patient care and public health concerns during the COVID-19 pandemic, independent of a country’s economic standing.

BACKGROUND As a result of the Coronavirus Disease-2019 (COVID-19) pandemic, significantly fewer patients are able to communicate with their health care practitioners (HCPs) as a result of internationally encouraged physical distancing. This has led to an unprecedented rapid expansion of digital tools to provide digitalized virtual care globally, especially mobile phone facilitated health interventions, called mHealth. To help keep abreast of different mHealth and virtual care technologies being used internationally to facilitate patient care and public health during the COVID-19 pandemic we did a rapid investigation of solutions being deployed and considered in 4 countries. OBJECTIVE To evaluate mHealth, and digital and contact tracing technologies being used in healthcare among 4 countries. METHODS This data was procured by accessing a variety of resources including grey literature, government & health organization websites, in addition to contacting our collaborators in Canada, the UK, Rwanda, and Kenya. We specifically requested information regarding various mHealth and virtual care interventions being used to facilitate patient care and public health, such as case contact tracing. RESULTS We identified a variety of technology in Canada, the UK, Rwanda, and Kenya being used for patient care and public health. The afore-mentioned countries are using both video and text-message based platforms to facilitate communication with HCPs (ex. WelTel, Zoom). Nationally-developed contact-tracing apps are provided free to the public, with most of them using Bluetooth-based technology. We identified that often multiple complimentary technologies are being utilized for different aspects of patient care and public health with the common purpose to disseminate information safely. CONCLUSIONS Virtual care and mHealth technologies have evolved rapidly as a tool for health care support for both patient care and public health. It is evident that, on an international level, a variety of mHealth and virtual care interventions, often in combination, are required to be able to address patient care and public health concerns during the COVID-19 pandemic. CLINICALTRIAL N/A

BACKGROUND As a result of the novel coronavirus 2019 (COVID-19) pandemic, fewer patients are able to communicate with their health care professionals due to widely encouraged physical distancing. This provides a unique opportunity to evaluate and test the effectiveness of virtual care globally, especially mobile phone facilitated health interventions, called mHealth. This review evaluates how this rapidly growing field of virtual care could be effective in a pandemic situation by using mHealth interventions to manage chronic diseases, in addition to filling gaps within the health care system that have arisen due to COVID-19. OBJECTIVE To synthesize the published information regarding mobile phone-based virtual care technologies for mHealth interventions implemented in previous pandemics and chronic care. This information can provide an evidence-base to the patient experience and public health virtual care approaches toward COVID-19 control and health services beyond the pandemic. METHODS For this rapid review, we included systematic reviews (restricted within the past 2 years), randomized control trials, controlled non-randomized clinical trials, prospective and retrospective cohort studies, and case control studies reporting on mHealth and telehealth technologies on chronic, non-communicable diseases and infectious disease outbreaks and patient centered clinical decision support tools (symptom checkers, chatbots, digital self-triage technologies). PubMed and Cochrane Systematic Libraries were searched for studies dated between 1973 (when the first mobile phone was invented) and August 10, 2020. AMSTAR2 was used to evaluate the quality of systematic reviews. RESULTS Of 4083 potentially relevant records, 130 meeting our inclusion criteria for this review. For virtual care and mHealth technologies managing patient care, the general consensus among systematic reviews was that there is mixed evidence evaluating its efficacy in improving overall health outcomes. Clinical trials assessing adherence to chronic diseases management strategies were the most promising. The inconsistency observed regarding the efficacy of mHealth and virtual care interventions stems from research study bias, dependence on self-reporting, small samples sizes, among many other factors. This noted inconsistency extended to mHealth and virtual care interventions used during pandemics, predominantly focusing on HIV. There have been no evaluations investigating the effectiveness of digitalized case contact tracing during a pandemic or support for isolated individuals and/or health care workers. CONCLUSIONS Virtual care technologies could be effective in communicating crucial health care support and advice to patients managing chronic and infectious diseases, as well as individuals in self-isolation. There is no direct evidence regarding the use of virtual care technologies during a respiratory disease-based pandemic; however, reviewing available literature can provide insights into effective virtual care interventions for implementation during a pandemic such as COVID-19. CLINICALTRIAL N/A