Secret IT Engineer

Currently there are 5bn people (67% of the population) using the internet daily. And every one of them rely on healthcare in one shape or form. In healthcare it is widely understood that to move patient care and services forward, we must break down siloes of information (lab systems, patient data, hospital systems, Point-of-care devices etc), and any successful transformation will start with a holistic mindset that looks at all 4 corners of the healthcare digital ecosystem.

it’s about enabling connections between these silos, but we can only make this connection efficiently with digitisation and embrace both on-premises and cloud-based technologies, once these connections are established and the silos are broken, only then can healthcare organisations link to innovations (internally and externally created). It’s good to be focussed on patient experience, patient care and data security, however there are so many other areas of the healthcare ecosystem and datasets which could be used to accelerate & elevate all aspects of the industry.

There is a big but, digitisation means letting go of current, trusted but outdated business processes, and trusting that disruption get the organisation big rewards. Some of these processes are going to be embedded into people’s way of life almost, so it is going to case of changing hearts, minds, and the technology, the payoffs for all 8bn on the planet will be huge, we are talking about big innovation gains, streamlining physicians work, optimising systems, improving patient outcomes (who doesn’t want that?), reducing human error, lowering costs, and optimising expenditure.

There are so many innovations that I’m not going to make a list here, but the key ones are Telemedicine, AI enabled medical devices, and Electronic Patient Record (EPR) systems. These initiatives have the power to reshape how healthcare is delivered and the interaction between patients and clinical staff, and decision made about potential treatments and outcomes.

There are some specific areas where healthcare could be brought kicking and screaming into the 21st century though:

• On-Demand Healthcare

We all want to just get whatever we want, wherever we are, on our own schedule. Healthcare is moving towards this mode. People move around and are very much time poor, healthcare customers are very mobile (52% of web browsing is performed on mobile devices) so need to access services remotely, at anytime, on any device. To consume health information systems on mobile devices or otherwise remotely, digitisation is going to be key.

There are other reasons for on-demand though, consumers of the digitised healthcare information are also research doctors and research hospital and medical facilities. Similarly, because of the distributed nature of people’s lives, there are many healthcare professionals who work as a gig economy or on a short-term contract basis, if data is not digitised and available on-demand, accessing the necessary data would make this gig economy for the healthcare impossible.

• Health Data Science

By bringing all available information into single pool we can spot trends a lot quicker, easier and more accurately. For Healthcare this could mean a reduction in medicinal errors and increase in positive outcomes by targeting medicines better.

Similarly, patients who have regular visits could have those visits correlated and a preventative care package created to try to reduce the likelihood of the return visit.

Staffing, by getting the number of staff into the goldilocks zone healthcare providers could reduce costs, improve patient outcomes or both.

• VR Patient Care

Virtual reality is no longer just for gaming, applications from warzones to operating theatres have been developed along with headset hardware. By very definition, Virtual Reality needs information and data to be digital in order for people to access it, digitisation is NOT just about getting written notes into 1’s and 0’s. Having critical health markers and sensor information that is displayed on monitors available as live data feed will help remote and virtual healthcare.

Digitisation of care will allow procedures, investigations, and initial triage to be performed remotely by experts. Similar to the last section of the previous point, having experts on tap no matter where they are is a key motivator for digitisation, being able to have a world class surgeon on hand to perform a procedure will help save lives, it will also help the economic and skills gap aspects of healthcare too.

• Wearable devices

I’ve been wearing a smart watch for over 10 years, from a simple Sony digital display, to a watch which can give me an ECG and monitor my Oxygen saturations constantly. Like any form of problem triage, it’s usually very difficult to diagnose a problem after the fact, which is why computer programmers and application designers build in logging systems into their programming. We want to know what went on before and after a fact, what were there contributing factors to the problem and how did someone recover from an event.

Having these devices able to store this data, and have it available for healthcare professionals is like a the tech support team asking for a support dump. The clinicians can go through it, did the SAT’s drop, did the heart rate flutter or stay constant etc.

• Predictive Health

Similar to the points 4 and 2, using data which is gained constantly, and crunching that data with data science and big data platforms we can look to predict how a patient’s health is going to be in the future. This is obviously very important for the patient, but also for the healthcare systems too, knowing how and when a group of people need the support of the clinicians and the recommendations of lifestyle changes for the patient in question.

On a more operational note, trying to understand when more and less staff are required we can avoid the build up of patients in our wards or A&E departments, which ultimately poses a health risk in itself.

This is only possible if we are aggregating data, then using data science and correlation to look for patterns against known outcomes from a similar set of data.

• Artificial Intelligence (AI) and it’s promises

AI has so much potential across a vast array of applications, but healthcare is one of the areas where AI is going to have a major impact on healthcare providers and patients alike. Like points 5 and 2, getting the data into an aggregated pool is going to be beneficial in predicting healthcare outcomes, but if we have trained digital expertise looking at all of the outcomes and all of the data constantly to be able to make recommendations on treatments will save more lives and save providers money.

AI has the power to be enormously beneficial, so looking at outcomes is only one area where AI can help, developing new treatments by looking into the medicines provided and suggesting new medicines is another aspect, precision medicine and drug discovery are all within the grasp of a well trained AI.

AI is not just about drugs and tracking outcomes. There is a huge amount of money being spent on social care, people with mental disability require help 24/7 yet may be able to supported by just simply talking to someone, or something. This is where AI comes in, by using a cleverly crafted bot, an AI could talk with patients giving them something to talk to initially, but also to spot where patients maybe at risk or maybe on a downward spiral.

AI might never be able to cure these patients who clearly need human intervention, but it can monitor the initial conversations and maybe take the initial load and triage patients who just wanted someone or something to respond.

• Blockchain and immutable EPR Platforms

EPR platform uptake has been ongoing for a long time, now that NHS-X have mandated that trusts must deploy EPR platforms by the end of 2023 the number of EPR projects I’ve been involved in is encouraging. But what’s the evolution of EPR platforms? They are usually deployed on-prem, Cloud based EPR platforms are pretty new, and that in itself brings around a conversation about who looks after it, who pays for the HW, who has the expertise, data sovereignty, data security and immutability.

Blockchain is a distributed database which uses transactional computations to ensure that blocks which come before the current set of blocks are not able to change, a bit like the Eiffel tower, if the beams at the bottom are removed or mutate in anyway, the whole thing is coming down.

The fact that it is distributed (or decentralised) means that it is ubiquitously available, therefore highly available for applications to source the data, the fact that it is immutable mean that the data on there is immune from deletion or tampering and will be stored forever. Whether these are a good idea or not remains to be seen as there are a lot of legal and moral hurdles to be jumped before patient data is stored in a blockchain.

We are only just approaching the tip of the iceberg with the promise of digitisation in healthcare, and there are probably a lot more than 7 benefits, but these early thoughts show that when we look at the range of possibilities, getting healthcare digitised should be a priority.