The machine, the doctor and the patient


I have parents who are getting older as days pass by. I wish I had someone at home, who can be there for my parents just like Jarvis has been there for Iron Man.  I imagine my mother doing her daily chores. But her wearable looks at her primary health parameters and recognizes that something majorly wrong is happening. It realizes and sends a distress signal to the emergency services. Meanwhile the Jarvis version at home does some prep work that can be done being in constant communication with the emergency team that is en route. This is a new age solution that can help the aging population across countries. At a time when many countries still face difficulties in providing affordable healthcare access to all its citizens such commercialized novel technologies could help in the future by not over pressurizing the emergency services and increasing the survival rates of the needy person.

But how soon can we have such a connected and automated world? It also depends on how the Healthcare industry recognizes these needs. Let us try understanding their recognition. This can be got from the annual HIMSS (Healthcare Information and Management Systems Society) U.S. Leadership and Workforce Survey. The survey offers insight into the IT concerns of U.S. health leaders, especially those involved in the hospital marketplace.

This year’s survey sends a positive signal that the priorities of healthcare leadership and the vendors/consultants matched on most of the fronts. Both the parties acknowledged the importance of data analytics and cyber security in the healthcare space.  But the divergence is in the perception of patient security and interoperability. Also, the vendors/consultants seem to be bullish about their would-be budgets, but the healthcare leaders felt otherwise. It is indeed good that both parties seem to agree on most of the fronts, but the fact that the Vendors and Consultants gave top priority to Data Analytics/ Business Intelligence while the hospitals gave top priority to patients seems to give an indication about each group’s perception. And that perception seems to be valid considering their holistic view. But the vendors need to be careful. Since the hospitals seem to have a bearish view on their IT spends and given that they have ranked Process Improvement and Change Management high, it speaks that they are not too hung up on the modern data world, but instead they want to optimize their existing systems further. This can be done by implementing six sigma initiatives religiously and  using Robotic Process Automation(RPA) to complement the manual processes to achieve better efficiencies and optimization results.  Various tasks like supply chain management, patient scheduling, and booking operating rooms or testing equipment can be also targeted by automation.

Also, Patient Safety which has not come in the Top 5 priorities for the vendors is worth a re-look and vendors need to figure out how this area can be focussed on with some new age technologies. According to the WHO, patient harm is the 14th leading cause of the global disease burden, making it comparable to other threats such as malaria and tuberculosis and malaria. However, the inflicted harm is considered preventable with an effective patient safety strategy. Here is where new age technologies can really help in enhancing patient safety. The biggest step here will be use of modern communication systems. Let us just look at the prevalent use of the dinosaur Fax machine. It could be because of the HIPAA regulations, the convenience felt by the old doctors in using the Fax machines or the fact that different systems are used for Electronic Medical Records at different places. All these factors put together brings in an age-old system where there are chances that reports would not be got on time and report retrievals by themselves steal away valuable time available for patient care. But instead if mobile technologies, cloud services and third-party servers are used to manage and route messages along with end-to-end encryption (using HIPAA’s privacy and security requirements for exchanging health data) are used, it will enhance patient safety. This will ensure real-time data and connectivity which in turn gives the professional the quick information needed to treat the patients at the earliest. If patient A’s previous records are in Hospital X with System 1 and Hospital Y with a system 2 needs access to the reports in X in the middle of the night Fax may not be always reliable.  If provisions for inter- hospital access to the electronic health systems can be provided, it will help the patient safety cause. The SMART interface launched by Apple is a positive stride to make data accessible. This open interface can be used connect the health app to hospitals and doctors’ offices. Other technology giants like Microsoft, Alphabet are also looking into this area. The future for patient safety from a technology perspective definitely looks bright.

So, does that mean we are very far from my dream? I think not. The strides in the wearable industry cannot be taken lightly. With the use of sensor technology along with the wearables the monitoring of biometric, motion and environmental data can give some key clinical parameters that include heart rats, blood pressure and respiratory rates. Along with apps the wearables have played also played a big role in the increasing numbers of patient activation, which is the skills, knowledge and confidence of a person to manage his/her health. In an era of increasing lifestyle disorders like obesity and diabetes patient activation can help to improve the general fitness of the people. The other aspect is Artificial Intelligence (AI) . The proprietary CANscript  algorithm of Mitra Biotech can helps in predicting how a cancer patient responds to different medicines. Their setup recreates the cancer environment based on the patient data and then in the test environment different drugs are tested. Thus, an algorithm helps in speeding up the entire treatment process and increases the chances of cancer cure. AI can also be extended to preventing adverse drug events, alerting providers when the patient’s health deteriorates and even predicting organ function decline. By ensuring patients get the right care system, right drug or right treatment procedure, huge cost savings can be ensured. This educed health expenditure bill can help other patients in need. The combination of genomics and Electronic Health Records (EHR) datasets can help in creating algorithms that can match the biological system to human interventions. These insights could help in creating a system of precision and timely healthcare.

The adoption of new age technologies will need a systematic approach in targeting existing processes that need to be complemented/replaced by new processes. It also includes helping people in the system to understand the impact it can create and will need an overhaul in the existing infrastructure to be able to use them. The machine can never replace the doctor or the nurse who makes personalized healthcare possible, but it can always help them to make better decisions and thus free up extra time for more patients/revolutionary thinking. But the key here is can the IT ecosystem create the trust in the doctor and the patient by facing existing privacy and safety challenges, if the yes nothing can stop the healthcare sector from leapfrogging into the new-age technology.



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