The future of care delivery: Optimising patient & doctor experience

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The healthcare industry has been severely disrupted by the Covid-19 pandemic – exactly when healthcare services are in greatest need around the globe. The shortage of masks and PPEs, and the risk of infection, have hampered caregiving throughout the globe. Added to this is the scarcity of healthcare professionals in many parts of the world, and their time and resources are being stretched thin.

How can technology help healthcare professionals in this difficult time, enhancing caregivers’ experiences and doctor-patient interactions? Can new platforms, devices, and tools make care delivery safer, more efficient, and more equitable?

In an online seminar hosted by Jicara Media, in partnership with Lenovo, Intel, and Microsoft, senior healthcare and IT professionals from Singapore discussed these issues and tackled pertinent questions dealing with digital transformation in healthcare and optimum care delivery.

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Medical devices, IoT, and caregiving

The discussion began with the current state of technology — in particular medical devices — available to such a specialised vertical as the healthcare industry. Here, participants agreed that the healthcare industry does not lack the necessary devices, and that technologies such as IoT have been used for a long time.

Said Bruce Leong, Director, Technology & Strategy at Mount Alvernia Hospital, “Long gone are the old days where nurses would chart temperatures manually, then transfer them to our Electronic Medical Records (EMR). For the longest time, IoT devices in healthcare have been used for automatic recording of temperature, automatic recording of vital signs, and these are automatically linked to our EMR systems via wireless devices. So that’s nothing new.”

Leong then stated that the challenge with healthcare today is to use technology in different ways, and for different applications, such as in the delivery of patient care.

Dr Patrick Chia, Director, Clinical Transformation at Integrated Health Information Systems, agreed, reflecting that many caregivers and providers do not undertake formal or systematic training to make full use of technology.

He said, “The challenge that we have is, I think, a lot of doctors, clinicians, etc., have never really been trained in medical school or nursing school to make use of all this technology beyond the theory. And the way you would use IoT technology — which is real-time, in contrast with episodic care — necessitates a different interaction with patients. This is required to develop the doctor- or nurse-patient relationship which is part of what new models of care require. It’s not just about translating a traditional in-person type of process to that which is e-enabled by tele-consultations.”

He added that part of the problem is that these technologies have not been properly integrated into existing workflows both at the system and process levels — this is sometimes an afterthought. “Using a particular type of technology in isolation to try and replace a traditional process, especially when it involves interactions with patients and families etc., can result in a lot of negative effects as well if you don’t do it correctly.”

Bringing the human touch to healthcare IT

After debating whether caregivers are currently using technology effectively, the discussion turned to whether or not it is even possible to use technology to replicate in-person interactions between the caregiver and the patient. Situations highlighted included the ability for doctors and nurses to gain intuitive insights through teleconsultations as they do in traditional in-person consultations.

Chia suggested that the model of care has to evolve and change in order to adopt pervasive, disruptive technologies.

He explained, “The current care models are not designed for the type of capabilities that these technologies bring. Traditionally, we’re not used to looking at a continuous type of care – patients are seen from episode to episode, when they keep their appointments and visit at regular intervals. But now, the data and the information is coming in continuously. So healthcare providers need to figure out how to work in a more “continuous” manner. The duty of care of the providers will have to change and new care models will be needed. But there is a plus side to it – there is a definite opportunity to use innovation and technology to be even closer to patients in many ways, to know more about their lifestyle, maybe about how they sleep or eat, which supports whole person care.”

Ronnie Lee, General Manager at Lenovo Singapore, proposed that a deeper partnership between technology companies and healthcare practitioners might help caregivers.

He said, “Technology is really an enabler. This is a partnership where technology companies and healthcare practitioners have to get together. There will be areas where technology can play a sort of bigger role, such as data collection and analysis, and how to use the data to really deliver better experiences. But there will be, in my opinion, cases where a personal touch and the individual needs of patients cannot be replaced just by technology alone. It involves a closer and more detailed partnership, where technology is seen as something to enhance the service level that already exists.”

Integrating and future-proofing caregiving technologies

One of the challenges of using caregiving technologies, said the participants, is to integrate them into the overall enterprise system and to make sure a growing number of devices can be adopted and included in the overall framework. The sheer number of IT systems in a single healthcare organisation, along with multiple campuses, can pose a challenge to this.

Leong said that the secret lies in data management. “Part of it is the maturity of data and analytics in data architecture. Today, you have so many different systems. You have your billing systems, your EMR, your ancillary systems, your IT devices. But starting with the data, we did some tweaking of process changes. We managed to bring the discharge time down by about 29-30%, which is quite substantial.”

Chia warned that data from multiple sources can pose a massive problem, citing the COVID-19 testing situation as an example.

He explained, “For example, in COVID-19 testing — which is so critical currently — when you start to integrate tests from all the different labs, you find that there are different ways of reporting a COVID-19 result. Standards are hard to agree on and enforce. How this information is used for direct care or analytics to support policy and surveillance etc would have to take into account these issues.”

Plugging the technology gap

The discussion then turned to the COVID-19 situation, and the technologies needed for the healthcare sector to cope during these difficult times.

Chia, for example, finds that current communication and collaboration tools cannot replace completely and compensate for the lack of human interaction through use of remote working and social distancing.

He said, “People are becoming very, very fatigued. And mental disorders, etc., will be on the rise. I think if there were an area I would like to see being developed — from a tech perspective — it would be the better of use of communication and collaboration technologies. I think the systems that we have today don’t really bring people together that well. We can do a lot better in the area of providing very strong communicative, collaborative tools that allow us to develop stronger teamwork, team-based care and service: which is key.”

According to Lee, the healthcare industry should look at other sectors for ideas on how to improve efficiency.

He explained, “Maybe there’s also a need to look at how other segments are doing in terms of leveraging technology so that we can also study what is suitable. So, for example, retail in US; you have a guy who comes into the store, and now technology through face recognition can really quickly enable the sales assistant to greet the customer on a first name basis, download the history of his or her purchases and other details. Why can’t we apply that to healthcare where it could be something that we can follow?”

Will Covid-era technology adoption be permanent?

Participants agreed that COVID-19 has accelerated digital transformation by forcing widespread technology adoption among previously-resistant employees. However, they differed on whether or not this adoption will be permanent, and will be carried over to the post- COVID-19 world.

Leong said the future is uncertain, especially taking into account the human need for in-person interaction.

He said, “I think as humans, we yearn for interaction. Colleagues lunching together, face-to-face meetings, and so on. Whether after the pandemic they would prefer to continue the way it is today…my view, after asking a lot of my peers, is — I don’t think so. For example, telemedicine has always been there, it’s not because of pandemic that we have telemedicine. We’ll have to see whether patients will prefer to continue with telemedicine, or go to the clinic.”

Chia concluded by saying that technologies have to be studied carefully and adapted in order to persist.

He surmised, “I think this is a good time for us to really see how far we can push some of these technologies to make them work for us. We can clearly see some areas where the technology really is better, than what has been before. But the challenge is, identifying and growing those areas so that they become mainstream at the end of the day. If we don’t do that, then people will definitely just go back to the normal way of doing it once this is over, and once restrictions are lowered”.

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