It is believed that in healthcare today there are two types of innovations – carrying gradual or evolutionary changes (sustainable) and breakthrough revolutionary changes (disruptive). The first type includes integrated medical information systems and their separate units such as screening systems, electronic registry, electronic queue, and so on. This type also includes systems developed for automating activities of pharmacological companies, pharmacy chains, laboratory research and clinical trials. The main goal of automation is to increase the efficiency of existing processes, which is an ability to input data once or reuse it in the electronic form. It ensures support for the adoption of medical and managerial decisions, reduces the risk of errors and losses to a minimum, provides transparency and manageability of the medical institution, and most importantly, a higher quality of medical services.
Only thanks to automation tools that cover the healthcare industry more fully today, can we talk about a new paradigm for the first time—a transition to personalized preventive medicine, where patients are at the center of the whole system, and not doctors. And not patients who are already ill and in need of treatment, but those who monitor their health and regularly seek advice in order to preserve it. With this approach, doctors become permanent proactive observers, whereas in the current model of healthcare in Eastern Europe, they start working with patients only after a problem has been revealed.
And here we are already talking about the second type of the systems that radically change the established working order of a medical institution. They include, for example, systems of remote interaction between a physician and a patient or telemedicine systems. This is, in fact, a new model for the provision of medical services by clinics, which creates additional opportunities, both commercial and related to the medical process itself. In telemedicine today, the most understandable to doctors is the functionality of video and text consultations. This is due to the fact that many doctors have already used this practice through instant messengers and the mode, when patients can ask questions at almost any time, is familiar and common to them.
Healthcare automation develops in several directions simultaneously. This concept unites both telemedicine tools and software that supports medical decisions and reduces the number of medical errors.
One of the main tasks that healthcare technologies solve is the collection of data on patients’ health, especially those who are incapacitated, and transfer this information to medical institutions. Most patients’ health data comes from tools and software products that measure and record indicators, such as steps, pulse, or sleeping time — and it’s not just fitness bands, step counters, and heart rate trackers. For example, such remote monitoring (via smartphones and connected home devices) can be conducted by Alexa, Amazon’s digital assistant, Google’s Deepmind Health, and other specialized applications. The obtained data is visible to the patient and in some cases can be sent to the attending physician. The applications such as Sense.ly, designed for remote care of patients who have just left the hospital, are now appearing on the market. The Center for Process Innovation (CPI) suggests that over 19 million patients will use remote monitoring devices in 2018.
Remote monitoring or doctor’s consultation is another promising area of digital medicine, the popularity of which is growing worldwide. To conduct a remote consultation, patients do not need to come to the medical center, so they can receive effective medical services more timely. With the introduction of telemedicine into hospital practice, people with physical disabilities get a chance to live full lives outside clinics. In 2019, experts expect a telemedicine boom.
Another popular direction in the development of automation is the creation of wearable and controlled gadgets or “smart assistants” that simplify patients’ lives. In English-speaking sources, the pool of such technologies is known as “health tech.” It includes a whole range of completely different systems, from shoes for the elderly who understand when a person is falling down and send a signal to emergency services, to gadgets checking food for allergens (for example, peanuts).
There are unique developments designed to ensure that patients actively and painlessly participate in social life. For example, the company Mimerse offers to maintain mental health plunging into virtual reality. A research center Wyss is working on the creation of costumes from fabrics with built-in artificial “muscles.” The systems follow the contour of the human body, they are controlled like robots and can help children and adults with movement disorders caused by stroke, multiple sclerosis, Parkinson’s disease, or any other diseases and injuries. Of course, right now it looks fantastical, but the wide practical application of these developments is just a matter of the future.
Now in healthcare, huge resources are allocated for the development of systems that facilitate the diagnosis process and conduction of therapeutic procedures for patients. Developments are being held in the field of biomimetic microsystems that should facilitate the delivery of therapeutic agents to organs and tissues during certain diseases. Research is underway in the field of molecular robotics and bioengineering. Thus, a number of research centers are developing programmable, biocompatible, self-organizing molecular robots that are able to collectively perform tasks without connecting to wires or batteries. Finally, systems for working with clinical data and patients’ data, the so-called “big data,” become the real “springboard” for digital medicine. Such IT tools help solve a number of challenges faced by modern medicine.
Case histories, test results, treatment data in other medical organizations – all this data can be delivered to a doctor from various sources. Without data exchange between different information systems, it would be impossible to build an e-health system that is efficient and convenient for patients and doctors. It would not be possible to create single patient portals for making appointments with a doctor with personal accounts and information about the medical care. It also would not be possible to transfer research data from laboratories to hospitals, and so on.
Assistance in building such systems is the task of an integration approach. Within this approach, patients’ information coming from medical information systems (MIS), laboratory information systems, specialized medical registers, picture archiving and communication systems (PACS) and other sources becomes available in the correct form in all integrated MIS. This, in turn, helps the doctor obtain information at the right moment to make a medical decision.
Besides the tasks of data exchange between institutions, the integration approach is also valuable because it allows focusing on specific business problems. For example, on managing patient flows.
Systems based on big data processing allow patient routing to be arranged effectively. Previously, a patient with a serious illness, such as cancer or diabetes, moving from one clinic to another, was forced to get a new medical history in each healthcare institution – or was completely lost from the view of the attending physicians and the state. Now, thanks to the fact that hospitals are able to customize the interaction of their information systems, each patient’s data can be transferred without serious consequences between clinics, diagnostic centers, and other institutions.
Such IT systems help avoid medical errors and control how doctors comply with patient treatment standards. Medical decision support systems are designed for this purpose. They contain the accepted treatment algorithms, standards as well as examples of successful treatment of a particular disease. Throughout the entire process of treating a patient, the doctor can check with the system in order to understand how the measures proposed to him correspond to those adopted in the world medical practice. Automation has been used in electrocardiograms for quite a long time: for example, if the system recognizes atrial fibrillation or blockage of a blood vessel, it informs the doctor, thus, facilitating the diagnosis process and significantly saving the doctor’s time.
Such systems are especially important for budding physicians or regional doctors who actually receive “consultations” based on the experience of the best specialists in their field.
Technical specialists, developers, business analysts who understand the specifics of healthcare informatization are necessarily involved in building healthcare IT solutions. But co-operation with the professional medical community, in which experienced medical specialists help create the most effective solutions that meet the needs of both medical professionals and patients, is valuable. In medicine, the problem of misinterpretation of diagnoses is still not realized – according to statistics, every tenth patient suffers from misdiagnosis. Of course, the introduction of appropriate software and automation of this process would solve the problem of early diagnosis in the field of oncology and other complex diseases with scattered or vague symptoms.
Interestingly, the corresponding artificial intelligence programs have already been suggested in the medical market by IBM and Google. For example, there is a case when an IBM program called “Watson Health” recognized a rare form of leukemia in an elderly woman. Previously, she had been given the wrong diagnosis.
The diagnosis was made in just 10 minutes. It took AI exactly 10 minutes to process the data from 20 million scientific articles about various types of cancer.
There is also the problem of a timely diagnosis. Often, it is sometimes possible to get to a specialist only in 2-3 weeks. But with the help of the latest technologies, this problem could be easily solved, for example, using mHealth. The idea is that people wear mart bands that, by certain parameters, are able to recognize diseases in the early stages.
In this field, the Ada program is quite an interesting project. The person answers the questions of a medical nature in the app, and the system analyzes the data obtained and gives advice on which specialist to contact and what lifestyle the patient should follow.
When talking about advanced software, software platforms for video conferencing should be mentioned that allow organizing various medical services.
With the help of the latest videoconferencing systems, doctors can hold interactive consultations, organize “tele-mastering,” and provide remote medical care to patients. Today’s videoconferencing software solutions are capable of transmitting video streams from a doctor’s camera and medical devices in real-time with high resolution video up to 4K Ultra HD and clear sound. It allows broadcasting unique operations, managing them, conducting primary and in some cases full patient consultations.
Software systems for video conferencing are easily adapted to the individual needs of medical institutions and are often compatible with the existing IT equipment and software from other manufacturers in clinics, which is important not only when implementing, but also further scaling the system.
As for maintaining medical confidentiality and ensuring the confidentiality of patients’ personal data, in order to mitigate risks of unauthorized access to video conferencing sessions and hacking the server on which the video conferencing system works, it is worth taking several measures to ensure information security. First, data should be transferred only via secure channels – in the local enterprise network or through encrypted VPN tunnels. Then it is necessary to close access to video conferences using a PIN code, connect participants via a complex ID or individual links and, in no case, distribute the rights of a high level of access to a large number of people – user rights should be clearly delimited.
In addition to solving socially important tasks, software systems for video conferencing allow healthcare centers to reduce significantly operating expenses for travel and communication.