There just aren’t enough doctors. So, can we rely on smarter healthcare technology?

Can’t read your GP’s notes? Don’t worry, the AI can

Paid Feature Doctors have been debating whether medicine is a science or art since Hippocrates coined the phrase “first do no harm”, two and a half millennia ago. At least they have until recently.

Not because the issue has been solved, but because healthcare systems are under tremendous pressure worldwide, clinicians are working flat out, and they and their patients are paying the price. They simply don’t have the time.

So, to understand whether technology can help healthcare, we need to understand there are three key pressures on healthcare – all of which predate the Covid-19 pandemic.

First, there is a simple labour shortage in the medical field – four years ago, the World Health Organisations predicted the global shortfall of medical staff would reach 15 million people by 2030. This isn’t just doctors. It’s nurses, technicians, radiographers and all the other professionals needed to keep us healthy.

Which raises the question, Andy Nieto, global healthcare solutions manager at Lenovo, says: “How do you distribute and extend your care without just working 24 hours a day, seven days a week, and then burning out? That’s a huge pressure.”

Secondly, says Nieto, “we have this glut of age and behaviour related diseases and illnesses.” Aging is unavoidable of course, but its effects are compounded by behaviour related diseases in a “general population that is less focused on personal wellness and personal health.”

What a type 2 diabetic says they are doing to manage their condition, and what a finger prick blood test shows they are actually doing may be quite different. Remote Patient monitoring (RPM) with regular biometric updates gives a more accurate view of the patient’s true status and provides a more timely and more effective clinical response.

How do you distribute and extend your care without just working 24 hours a day, seven days a week, and then burning out?

The result, says Nieto, is “catastrophic and extremely expensive care demands.” In the US, for example, up to 80 per cent of national health expenditure relates to chronic conditions and mental health.

The third factor is the evolution of patients as consumers. Of course, this can mean more engaged patients, which can be a good thing. But it also means trained medics are forced to compete with Doctor Google. This can then influence the care and treatment patients expect, as opposed to what they need.

All of these were issues before the Covid-19 pandemic, but the last year and a half has highlighted and exacerbated their impact, whether it’s the acute burnout of medical staff, pressure on medical infrastructure, or patients who are noncompliant with treatment plans or know better than their physicians.

You can see the doctor now … and they can see you

Yet the pandemic has also highlighted some of the ways smarter healthcare technology can potentially ease the burden on both over-stretched clinicians and society more broadly.

One of the most obvious effects at a societal level has been a rethinking of the role that technology plays in personal and professional communication. “This transition … has really opened the window for virtual health, beyond just point solutions to be much more around a true avenue of care delivery,” Nieto explains.

At its simplest, this can mean something like a concerned parent consulting a doctor or other practitioner about a child’s fever, saving a resource-intensive trip to the emergency room. Lenovo research showed a 600 per cent increase in “virtual healthcare visits” in the first quarter of 2020.[3]

But step it up a level and you reach the idea of what IDC calls “The Digital Front Door”, whereby the patient’s initial interaction with their healthcare provider is similar to any “other transactional parts of our lives”. So, the patient’s first contact may be by phone or online, and with an automated system, or even a chatbot, rather than a walk-in visit to a bricks and mortar medical facility.

This digital triage then steers people towards self-care, towards a specialist or a clinic for a non-emergency matter, or alternatively rushing them towards the emergency room if necessary.

“The low acuity conditions, which typically is a larger volume of population, can be disseminated away from the traditional brick and mortar hospital,” says Nieto. At the same time, he says, “You allocate the resources in that hospital more directly to those that really do need it.”

Beyond the initial consultation, is an expanded role for telehealth. This can include doctors being able to conduct “Virtual Rounding” in traditional hospitals, potentially seeing far more patients while simultaneously not being a vector for infection themselves.

And, at the same time, telehealth encompasses better monitoring of patients’ conditions in their homes. “And so if we start addressing these chronic and age and behaviour related diseases, at home, with tools like a Virtual Care platform that helps you build the appropriate habits, it helps you become more compliant to your care plan.”

One result of this increased digitalisation of patients’ healthcare journeys – and health providers’ own backend systems - is easier capturing and managing of health data. This can then be interpreted using AI and predictive analytics, Nieto says, making it easier to spot trends or emerging conditions.

A steady rise in blood sugar or data from a wearable or camera that could suggest a patient might be a fall risk, could prompt an earlier, and less costly, intervention. As this monitoring is increasingly automated – whether at home or in health facilities - researchers can also have more confidence that the data is correct.

The AI in the white coat

Beyond the individual patient, this raises the prospect of aggregating data to better inform policy making as well as cutting edge, fundamental research using HPC and AI. This could increasingly include the capturing of non-structured data such as doctor’s notes or discussions using natural language processing. As Nieto says, doctors have always used informal channels and quick consults to discuss patients’ conditions and spot trends.

But this digitized, data capturing vision naturally raises fundamental issues around patient privacy and data security. Technology providers, and the medical community, face the challenge of ensuring that data is private – de-identified and anonymised – and an even bigger challenge in convincing their patients that this is the case.

The volume of data we're creating in the science of care is staggering

And beyond issues of patient confidentiality, Nieto says, the more data that is created, and the more widely it is shared, the more attention administrators have to pay to access control, while the broader the potential attack surface for cyber attackers. Healthcare systems are already a prime target for ransomware gangs.

“It’s a very challenging, delicate balance,” says Nieto. And while technology is part of the answer – Lenovo offers a dedicated version of its ThinkShield security portfolio for healthcare for example – approaches to data confidentiality can differ markedly between countries, and even between healthcare providers.

In parallel, he says. “The volume of data we're creating in the science of care is staggering. I've recently seen a number as high as six petabytes of healthcare data being generated globally each week - the volume of data that we're managing and manipulating actually has a measurable heat output for the planet.”

Tell me how you feel … about big data?

So, as well as facilitating the creation of ever more data, tech providers like Lenovo have to help the medical community gain a better understanding of what data is actually important, and ensure it gets to the right people. And do so as efficiently as possible.

As Nieto explains, it’s simply unrealistic to expect physicians to read every relevant journal AND see all their patients AND deal with documentation each generates. “It becomes an incredible burden on the physician.” And everyone else on the team.

Ultimately the aim of technology providers should be to make their products and platforms as transparent as possible, whether that’s leveraging the potential of telehealth and wearables, helping physicians make sense of data, or, literally, by enabling practitioners to collaborate to treat patients or update their skills, using augmented reality. (Or assistive technology as medics prefer to call it.)

And this gets to the heart of what technology can do for medicine and health. Getting back to that age-old debate, Nieto says there is a “science of care” that can be bolstered through the use of technology. For example, he notes, it wasn’t until the early 20th century that blood pressure could be reliably measured. “And now we understand how important it is in cardiovascular health indicators and other things.”

But, he continues, “there is an art to care. The concept of compassion, of empathy, and of connecting interpersonally between provider and patient. That is a critical part of the delivery of medicine.”

Smarter healthcare can take many of the administrative burdens of healthcare, as well as providing data that can inform the science of care. And that, says Nieto, “Allows us to address the art of care.”

This article is sponsored by Lenovo.

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