Future of Healthcare

The Digital Transformation of Healthcare

Dr. Brendan O'Brien

As we stand at the start of this decade, it has become clearly evident, that the tumultuous events from COVID 19, have precipitated a rapid acceleration of changes through worldwide healthcare delivery. It is also noteworthy, to affirm that these changes were already gathering pace over the last five years. However, through this years’ global pandemic, the transformation has been greatly magnified.

In addition, a concentration of progressive technological advancements are combining to catalyse this next normal. This refers to the impending widespread uptake of 5G, improved machine learning capabilities in bigdata analysis and further developments in real time human biosensor data acquisition. Whilst these components are all focusing on the one point- individual human health, we are required to carefully analyse the various components, in order to maximise the smooth transition and implementation within healthcare.

As mobile biosensors, available in skin patches and smartwatches are also quickly improving in accuracy and reliability, the amount of human biomarker information is greatly increasing. Thus, secure data analysis and storage has become a central requirement and possible cause of concern in global healthcare re-imagining. This concern is first and foremost, articulated by the User themselves. The potential for data hacks, cybersecurity missteps and inappropriate sharing of identified data sharing are readily apparent. Many platforms and technologies fail to provide the level of data privacy that is the required minimum standard in this field. Market research confirms that the most front of mind concern for the patient (or User) is data governance and data safeguards.

Thus, any considered new healthcare platform must comprehensively tackle this issue. How is this done? Firstly, the tenements of data protection, data storage and secure transfer as articulated in the HIPAA and GDPR recommendations, must form the bedrock of all subsequent design. With these provisions forming the blueprint, any health platform and mobile application needs to incorporate “privacy by design.” This refers to the highest standards being comprehensively and fully implemented before writing the “first line of code”. In addition, before any mobile application or platform is offered to the general public, thorough Independent data security auditing and penetration testing need to be enacted by external accredited organisations.

A thorough system of quality assurance and quality management needs to be implemented across all organisational levels to ensure transparency and reproducibility of design to the highest regulatory standards. Anything less than this, will not be appropriate. Nor will it create the development of sophisticated levels of trust, so crucial to the interchange of personal human data. The bar needs to be set much higher than is currently seen exhibited by many large multinational companies providing smartwatches. In healthcare we need to always strive to achieve this high water mark.

In short, adoption of all of these standards is mandatory, in any new platform that functions in the Software as a medical device class- SaMD. These standards should include external software audits and the careful ultimate protection of all personal data. Users’ data should never be shared in any way that is identifiable.

However, a platform could enable secure data transfer if and only if the User / patient desires, requests and requires. For instance, this would be via secure application programming interfaces to their family medical practitioner, medical specialist, hospital or pharmacist. The control and segmentation of this transfer would only be in the hands of the User. Their data, their control, that is the required mantra. This is the standard that all should follow.

The Healthcare Landscape in 2020

Rise of On-demand Healthcare
Patients are seeking healthcare delivery and availability on their own terms, own time and own schedule. 52% of all web- browsing in 2018 is performed on a mobile device.

77% of all US residents own a mobile device. Consumers are increasingly going online to procure medical information or services- such as appointments, advice or diagnosis. This has been termed the rise in consumerism.

A shift has also been observed towards a value-based service model, from a fee for service.

Medical wearable devices
Improve / Aid preventative healthcare programs. 33% of US consumers in 2018, regularly use smartwatches and fitness trackers.

Real-time Data
Real-time data gives patients greater insight into their own daily health and thus improves compliance, behavioural changes and compliance. Think of 24 blood pressure patches or sensors (via photoplethysmography, PPG) that give much more immediate feedback of the effectiveness of anti-hypertensive medication.

Pulse oximeters (PPG) used to aid screening with nocturnal sleep apnoea or hypopnea.

The implementation of PPG for the identification of these metrics as well as heart rate variability, resting heart rate and sleep cycle analysis has been extensively covered in the literature. Suffice to say these techniques with noise and movement artifact reduction and algorithmic overlay are repeatedly shown to be within 3% of in-hospital delivered devices.

Personalise the Healthcare Experience - provides patients with ownership of their data and thus can take more direct responsibility in their own health outcomes. This is also facilitated by machine learning backend data analysis.

Big data insights via AI
Physicians and Hospital providers are increasingly using big data insights via Artificial Intelligence (AI) in the extended field of Bioinformatics.

The real power of AI is in areas of precision personalised medicine, medical imaging, drug discovery, and genomics.

  1. The real power of AI can be best observed in areas, such as precision personalised medicine, medical imaging, drug discovery, and genomics.
  2. Lowered rates of medical errors through better cross-data analysis.
  3. Lowered rates of medication errors.
  4. Identify over presentation of patients to the emergency departments and give them specific information. Up to 28% of visits may be from recurring patients that do not require emergency care.
  5. Permits more accurate staffing allowances and better management of human workforce capital.

Treating patients with Virtual Reality (VR). This market estimated to reach 51 B by 2025 in the US alone. VR is being used in pain management programs, treatment of anxiety, and post-traumatic stress disorder. In addition, task-related or operative simulations and educational preparative training is being improved with VR. This has demonstrably lowered error rates and sped up task completion.

Predictive Healthcare

  • Big data market share is expected to reach 14.9 B by 2022 in the US.
  • Understanding current biometrics and psychometrics with big data analysis may allow for health patterns and disorders to be future predicted.
  • May allow more predictive future staff requirements and fine-tuning to staff deployment.

The need for digital transformation is therefore absolute. For the human condition, multiple benefits will accrue, so long as the effective planning and execution is carefully considered and widely consulted throughout society, institutions and governmental organisations.

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