Health Technology, Digital Healthcare
Article | August 16, 2023
As the cost of care continues to rise, many hospitals are looking for long-term solutions to minimize inpatient services. Learn how technology and health care delivery will merge to influence the future of hospital design and the patient experience across the globe in this report developed by Deloitte US.
Five use cases for the digital hospital of the future
The future of health care delivery may look quite different than the hospital of today. Rapidly evolving technologies, along with demographic and economic changes, are expected to alter hospitals worldwide. A growing number of inpatient health care services are already being pushed to home and outpatient ambulatory facilities. However, many complex andv very ill patients will continue to need acute inpatient services.
With aging infrastructure in some countries and increased demand for more beds in others, hospital executives and governments should consider rethinking how to optimize inpatient and outpatient settings and integrate digital technologies into traditional hospital services to truly create a health system without walls.
To learn what this future of health care delivery may look like, the Deloitte Center for Health Solutions conducted a crowdsourcing simulation with 33 experts from across the globe. Participants included health care CXOs, physician and nurse leaders, public policy leaders, technologists, and futurists. Their charge was to come up with specific use cases for the design of digital hospitals globally in 10 years (a period that can offer hospital leaders and boards time to prepare).
The crowdsourcing simulation developed use cases in five categories
Redefined care delivery
Emerging features including centralized digital centers to enable decision making (think: air traffic control for hospitals), continuous clinical monitoring, targeted treatments (such as 3D printing for surgeries), and the use of smaller, portable devices will help characterize acute-care hospitals.
Digital patient experience
Digital and artificial intelligence (AI) technologies can help enable on-demand interaction and seamless processes to improve patient experience.
Enhanced talent development
Robotic process automation (RPA) and AI can allow caregivers to spend more time providing care and less time documenting it.
Operational efficiencies through technology
Digital supply chains, automation, robotics, and next-generation interoperability can drive operations management and back-office efficiencies.
Healing and well-being designs
The well-being of patients and staff members—with an emphasis on the importance of environment and experience in healing—will likely be important in future hospital designs.
Many of these use-case concepts are already in play. And hospital executives should be planning how to integrate technology into newly-built facilities and retrofit it into older ones.
Technology will likely underlie most aspects of future hospital care. But care delivery—especially for complex patients and procedures—may still require hands-on human expertise.
Laying the foundation for the digital hospital of the future
Building a digital hospital of the future can require investments in people, technology, processes, and premises. Most of these investments will likely be upfront. In the short term, hospital leadership may not see immediate returns on these investments. In the longer term, however—as digital technologies improve care delivery, create operational efficiencies, and enhance patient and staff experience—the return result can be in higher quality care, improved operational efficiencies, and increased patient satisfaction.
These six core elements of an enterprise digital strategy can help you get started as you begin to push your hospital into the future
Create a culture for digital transformation
It is essential that senior management understands the importance of a digital future and drives support for its implementation at all organizational levels.
Consider technology that communicates
Digital implementation is complex. Connecting disparate applications, devices, and technologies—all highly interdependent—and making certain they talk to each other can be critical to a successful digital implementation.
Play the long game
Since digital technologies are ever evolving, flexibility and scalability during implementation can be critical. The planning team should confirm that project scope includes adding, modifying, or replacing technology at lower costs.
Focus on data
While the requirements of data interoperability, scalability, productivity, and flexibility are important, they should be built upon a solid foundation of capturing, storing, securing, and analyzing data.
Prepare for Talent 2.0
As hospitals invest in exponential technologies, they should provide employees ample opportunities to develop corresponding digital strategies.
Maintain cybersecurity
With the proliferation of digital technologies, cyber breaches can be a major threat to hospitals of the future. Executives should understand that cybersecurity is the other half of digital implementation and allocate resources appropriately.
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Health Technology, Digital Healthcare
Article | September 7, 2023
The COVID-19 virus (C19) pandemic is turning out to be the event of the century. Even World War seems timid in comparison. We are in the 4th month of the virus (in non-China countries) and have gone past the lockdown in many places. Isn’t it time we re-think the approach? What if there is another wave of C19 coming soon? What if C19 is the first of many such events in the future?
Before we get into analysis and solution design, summarizing the C19 quirks:
While a large section of the affected population is asymptomatic, for some it can be lethal
There isn’t clarity on all the ways C19 spreads
It’s known to affect the lungs, heart, and kidneys in patients with weak immunity
It has been hard to identify a definitive pattern of the virus. Some observations in managing the C19 situation are:
With no vaccine in sight, the end of this epidemic looks months or years away
Health care personnel in hospitals need additional protection to treat patients
Lockdowns lead to severe economic hardship and its repeated application can be damaging
Quarantining people has an economic cost, especially in the weaker sections of society
If one takes a step back to re-think about this, we are primarily solving 2 problems:
Minimise deaths: Minimise the death of C19 and non-C19 patients in this period
Maximise economic growth: The GDP output/growth should equal or higher than pre-C19 levels
One needs to achieve the 2 goals in an environment of rising number of C19 cases.
Minimise deaths
An approach that can be applied to achieve this is:
Data driven health care capacity planning
Build a health repository of all the citizens with details like pre-existing diseases, comorbidity, health status, etc. The repository needs to be updated quarterly to account for patient data changes
This health repository data is combined with the C19 profile (disease susceptibility) and/or other seasonal diseases to determine the healthcare capacity (medicines, doctors, etc.) needed
The healthcare capacity deficit/excess needs to be analysed in categories (beds, equipment, medicine, personnel, etc.) and regions (city, state, etc.) and actions taken accordingly
Regular capacity management will ensure patients aren’t deprived of timely treatment. In addition, such planning helps in the equitable distribution of healthcare across regions and optimising health care costs. Healthcare sector is better prepared to scale-up/down their operations
Based on the analysis citizens can be informed about their probability of needing hospitalisation on contracting C19. Citizens with a higher health risk on C19 infection should be personally trained on prevention and tips to manage the disease on occurrence
The diagram below explains the process
Mechanism to increase hospital capacity without cost escalation
Due to the nature of C19, health personnel are prone to infection and their safety is a big issue. There is also a shortage of hospitable beds available. Even non-C19 patients aren’t getting the required treatment because health personnel seek it as a risk. This resulted in, healthcare costs going up and availability reducing.
To mitigate such issues, hospital layouts may need to be altered (as shown in the diagram below). The altered layout improves hospital capacity and availability of health care personnel. It also reduces the need for the arduous C19 protection procedures. Such procedures reduce the patient treatment capacity and puts a toll on hospital management.
Over a period, the number of recovered C19 persons are going to increase significantly. We need to start tapping into their services to reduce the burden on the system. The hospitals need to be divided into 3 zones. The hospital zoning illustration shown below explains how this could be done. In the diagram, patients are shown in green and health care personnel are in light red.
**Assumption: Infected and recovered C19 patients are immune to the disease. This is not clearly established
Better enforcement of social factors
The other reason for high number of infections in countries like India is a glaring disregard in following C19 rules in public places and the laxity in enforcement. Enforcement covers 2 parts, tracking incidents of violation and penalising the behaviour. Government should use modern mechanisms like crowd sourcing to track incidents and ride on the growing public fear to ensure penalty enforcement succeeds. The C19 pandemic has exposed governance limitations in not just following C19 rules, but also in other areas of public safety like road travel, sanitation, dietary habits, etc.
Maximise economic growth
The earlier lockdown has strained the economy. Adequate measures need to be taken to get the economy back on track. Some of the areas that need to be addressed are:
One needs to evaluate the development needs of the country in different categories like growth impetus factors (e.g. building roads, electricity capacity increase), social factors (e.g. waste water treatment plants, health care capacity), and environmental factors (e.g. solar energy generation, EV charging stations). Governments need to accelerate funding in such projects so that that large numbers of unemployed people are hired and trained. Besides giving an immediate boost to the ailing economy such projects have a future payback. The governments should not get bogged down by the huge fiscal deficit such measures can create. Such a mechanism to get money out in the economy is far than better measures like QE (Quantitative Easing) or free money transfer into people’s bank accounts
Certain items like smartphone, internet, masks, etc. have become critical (for work, education, critical government announcements). It’s essential to subsidise or reduce taxes so that these items are affordable and accessible to everyone without a financial impact
The government shouldn’t put too many C19 related controls on service offerings (e.g. shops, schools, restaurants, cabs). Putting many controls increases the cost of the service which neither the seller not buyer is willing or able to pay. Where controls are put, the Govt should bear the costs or reduce taxes or figure out a mechanism so that the cost can be absorbed.
An event like the C19 pandemic is a great opportunity to rationalise development imbalances in the country. Government funding should be channelized more to under-developed regions. This drives growth in regions that need it most. It also prevents excess migration that has resulted in uncontrolled and bad urbanisation that has made C19 management hard (guidelines like social distance are impossible to follow)
Post-C19 lockdown, the business environment (need for sanitizers, masks, home furniture) has changed. To make people employable in new flourishing businesses there could be a need to re-skill people. Such an initiative can be taken up by the public/private sector
The number of C19 infected asymptomatic patients is going to keep increasing. Building an economy around them (existing, recovered C19 patients) may not be a far-fetched idea. E.g. jobs for C19 infected daily wage earners, C19 infected taxi drivers to transport C19 patients, etc.
In the last 100 years, mankind has conquered the destructive aspects of many a disease and natural mishap (hurricanes, floods, etc.). Human lives lost in such events has dramatically dropped over the years and our preparedness has never been this good. Nature seems to have caught up with mankind’s big strides in science and technology. C19 has been hard to reign in with no breakthrough yet. The C19 pandemic is here to stay for the near future. The more we accept this reality and change ourselves to live with it amidst us, the faster we can return to a new normal. A quote from Edward Jenner (inventor of Small Pox) seems apt in the situation – “The deviation of man from the state in which he was originally placed by nature seems to have proved to him a prolific source of diseases”.
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Health Technology
Article | September 12, 2023
A wealth of evidence supports the health benefits of keeping pets: increased life span, exercise, improved mental health, and a sense of purpose. But for older adults and those with disabilities, the responsibilities and expense of owning an animal can be overwhelming, and caregivers are often forced to take on those burdens themselves. To make matters worse, dementia patients can pose a physical threat to live animals.
What alternate solutions exist for those who cannot safely or practically keep a live pet? Fortunately, information technology and robotics have advanced to the point that realistic, robotic emotional support pets are becoming a legitimate option. As research in this area advances, experts have found that robotic emotional support animals can offer a myriad of benefits similar to those associated with live pets. Robotic companions can also help caregivers.
Robotic Emotional Support Animals in Practice
Imagine the following scenario: An elderly woman with dementia suffering from Sundowner’s Syndrome relies on a strict daily regimen established by her caregiver. This routine is a delicate dance, balancing the patient’s meals, medication, and personal care, all designed to keep her as relaxed as possible.
One afternoon, as the caregiver prepares dinner, the caregiver realizes that the patient’s beloved dog is nowhere to be found. She runs outside to look for the dog, leaving the patient to fend for herself. The patient is agitated over her missing dog and suddenly alone in a kitchen with pots and pans boiling.
Fortunately, the caregiver finds the dog outside, but the patient is now too overwhelmed to eat or take her medication. Despite the caregiver’s best efforts at redirection, it’s a rough evening for everyone.
How a Robotic Emotional Support Animal Can Ease the Role as Caregiver
As any experienced caregiver knows, consistent emotional support for patients is critical. A robotic emotional support animal can significantly ease a caregiver’s role in this respect. Robotic companions replicate many benefits traditional pets provide – affection, responsiveness, and companionship – without the associated caregiving demands, such as feeding walking, or veterinarian visits.
The Benefits of Robotic Emotional Support Animals
The owners of pets are known to enjoy
Reduced impact of depression
Lower blood pressure
Reduced triglycerides and cholesterol
Longer survival rates after a heart attack
30% fewer doctor visits after age 65
Longer life spans
Robotic companion animals provide genuine comfort, mirroring the emotional connection that living pets provide while lightening the caregiver load. Uplifting conversations about the robot companion elevate the moods of both patient and caregiver, potentially reducing feelings of burnout. In embracing such technology, senior care and assisted living facilities can foster an environment that makes staff and residents all smile a little more.
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Healthtech Security
Article | November 29, 2023
NIS2 Cybersecurity Rules Approaching: Is Your Organization Prepared? The EU NIS cybersecurity regulations are evolving for 2024, and if you’re not currently aware of how they’ll apply to your organization, now is the time to get up to speed with the desired requirements. Not only is the directive being tightened, but an extended range of healthcare and related organizations will be added to the list of ‘critical entities’ that must comply. These include certain medical device manufacturers, pharmaceutical companies, and organizations that carry out R&D. The Network and Information Systems (NIS) standards were set up in 2016 to protect essential services – such as water, energy, healthcare, transport, and digital infrastructure – from online cyberattacks. The updated legislation, NIS2, will have stricter rules,reporting requirements, and higher penalties for non-compliance. They will apply to medium-sized and large businesses that operate within one or more EU countries. Those based only in the UK can’t sit back; however, the original NIS regulations will still apply as part of British law. What’s more, a UK version of the rules is coming very soon, and it’s likely that the framework will closely resemble the EU’s. What will the requirements cover? There are a number of cyber risk management measures that all organizations that come under the scope of NIS2 will be required to put in place. For instance, they will need to conduct regular security assessments and risk analyses, adopt incident response and handling plans, and appoint a chief information security officer (CISO), among other obligations. The new directive will streamline and strengthen incident reporting requirements. Entities must notify regulators of any incident that has compromised data or had a significant impact on the provision of their services, such as causing severe operational disruption or financial loss. Applying information system security policies and business continuity plans will form part of the obligations, as will conducting cybersecurity testing and training for all staff. The use of multi-factor authentication (MFA) and encryption, wherever appropriate, will also be mandated. There is plenty of focus within the directive on the cornerstones of cybersecurity best practices particularly, the proper control of administrator-level account credentials, privileged access, and endpoints, all of which are prime targets for attackers. Under NIS2, organizations are being separated into ‘critical’ and ‘important’ entities. It’s important to determine which category yours’ will fall under, as each has different requirements. The third-party threat will also be addressed in NIS2 by pulling in managed service providers (MSPs) to the list of ‘critical entities’, with the aim of keeping digital supply chains secure. MSPs are often granted privileged access to clients’ corporate systems and networks, which creates security risks. What are the consequences of non-compliance? Organizations that come under the regulations’ purview will be subject to random checks, regular security audits, on-site inspections, and off-site supervision. For those found to be in breach, sanctions could include warnings, temporary suspension of certain activities, and temporary prohibition to exercise certain managerial functions. Financial penalties could be as high as 10 million Euros or 2% of an organization’s global turnover, whichever is higher. What steps should healthcare organizations take now? Organizations should take action to establish whether the EU or UK NIS2 regulations will apply to them and what their responsibilities will be. Having identified any gaps in existing cybersecurity processes, policies, and practices, they must determine what changes need to be made to address them. As a priority, they must review their incident response plans and incident management and reporting procedures. It’s also a good idea to begin assessing the security posture of partners and third parties in the supply chain and incorporating relevant security requirements into contracts. Given the framework’s focus on protecting privileged admin accounts, organizations should implement controls limiting the number of staff members with these robust credentials. Implementing privileged access management (PAM) will allow IT to control who is granted access to which systems, applications, and services, for how long, and what they can do while using them. Preparing for the introduction of the EU NIS2 regulations should be considered more than just a compliance exercise. By meeting the strengthened requirements, healthcare organizations will be building a foundation of resilience that protects them, their customers, and the essential services they provide.
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