Sponsored: EMEA's digital health landscape: What's next in 2021?

Dr Charles Alessi, chief clinical officer, HIMSS, says it’s time to start some difficult conversations about interoperability as we build health models for a blended world.

One of COVID-19’s many consequences has been the life-changing increase of stress and work overload on clinical professionals. Dr Simon Wallace, CCIO of Nuance’s healthcare division explains how speech recognition technology can ease the pressure.

Automated patient monitoring has been central to the digital response of hospitals to the pandemic. Jean-Baptiste Michon, product marketing manager, interoperability and solutions at Masimo, suggests it can also help to drive emerging value-based care models. HITN: What do you see as the current patient monitoring trends, especially those which have been heightened during the pandemic? Michon: I think we all learned a lot during the pandemic! Caregivers need to have real-time information to prevent patient deterioration as early as possible. This is not only in critical care environments. For online management, for continuous monitoring systems, we have seen that innovation and digitalisation of healthcare – screen replication outside the room, mobility solutions, access to the patient’s status – and new ways of collecting data can help. We have seen some changes in the hospitals moving to these kinds of technology. HITN: How critical do you think integration with other systems such as the EMR to continuing this shift? Michon: Very. The trend in patient monitoring is to use more mobility solutions, more tetherless sensors, for the comfort of the patient and the caregiver. This is what we have learned during the pandemic, and it is also part of interoperability, because when you use such sensors you need connectivity to collect the data to your own and other systems. Patient monitoring is at the centre of integrated care but it is also a piece of this puzzle. HITN: How can we overcome interoperability challenges so that everyone on the care continuum benefits? Michon: Apart from the technical challenge, everyone has to know and understand that the solution exists. The second challenge is managing the IT ecosystem and sometimes change management into the hospital, talking about interoperability, continuous monitoring, so we can improve care everywhere. These changes are key, part of how we are able to maximise the value of the patient data collected at the bedside. Interoperability is many things. It focuses on the continuum of care but also we are now moving into value-based healthcare systems. We need to be able to understand and demonstrate the value of interoperability in hospital automation solutions. HITN: What other ways do you think data will play a role in the development of these more streamlined care models? Michon: Today everything is about data, analytics, AI, predictive medicines. If you are talking about early detection, sepsis management, you need this patient data. One of our baselines is “do more with patient data”. We need to have the vision of the full ecosystem and then, with such a medical interoperability platform, to be able to connect, collect, send and integrate the data. HITN: So we are talking about an environment in which patient monitoring data can also be used to improve other aspects of hospital administration and workflows? Michon: Today we are talking about the continuum of care. When we start to look at patient workflows, we are looking more at bringing the hospital into the home. The system begins and finishes there. The patient themselves will be more engaged and involved in their care. In the pandemic, we were also able to provide some solutions to monitor the patient at home. I think this is a great patient experience. It will also simplify the hospital workflow, and the workflow into the hospital. And improve the clinical outcome – but outside the hospital. HITN: How would you define hospital automation in 2021? Michon: For me, you can define it in the rule of four As: Acquisition of data, Aggregation (we are able to apply some algorithm to detect or prevent patient deterioration), Accessibility (so the caregiver has access to the right patient data at the right time), and last but not least Actionable insights. Healthcare IT News spoke to Jean-Baptiste Michon, product marketing manager at Masimo, as part of the 'Summer Conversations' series.  

Data silos started to open up as hospitals put collaboration at the heart of their pandemic response. Simon Philip Rost, marketing executive for GE healthcare’s digital health and AI portfolio, says this trend can drive a provider-focused industry ecosystem HITN: Tell us about your healthcare ecosystem vision. How will it work as a launch-pad for more pervasive data use throughout health systems? Rost: We believe that the future of innovation is breaking down data silos and working together at eye level. This includes start-ups, research organisations, hospitals, clinicians, but also patient advocates and associations like HIMSS. Every stakeholder can bring their strength into this ecosystem. Our ecosystem brings together five areas: medical applications, medical devices, IT solutions, developer services, and an ecommerce marketplace in which providers can purchase applications and algorithms in a scalable way. HITN: How do you think it will help us to positively exploit the accelerated learnings and experiences of the pandemic? Rost: COVID-19 has highlighted that if we come together as an ecosystem, we can accelerate digital transformation and furthermore, provide our sector with opportunities to learn across sectors and regions. The healthcare provider is the most important partner because we want to address their day-to-day problems. The best use case comes from them because they know best what they want to solve. This empowers the rest of the ecosystem to build a tailored solution. They become the core orchestrator of development. HITN: Can you point to some of the most notable problems exposed in our health systems by the pandemic? Rost: The first one is managing access to treatment. During the pandemic, a lot of elective surgery has been pushed to one side. Costs have stayed the same or increased but income is less, and you have a backlog building up. You don’t get less cancer just because of COVID-19. So triage and scheduling are two examples of where start-ups can work to improve scheduling processes to find people who have a higher probability of getting cancer and bring them to the screening process first. The second is data access for decision-making at a time when you are fighting for people’s lives. What COVID-19 has shown is that if you invest in telehealth, remote monitoring, AI development and digital platforms, it works. It’s the first time I really see that we are working on breaking down these data silos. That’s the biggest value I see, bringing these data points together in weeks or days rather than years. HITN: Could you share some insight into this digital transformation: what has the impact of AI been in reality, for example? Rost: I think AI in healthcare is shifting from being feared to being applied in certain times, especially in the workflow. Hospitals that don’t start developing AI use now, dealing with their information and data, will face problems in the near future. I really believe you can humanise healthcare a little, because technology takes over redundant tasks and augments your capability. It’s happening in some cases but there is still some way to go to get full adoption in the standard workflow of clinicians. HITN: What about operational data? We hear some eye-watering estimates about waste, for example – as much as 25% of hospital costs in the United States, for example. How can AI help to reduce this? Rost: For sure in the medical community, it’s the fancy stuff that gets the headlines and of course the clinical value is important. But I think there should be more focus on operational AI. The cost of waste is huge and technology can address this. These technologies guarantee more qualitative, sustainable healthcare and in the long run, I would guess, patient satisfaction - because waiting times don’t help anybody. Healthcare IT News spoke to Simon Philip Rost, marketing executive for GE healthcare’s digital health and AI portfolio,​ as part of the 'Summer Conversations' series.

Even before the pandemic, health systems were moving tentatively towards data-enabled, value-based health models. Ibo Teuber, partner of Deloitte’s healthcare practice, says the acceleration of transformation will take patients and players to the next stage of the journey. HITN: What do you think are the three main things the pandemic showed us about the state of digital transformation in Europe? Teuber: I think the most important thing it showed us is how valuable it is to have the data points available along the patient’s - even the citizen’s - health journey, interoperable and flowing through the health system. It also showed how willing patients are to share data as soon as they see any benefit for their personal health, and beyond – some of them even felt free to donate their data sets for the better health of community or population health research. The third aspect is that many of the technologies to virtualise part of the patient journey are basically already in place at different levels of maturity, and the pandemic has accelerated utilisation. HITN: Would you agree that as transformation accelerates, so do the interoperability challenges that come with it? Teuber: The good thing is that many of the evolving trends fuelling digital transformation are strongly inter-dependent. Interoperable data will enhance collaboration in the ecosystem, support a shift in point of care and ultimately empower the patient to own their health journey. I think we are seeing strong efforts in establishing data exchange standards, open and secure platforms that allow for data exchange across sectors, and the patient will demand this because more patient records are evolving around them where they are the orchestrator of the system. If you are a provider that is not contributing to that data set, they will probably vote with their feet. HITN: So data and how we use it will also play a major role in transformation. What’s your perspective on the future for AI at a more granular level, throughout healthcare? Teuber: I really believe these technologies will emerge in in a meaningful way but on different horizons. Leveraging biomarkers in devices like lenses or toothbrushes that identify illnesses before they arise will be a crucial tipping point, the basis for the patient to have their health journey in their hands. That will emphasise a shift in the discussion from the break-fix health model we have at the moment to a more preventive model. This is something I really see as beneficial for the individual and all the way to academia and research, and for population health models. HITN: These are technologies that will become available quickly in more digitally advanced countries – how do you think they can address the digital gap elsewhere? Teuber: As seen before with many other evolving technologies, they will very likely become commodities and available to all communities. This will contribute to a more harmonised patient journey across geographies. I can also imagine we’ll see healthcare providers in different countries and new market entrants seeing the benefit of providing their virtual health services to a broader range of communities. The required devices won’t come with a cost question any more and developers will likely provide devices to lower income countries, scale their services on a global basis, and offer them at different price points. That’s something that we are also seeing in the pandemic with pricing discussion around vaccines. HITN: You mention the shift from break-fix to preventive health models, the value-based systems that we hear a lot about. How do you see digital transformation influencing this? Teuber: In most developed countries we see an ever-rising portion of the GDP allocated to health care. Since this won’t continue forever, the transformation towards value-based health provision will also be a lot about taking structural inefficiencies out of the  system. Digitalisation could help gain transparency and reduce complexity. Duplicated services would disappear if there was a longitudinal patient record containing all the radiology images, lab tests and an AI algorithm to check the reimbursement billing. So would unnecessary treatments. Even though the shift towards prevention will not pay off in the short term, I strongly suggest that we foster the design of digitally enabled population and value-based care models.  Healthcare IT News spoke to Ibo Teuber, partner of Deloitte’s healthcare practice,​ as part of the 'Summer Conversations' series.  

Sebastien Villars, senior director of product management at Omnicell, discusses how he predicts automation will have an impact on more streamlined medication management. 

The pandemic has accelerated the development of connected health models, and digital transformation is bringing the smart hospital closer to reality. All it need, says Huawei senior business development manager for Western Europe Simone Pretti, is the right infrastructure.

Engin Demirel, EMEA Head of Product management, Marketing and Sales operations, Customer Solutions at Olympus, explains how telementoring is growing in value, providing many clinical and operational benefits to hospitals.

The acceleration of digital transformation during the pandemic has opened a new era of opportunity. Nicolas Monsarrat, managing director and digital health lead at Accenture Health, says every company has the potential to be a health business.