How risky is eHealthcare?

Astudy by Dutch health specialists in 2013 warned of potential risks and need for investigation, whilst recent round table at World Economic Forum 2017 discussed the ‘Hospital of the Future’, otherwise known as eHealthcare.

eHealthcare under the microscope

As far back as 2013, Dutch researchers were aware of the risks of a relatively new concept - eHealthcare. With the increasing use of online therapy, remote care and telemedicine, many healthcare institutions were integrating eHealthcare into their services but may have been totally unaware of the potential risks. While information regarding its potential was abundant, the risks associated with the use of information ( including mobile) and communication technology in healthcare had scarcely been addressed. In order to implement eHealth technology successfully and safely, regular evaluations of possible benefits and appropriate risk assessments should be undertaken. Following a review of scientific literature in 2013 at the request of the Dutch Health Care Inspectorate, researchers couldn't find any studies of randomised controlled trials that directly investigated the risks of eHealth technology. However, many unintended, ' secondary', outcomes were reported that indicated risks for patient safety or quality of care at the level of the technology, the enduser (patient, professional) or the organisation. They varied from high time consumption, adverse effects, usability problems, limited server access and malfunctioning devices due to improper use or financial issues. Similar outcomes were found through internet searches of ' grey' sources. Grey literature is materials and research produced by organisations outside of the traditional commercial or academic publishing and distribution channels. From the combined scientific and grey sources, researchers found anecdotal evidence for a wide variety of risks in e-Health, of which the magnitude is largely unknown.

eHealthcare discussion at Davos 2017

At the most recent World Economic Forum in Davos, a panel of experts discussed the ‘Hospital of the Future’ on the concluding day of the event. Panelists in the discussion included Dr. Shamsheer Vayalil, Founder & Managing Director of VPS Healthcare; Sean Duffy, Cofounder & CEO of Omada Health; Dr. Elizabeth Nabel, President of Brigham and Women’s Healthcare; Thomas DeRosa, CEO of Welltower USA; Sarah Doherty, Co-founder & Chief Technology Officer of TeleHealth Robotics and Dr. David B. Agus, Professor of Medicine & Engineering at the University of Southern California. Noting significant transformations affecting the world and the advances made in healthcare, the panel was tasked to find answers about the emerging technologies that would impact the way of healthcare delivery in the future. Dr. Shamsheer said, “As almost every expert agrees, data is the new oil, the new currency and healthcare industry is already using this and moving towards sustainable, accessible and affordable delivery model.” With the advancements in technology, it is imperative that digital health records be standardised and the interoperability of data is going to play a major role in the future of healthcare delivery. “We would like to take healthcare delivery systems as much in to the homes and in to the communities as possible because we believe we can deliver better care at lower costs. If you believe in value-based healthcare, the definition being patient measured outcomes defined by cost. We believe that outcomes will be better delivered in the homes and communities rather than hospitals,” said Dr. Elizabeth Nabel.

More awareness is needed about the risks of eHealth technology The management and delivery of healthcare in the hospital of the future will be driven by big data and powered by artificial intelligence and this trend is going to get bigger and better Davos 2017

The healthcare industry has been a bit slower to embrace the digital revolution as compared to others. There is a lack of uniformity across technology systems and these selfcreated silos are creating confusion, errors, redundancy, missed opportunities, and waste.

“The healthcare industry is very risk averse because of the issues of quality and safety. There has to be some disruption in the industry but I believe the disruption in healthcare will come from outside the industry because we still tend to think very conventionally. We need to come up with new ideas, new technologies that will lead to disruptions else we won’t see a hospital of the future. We need a change across the globe, a change which can make things work,” added Dr. Shamsheer.

Digitisation continues to be at the heart of change in healthcare delivery and has led to the introduction of complex technical systems across the globe.

“Privacy is going to be a big issue because of cyber security. We need to encrypt data. As we know, a single stolen electronic health record (EHR) is valued at hundred times that of a stolen credit card, so we need to be careful about online security,” said Dr. Shamsheer.

On the curative side, hospitals and clinics are becoming increasingly aware of the pivotal role of hospitality and service culture in the patient experience and the impact on the bottom-line. On the preventive and recovery side, hotels and resorts are increasingly improving their health and wellness services for their guests.

“It is an exciting time to be in healthcare. Medicine is becoming more democratised and patients are already pushing health systems to innovate and to collaborate with them,” said Sean Duffy.

“The hospital of the future will only be used for catastrophic care with individuals using the quantified self with sophisticated artificial intelligence and predictive analytics to create the best possible scenarios for their health. I for one am excited to be a part of this brave new world and believe that a broad based revolution in healthcare is just on the horizon,” added Dr. Shamsheer.

Editor's note: 12 May 2017 saw 99 countries affected by a ransomeware attack, including all of the UK's National Health Service hospitals and GP surgeries.