How risky is eHealth­care?

Middle East Business (English) - - CONTENTS -

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.

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