Wednesday, November 22, 2017

There Are Lots Of Exciting Visions For Digital Health Out There! I Often Wonder How Real They Are?

Three forward looking articles  appeared last week:
First we had:

How data is ushering in the era of personalised healthcare

AI, augmented reality and vast amounts of data will help drive a new revolution in healthcare, Murray Brozinsky says.
Rohan Pearce (Computerworld) 15 November, 2017 06:00
Roughly every half century, there’s an innovation that drives a revolution in healthcare, according to Murray Brozinsky.
In the 1840s it was the use of anaesthesia in surgery; in the 1870s, germ theory. Then in the 1920s penicillin was discovered, and in the 1970s evidence-based medicine emerged on the back of the use of randomised clinical trials.
“We are at the dawn of the next revolution,” Brozinsky — the chief strategy officer of health technology firm Conversa — yesterday told Commonwealth Bank’s Future of Health conference. More than 100 of the bank’s corporate clients attended the conference, held at Telstra’s Customer Insight Centre in Sydney.
That revolution is the emergence of digital healthcare: Personalised healthcare driven by the availability of an enormous amounts data and the technology to leverage it. In 2020, there will be 25,000 petabytes of health-related data, Brozinsky said — “that’s roughly 500 billion four-drawer filing cabinets that would contain 500 times all of the written words since the dawn of human history”.
“We’re starting to get a glimpse of what that revolution is,” he told the conference. Evidence-based medicine draws on data but treats the “average” patient, Brozinsky said.
“We’re driven by clinical trials, which uses a set of patients to provide a standard of care or a guideline for the rest of the population — many of whom don’t look like those patients. And now we’re moving to a world where instead of treating the average patient, we’ll treat the individual person.”
That shift will be enabled by drawing on a vast array of data — including clinical data, genomic and other omics data, demographic data, data collected from sensors and patient-reported outcome data.
“In oncology we have treatments today that we know don’t work in 70 per cent of cancer patients,” Brozinsky said. “We need to move to a world where we know that the treatment will work 100 per cent of the time in the right 30 per cent of cancer patients. That’s personalised health.”
Artificial intelligence, blockchain, telehealth, virtual and augmented reality, sensors, 3D printing and, further down the track, CRISPR and SENS, are all set to change the face of healthcare, Brozinsky told the conference.
Lots more here:
And then we had this:
17 November 2017

Whatever happened to our digital health utopia?

Posted by Felicity Nelson
The digital health revolution has been a long time coming.
Once it arrives, we are told, everything will run at peak efficiency, for less money, with higher quality care, greater transparency and immaculate interoperability.
The digital data trinity – electronic medical records, artificial intelligence and big data – will, futurists claim, metamorphose healthcare.
But this sparkling vision grates uncomfortably against the reality; the dull dialling of fax machines can still be heard in most waiting rooms around the country. Frustrated, sick patients still cannot access their most basic medical records remotely online.
Experts came together this month at the Medical Technology Association of Australia annual conference in Sydney to discuss what is being done to close the expectation gap between what technology can do, and what it is actually doing right now.
Australia has fallen behind much of the Western world in terms of hospital digitisation; while the US has around 2000 “digital” hospitals, Australia currently only has three.
But significant work was under way to push many more hospitals into the digital age, Richard Royle, the national digital health leader at PricewaterhouseCoopers Australia, said
Australia’s first fully integrated digital hospital, St Stephen’s Hospital in Hervey Bay, Queensland, went live in 2014.
Since then, two additional hospitals have reached the highest levels of digitisation (called HIMSS Level 6): the Princess Alexandra Hospital in Brisbane and The Royal Children’s Hospital in Melbourne.
Mr Royle was the man behind the pioneering project at Hervey Bay.
As the former executive director of Uniting Care Health, Mr Royle transformed the Queensland facility using $47 million in funding from the former Gillard government.
Gone were the laborious, time-sapping and inaccurate paper records at this “hospital of the future”. Instead of clinicians at St Stephen’s having to write down the heart rate, blood pressure and temperature on the patient chart, data was automatically fed from monitoring systems into the electronic medical record.
The system nudged clinicians towards best practice by displaying standardised clinical decision-making pathways, Mr Royle said.
Medications used at St Stephen’s were packaged in individual, barcoded dosages and fully tracked to reduce waste and medical errors.
Doctors could also receive alerts about their patients in real-time, including information on allergies, medications, abnormal vitals and test results.
“The ability for the clinician to look on his or her laptop at home for the live vital signs, to be able to review and change the medications, to be able to talk directly with the staff who are treating the patients, that’s gold for the doctors,” Mr Royle said.
While Australian hospitals weren’t exactly embracing a digital future yet, there was significant traction occurring, particularly in NSW. But getting digital projects off the ground required engagement at all levels – from patients, to clinicians, up through management and inside parliament, he said.
A major obstacle was the cost. At around $50,000 to $70,000 per hospital bed, the price of digitisation remained steep. Mustering the political will to fund these projects was difficult, as the investment would only start produce efficiencies well into the following election cycle.
The government was also nervous about disasters in digital health because these could be very high profile and they hurt people, Mr Royle said.
Vastly more here:
and third we had this:

Transform GP care and trash fax machines, new digital healthcare report says

Lynne Minion | 17 Nov 2017
Abandon the idea of continuous GP care and throw away your fax machine - a new Microsoft report has told Australian healthcare it needs to undergo a dramatic change in mindset and get with the digital revolution.
Embracing the Change Mandate: The 2020 Digital Transformation Agenda for Australia’s Health Care Sector gathered input from a number of Australian experts, with GP and president of the Australasian College of Health Informatics Dr Chris Pearce claiming we are on the verge of the most significant shift in how healthcare is delivered since the scientific method arrived.
The ‘GP for 30 years’ care delivery model will disappear, according to Pearce, with patients already seeking primary care from five different clinics and 11 doctors in their lifetime.
“One of the cornerstones for general practice has always been this concept of continuity of care. But the reality for a large percentage of the population is that they are usually young, relatively fit people and there is no need for continuity of care – a vaccination here, a sore knee there – and that’s fine,” Pearce told Healthcare IT News Australia.
More here:
You can download the report here (with the usual seeking of details to permit pestering you with marketing):
Sadly I have been reading enthusiastic stuff like this for at least the last 15 years and so far very little of it seems to have come true – will the riskiest saying in finance and elsewhere actually come true in saying ‘this time it is different!” and actually mean it!
We will see! Comments welcome if you are a believer or not!
David.

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