New digital technologies could improve the experience of healthcare for both the patient and practitioner
Traditionally, medicine and healthcare have always been sectors rife with innovation. Healthcare practitioners are keen on experimenting with new technological tools, aware that they might greatly improve the way healthcare is delivered – and how lives are saved. VR applications are already being trialled in some medical facilities as a way to alleviate pain in burns victims; computer vision tools are being developed to spot tumours and early signs of Alzheimer’s disease; and trainee surgeons might soon attend lectures using AR systems.
New digital technology is also changing the day-to-day routine of hospital workers – including nurses, general practitioners and specialists. Computers have been integrated into hospitals as key record-keeping tools for over a decade, sometimes with mixed results: in a 2018 New Yorker article, surgeon and writer Atul Gawande complained that, according to a 2016 study, doctors spent nearly 120 minutes doing computer work for every hour spent interacting with their patients. What made the thing especially frustrating for Gawande was that oftentimes those computers were clunky and counterintuitive to use.
“Doctors spend an inordinate amount of time with their head in their computer” says Robert Wachter, chairman of the Department of Medicine at UCSF and author of best-selling book The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age.
“In a hospital you’ll see doctors and nurses busy with their computers; sometimes that is healthy because the computer is where a lot of the information is kept. But sometimes it’s unhealthy because things we used to do by talking to each other or by being on the same floor – now we go off to separate rooms and do it.”
Eric Jeffrey Topol, a digital medicine researcher at Scripps, agrees. “Keyboards are the most hated thing amongst doctors, clinicians and nurses. Everybody wants to be liberated,” he says.
Laura Robinson, enterprise account executive at Microsoft Healthcare, agrees.
“It is hard to be collaborative, it’s hard to tap in to a lot of the digital advances that we have when you have ten-year old hardware,” she says. “There is a general need for modernisation and I don’t think we’ve probably invested to the degree we need in order to take advantage of what technology has to offer.”
The most urgent problem is a lack of interaction and collaboration both between doctors and patients, and – more crucially – between healthcare workers with each other. It does not have to be that way, though: technology can and must be adapted to meet healthcare professionals’ needs. In fact, the tools to meet those needs, allowing a more fluid sharing of information among clinicians, are already here.
Wachter cites the pager to exemplify a device that has not been updated for the 21st Century. “The pager is still used in many hospitals, but is a really dumb device: it’s got a single message, there’s no record of communication,” Wachter says. “When I go through my patient’s medical record, I want to see what the cardiologist said, or the nurse wrote. Communication and collaboration should be built into the electronic medical record – [and help doctors understand when they] need to speak with the nurse or the specialist.”
Devices able to carry out such effective information sharing tasks are already being adopted in some UK hospitals. In 2017, the Isle of Wight NHS Trust decided to equip its staff with Microsoft Surface devices, which allowed care teams to have swifter access to each patient’s medical history and record, to share information with their colleagues, and to use the tablet to explain diagnoses to the patients. (All that, without keyboards – thanks to the touchscreen function and the Surface pen.)
Another Surface device, the Surface Hub, is also being adopted in meeting rooms across Liverpool’s Alder Hey hospital to allow doctors and nurses to consult and communicate through digital screens in a seamless fashion.
Alder Hey Hospital also implemented another cutting-edge device that could provide guidance to doctors right inside the operating theatre: HoloLens, Microsoft’s holographic computer. As one of the Alder Hey surgeons explained, the device would allow him to “[create an image of] a patient’s heart from the inside and from the outside,” and – in the future – maybe to access a patient’s scans while operating on them.
Crucially, Mixed Reality headsets such as HoloLens could also revolutionise the way diagnoses are carried out and treatment is administered. That is according to Professor Neil Sebire, of the UCL Great Ormond Street Institute of Child Health.
“We have seen demoes where you’ve got someone wearing HoloLens in one country and someone in another country, looking at the same thing,” he says. “So, you can imagine having an X-ray that I’m looking at here in London while another doctor in another part of England is looking at the same thing at the same time and we can communicate and interact with the object at the same time.”
“That is potentially huge for healthcare. Right now, the patient moves to go where the expertise is. What could happen is that the patient goes to their local hospital and has a joint consultation with their local doctor and a specialist from another hospital elsewhere.” The rise in “virtual GP” apps and services, which help people avoid long queues or inconvenient appointments, is already heralding a similar shift.
But the way these tools could improve the care patients get is not limited to swifter access to their practitioners, better information sharing, and more creative problem-solving. The right technology also has the potential to make doctors and nurses more efficient, freeing up their time to allow them to focus more on their patients. As a recent report on Artificial Intelligence from the Academy of Medical Royal College underlined, “At a time of widespread clinician burnout and a shortage of staff, AI offers the potential to automate some of the workload and reduce the burden of routine tasks. This could leave doctors free to engage in the more interesting and challenging work.”
And indeed AI, together with devices streamlining practitioners’ workflow, and cutting-edge tools such as MR, VR and AR, is poised to trigger a sea change, Scripps’ Topol thinks.
“All clinicians can be augmented in terms of accuracy, speed, and workload efficiency through AI,” he says. “Patients will have their data increasingly algorithmically interpreted. So, you’ll have decompression of doctors because some of the charge is taken up by the patients.”
That is the big challenge – and opportunity – of future healthcare, Microsoft Healthcare’s Robinson says.
“One of the big problems in the UK we’re trying to solve right now is a shortage in the workforce – and there’s technology that can help address that. Artificial intelligence, machine learning, data and computing power can help us try to figure out how to reduce mortality rates for progressive diseases, or early childhood rare diseases,” she says. “If the intention is putting the patient at the centre and providing a more personalised care, it all boils down to leveraging the data better.”
In other words, patients will be empowered, and doctors will be able to take better care of them.