In light of the COVID-19 pandemic, digital adoption and data-driven shifts in healthcare tech have been in the spotlight. How is the healthcare sector in Asia Pacific slowly but steadily being revolutionized?
CJ: Let us start by looking at the effects of the COVID-19 pandemic on healthcare in general, before focusing on the more specific regional changes. I feel the way medicine is being practised is evolving, both for clinical staff and patients. Although we saw some significant shifts over the last 18 months or so, I believe the longer-term changes will be much more gradual, especially once the re-balancing is done. However, I believe some key changes will not revert back to the way they were pre-pandemic. Some of the triggers for this are:
- An increase in pressure on healthcare organizations as the number of critically ill patients rose above and beyond the numbers they were designed for.
- An increase in the acuity of the patients which outstripped the number of intensive and high-dependency beds available.
- The shifting of medicine outside of the traditional four walls of acute centers, in particular the home of patients.
- Staff pressures, ranging from the number of staff who were ill or isolating all the way to the redeployment of staff to work in areas unfamiliar to them.
- The impact of decisions being made at organizational level, in addition to regional and national government, using big data.
These are some of the key reasons as to why there has been a shift in the way healthcare is being delivered around the globe. The single reason which has impacted more individuals has been the use of and the actions that resulted from the interpretation of big data; large amounts of data which in many cases originated from solutions already in place.
Starting to focus now on the Asia Pacific region, we can look at the developments that have been driven forwards by the pandemic. The prevalence of technology in some countries in the region has made some of these changes a lot easier to rollout and support.
The key trigger, in my opinion, is the shift of healthcare outside of the acute centers into the community. During the busiest period of the pandemic, this meant setting up acute beds in carparks, and as the pandemic continued, we saw the move of telehealth medicine from the peripheries into mainstream medicine. This led to an increase in support of patients in the community. It included the care of those with chronic conditions, who during the pandemic were forced to isolate, as well as the creation of virtual wards. With this, we saw a shift of acute care from the hospital to the home.
An example of this was an early discharge of patients with COVID-19, where their observations were being done at home and fed back to the carers in the hospital to intervene or eventually to be discharge, based on data such as physiological parameters.
Underlying all this is data, which as mentioned has been used extensively to inform decision-makers in healthcare organizations, as well as wider government. This led to a wider use, or phrasing it in a different way, a wider acceptance and acknowledgment of the importance of data. In addition, we are seeing the continued acceleration of EMR solutions, as well as development of the existing ones in use. Invariably both in the Asia Pacific region, as well as globally, we are seeing an increased focus on cybersecurity.
One final tech development that we are seeing is the increased use of AI and machine learning to support clinical workflows and processes. This will be increasingly a bigger part of start-up offerings, and it will also be part of the accelerated development of existing solutions, such as ours at Allscripts. This will go a long way in supporting clinical staff and their patients, especially now when there are additional pressures brought on from the manpower challenges of reduced skilled resources.
Although I was considering the Asia Pacific region, the points I raise reflect what we are seeing around the world.
In what ways is technology overhauling the premise and concept of healthcare delivery?
CJ: Healthcare is following (albeit often reluctantly) a journey of evolution; one that it has been on since the creation of modern medicine. For a large number of healthcare organizations, this evolution is all about starting the ‘simple’ transition away from paper, rather than anything more digitally focused. This first step is the most crucial one. I feel it is all about acknowledging that they are starting the journey, that there is acceptance that technology has a role in their organization – it is less about adopting technology. For me, this is the most important step of the journey.
For those organizations who have already started the journey, it is about moving from electronic to digital. What do I mean by this? It is about moving from the digitalization of paper-based processes to fully digital processes by incorporating simple workflows into the clinical process that help drive the right decisions. This is supported and driven by what we know as Clinical Decision Support (CDS).
I would like to expand on what I mean by CDS, which in some ways is the core piece that drives us clinicians to do the right thing at the right time. In its most basic form, it is a simple branching logic that tells the clinical users what they should do next. However, as we bring in machine learning and AI, the CDS can start to support more directly the users in decision-making by learning what they are doing and advising them as to the correct thing to do.
This will continue to evolve and change the way we deliver healthcare. In particular, the use of AI and machine learning will start to drive workflows directly. The pandemic has started to accelerate this process. I believe this will continue and start to move out of innovative organizations to the more mainstream ones.
From a patient perspective, technology is making it easier to interact with healthcare as an individual. They are able to start to access their information and, in some cases, interact with the information. They are also able to update information that feeds directly to the clinical teams looking after them. As discussed already, this impacts virtual wards as well as those patients with chronic conditions. In fact, the Asia-Pacific region has the potential to be a world leader in personalized care, with Singapore leading the way.
