A missing machine or an untraceable staff member is among the worst possible scenarios for Basant, a staff supervisor at a 11-acre hospital facility in the city. He says that monitoring the whereabouts of nurses and machines is, however, getting simpler through an indoor tracking system on his mobile phone.
In a facility where he supervises 130 nurses at the in-patient department, besides being in charge of several ultrasound and X-ray machines, which receives at least 800 patients every day, keeping a track of clinicians, staff and assets, and monitoring the whereabouts of workers and medical equipment is a complicated task, says Basant.
The use of newer technologies in this aspect is revolutionising the healthcare domain, with an indoor tracking system in the hospital being one such technology that helps Basant do his job. Through a general duty assistant tracking system on his smart phone, he can track caregivers, assign tasks for patient care, locate medical machinery and notify the staff if they are exposed to high levels of radiation.
In an industry where the slightest inefficiency can lead to loss of lives, technology, such as the real-time location system, is increasingly being adopted by hospitals in the western countries, said industry experts.
Recently, in Gurugram, a global medical hub, newer technologies and data processing algorithms are changing how hospitals have traditionally functioned — not as brick and mortar structures, but heath systems beyond walls and in their smart phones. Multi-speciality hospitals are setting up programmes that monitor patients 24/7 at their homes. They are also making use of artificial intelligence and algorithms to intervene before a medical condition turns severe.
A 2018 study by GII states that the realtime location system market in healthcare is expected to reach $3,442.2 million by 2023. Experts in healthcare technology are of the opinion that hospitals in Gurugram have been “early adopters of technology, and have been carrying out pilots the last two to three years.”
Hospital representatives said the innovations here stem from the resources and investments in technology, and a large footfall of patients that Gurugram receives. “The city, being a hub of start-ups, gives more scope for innovations to be adopted,” said Dr Ritu Garg, head of Fortis Memorial Research Institute in Sector 44, which rolled out the assistant tracking system in December 2019.
It is also being tested to track and monitor patients, according to the hospital staff.
Wearable, smart monitoring devices
Newer healthcare technologies are aimed at engaging people and equipping them to monitor themselves, according to experts in the field. Hospitals in the city have adopted devices that constantly measure vital signs, such as heart rate, blood pressure, etc.
A 36-year-old Gurugram resident, diagnosed with diabetes recently, has been relying on an app connected to a bluetooth sensor in the arm to monitor glucose levels. Manually tracking fluctuating glucose levels and figuring the next dose of medication was initially an intimidating experience, he said. The app displays glucose levels an informs the user when there is a deviation or a fluctuation. Data can also be retrieved and converted into a document, he said.
With advancements in technology, miniaturisation of devices is also taking place rapidly, according to industry experts. An app-based, wireless holter has helped a 45-year-old patient having arrhythmia (irregular heartbeat) record electrocardiogram (ECG) levels for longer periods, as compared to conventional holters that are bulky and uncomfortable to wear. The device has embedded electrodes with the capability to transmit ECG data wirelessly.
At the Centre of Diabetes and Allied Sciences in Sector 47, a ‘rapid rescue app’, through which and patients can monitor the above metrics and other signs, such as body temperature and movements, is currently being tested and is set to be launched in a month, said hospital staff.
Streamlining, reducing patient visits
Gurugram is a preferred destination for patients from Afghanistan, Bangladesh, Iraq, Iran, Uzbekistan and Russia, according to healthcare executives. After treatment is complete, online sessions with doctors from thousands of kilometres away are routine for the patients from these countries. Healthcare experts say it is only a short time before all patients have realtime audiovisual availability, keeping with appropriate professional standards.
Hospitals here are pushing for a reduction in patient visits. Clinical records are being presented to patients online, in an easy-to-understand format, which they can download and view remotely.
At Medanta -The Medicityin Sector 38, where millions of patients visit and double the number of diagnostic tests are done every year, an electronic medical record system gives patients access to reports, prescriptions, and discharge summaries at any location. The record system has been in use for three years now.
Reports have colour-coded visuals for easy understanding. “People across the globe are now accustomed to getting information whenever and wherever they want. They expect the same quick response to their healthcare questions,” a healthcare expert said.
The hospital’s mobile telemedicine platform lets patients search for the possible ailment, treatment procedures, the suitable doctor and book appointments online.
Artificial intelligence in healthcare
The healthcare industry has a need to store enormous amounts of medical data, in multiple formats (images, audio, tests, visuals), which have laid the foundation for artificial intelligence (AI).
AI is being used saving lives in several hospitals across the country — particularly in the field of diagnostics due to the huge repository of data available. It is only a matter of time that predictive care brings down the rate of heart failures and diabetes by suggesting preventative measures before the condition worsens, say experts.
The use of AI to detect referable diabetic retinopathy — damage to the blood vessels of the light-sensitive tissue as a result of diabetes — is being done, on a pilot basis, at Fortis Hospital for three months now. India is home to over 72 million diabetic patients, with an estimated diabetic retinopathy prevalence of 18%, according to a 2005 study published in the Investigative Ophthalmology & Visual Science journal.
Dr Anita Sethi, an ophthalmologist at Fortis Hospital, said a majority of clinics across the country are not equipped to detect diabetic retinopathy and many cases go undetected.
Considering the increasing number of people with diabetes and a shortage of retinal specialists in the field, an automated approach using AI for diabetic retinopathy screening has gained traction in the healthcare industry, according to experts.
Patients tested for diabetes are also screened for diabetic retinopathy and images of the retina are uploaded to the AI platform for evaluation, based on past data. A report is generated, based on the risk levels of developing retinopathy, said Sethi, adding that the technology has helped screen 64 patients so far.
“The technology will be highly useful at smaller health centres, where there are no eye specialists. However, the technology isn’t always accurate and needs to pick up more findings,” said Sethi.
At Max Hospital in Saket of Delhi, an AI-enabled X-ray machine alerts the radiographer in cases of suspected pneumothorax, a life threatening disease in which air from the lungs escapes into the pleural cavity, having a potential of collapsing the lung and resulting in acute respiratory failure.
Experts said this is important as cases, where the pneumothorax is small or at an early stage, often go undetected.
AI is also being tested to predict hospital bills before admissions, based on relevant parameters such as the patient’s medical condition and medical practices.
“It is difficult to give bill estimates in hospitals as one can’t account for factors such as disease aggravation, unplanned surgeries and unexpected complications. The AI generates estimates based on parameters, such as existing co-morbidities, age of the patient and previous admissions, among others,” said Dr Ritu Garg, zonal head, Fortis Hospital, adding that the system needs more learning, as per the trials.
While AI and other technology are more or less at an early stage in these hospitals, the potential of this technology could help with major breakthroughs in healthcare, said experts. Garg said that AI will expand into other medical departments and hospitals are leading the way.
Dr Raghuram Janapareddy, an expert in healthcare innovation, working with National Association of Software and Services Companies (Nasscom), gives it five years. “By 2025, AI has the potential to be used to capture data faster and make medical procedures more efficient. It will play the role of a doctor’s personal assistant and provide information to them anywhere. It can suggest the right medication and alternative therapies for patients,” he said.
Janapareddy said that however, in the long term, AI will not make the role of a medical experts obsolete. “The demand and supply gap in healthcare is huge, and as the population grows and new viruses are discovered, doctors will stay relevant,” he said.
However, policy changes have to be made in telemedicine, experts said, as there are certain ambiguities in the law.
For technology to transform how hospitals work, hospitals need to make investments for the future. “Hospitals need to invest in information technology and adopt newer technologies in the longer term,” said Janapareddy.-Hindustan Times