Artificial intelligence can be used in medicine, robots in care, wearables as potential lifesavers: The list of currently discussed and already used digital technologies that will determine the future of health care can be extended indefinitely. But do these digital initiatives also work together? A look at the emerging Smart Hospital shows what the digital future looks like in the hospital field.
Medicine is undergoing the greatest process of change ever. It has to undergo a double paradigm shift, the transition to molecular medicine and digitization itself.The last comparable but comparatively slower paradigm shift dates back to the middle of the 17th century, when Antoni von Leeuwenhoek (1632-1723) used his microscope to visualize the capillary system, red blood cells, sperm and bacteria. The use of digital technologies for molecular medical findings or procedures has a potential beyond that.Before discussing specific incremental applications or the benefits of digital developments and innovations in medicine, it is important to focus on the larger, ongoing digitization projects.The digitization of health care is in full swing. Outstanding objective is the successful digital interaction of hospitals, practices, post-treatment institutions, pharmacies, payers and a host of other facilities. To support this project, the “Law for Secure Digital Communications and Applications in Health Care” – the E-Health Act – was adopted. The electronic health card (eGK) should finally be equipped with applications.The digital platform for this – the telematics infrastructure – is intended to network the different areas of the health care system across sector boundaries. The connection of all medical and psychotherapy practices and hospitals to the telematics infrastructure must be completed by Dec 31, 2018
Of course, this undoubtedly important step in the context of digital health support does not release its individual institutions from dealing with their own digitization initiatives. Anyone who has had the opportunity in recent years to experience the clinic’s everyday life at one point or another knows that it is no longer possible to manage a hospital without digital high-tech. Particularly relevant stimulators for digitization are university hospitals.
Not least because of its special structure, the Essen University Medical Center has set out to develop into a smart hospital. The University Hospital, a large lung specialist clinic, a heart center, a primary care hospital, the West German Proton Therapy Center Essen and several grandchild companies form the basis for a complex digital network within a group with a connection to external partners.
Digitization is picking up speed
Digitalization in the hospital is by no means something new, but rather an evolutionary process. This is currently gaining incredible momentum, also because different technologies such as artificial intelligence , blockchain technology or robotics are moving into various areas of a clinic operation in parallel.
This not only changes the processing speed for individual tasks. It also generates large amounts of data and information. What is often missing is the right infrastructure to network the different digital initiatives. In addition, the data and information generated at different points must be brought together and used in the interests of the patients to a substantial increase in quality in health care. Because the goal of digitization in health care must always be to provide the patient with greater benefits.
Hospitals have a very special significance in all the above considerations. It requires thought leaders and trailblazers who drive the necessary changes and establish. This challenge has been accepted by the University Medical Center Essen. It plays a central role in the regional health care of the Ruhr Metropolitan Region and is to be further developed as one of the first hospitals in Germany to become a Smart Hospital.
Under Smart Hospital, the University Medical Center Essen understands the restructuring of the university hospital and its daughter clinics with the clear goal of significantly improving the care of patients through a digital transformation and to relieve the patient-related staff of numerous non-specialist activities through the use of modern IT systems ,
In addition to these objectives, a priority concern is the collection and validation of numerous data groups, which are intelligently linked and merged with the medical data. Without doubt, this approach accelerates and optimizes diagnostics and therapy decisions.
The further development of the Smart Hospital is not just about process optimization or data-based treatments with or without systems like IBM-Watson. Rather, it is about a digitization process in numerous steps that needs to be shared with patients and employees. It is not so much the information technology as the human being who stands in the way of a rapid development.
For this reason, the digitization of a hospital requires an extensive internal process of change, which must be done step by step and can not be prescribed. At the same time, the problems associated with digitization must be identified, openly addressed and solutions worked out. This includes, in particular, the communication of expected results and impacts, which must motivate all participants to support the change process.
Requirements for Smart Hospital
The aim of the digitization process is to convert the data generated by medical staff and digitized medical devices into an electronic patient record by means of a broad network. The electronic patient record is the basis for the Smart Hospital, which will include several other support and specialization systems in Essen, such as
• a digitally supported call center
• the connection of a cross-sector telemedicine network
• a cross-sector communication platform
• The availability of an App Store for optimized patient care and after care in all medical areas
• a Center for Artificial Intelligence in Medicine
• a robotics center
• a department for 3D printing
• a data validation center
All of these and other components are implemented in a defined order in the context of the Smart Hospital Master Plan. Some things are slower, some faster, others are a continuous digitization process, always geared towards the two key target groups for successful hospital digitization, patients and employees.
At the heart of man
Digitization in the hospital is therefore not an end in itself but serves to improve quality and optimize processes. The overall objective in a smart hospital is that patients will experience this as a place of personal and warm-hearted care with top-notch medical treatment.
The success-determining factor for achieving this goal is the human being itself. Both the healthcare workers and the patients must be taken on the way. You need to recognize the benefits that digitization can bring to everyone in their field today. This applies both to the digitally open-minded and to those who have worries or even fears of the unknown. It is important that the benefits of digitization for people do not remain abstract but can be experienced.
A good example of a recognizable benefit is the clinical application of Artificial Intelligence (AI). Cognitive computer systems at the Department of Radiological Diagnostics (Director: Prof. Dr. M. Forsting) are already being used at the Essen University Hospital to diagnose clinical pictures faster and more accurately. By networking with international databases, an immense amount of knowledge is used, but also made available in order to create and implement tailor-made therapy concepts for each patient.
Universitätsmedizin Essen comprehensively incorporates the expertise of patients on its way to the Smart Hospital. The Institute for Patient Experience was also founded for this, which is closely involved in the digital restructuring processes. Digitalization is therefore the key to putting patients back into the focus of hospital treatment.
In addition to process optimization and relieving the staff of non-specialist work, the standardized medicine towards personalized medicine – or more accurately expressed: open to precision medicine.
Even if both terms are used for a similar suggestion, there are significant differences: Personalized basically means a strictly focused on this one person therapy, so for example, a targeted for this one person antibody therapy.
This is not really true. Rather, it is about a very precise selection of patients for the most appropriate treatment concept according to current treatment criteria. This selection is becoming increasingly digital and AI-based.
Another common term is individualized therapy. Not the conceptual is the innovative, but the intelligent data analysis, based on individual data from radiology, pathology, molecular genetics, microbiology, virology, serology and other diagnostic procedures, which are associated with the knowledge of medical literature.
Of course, with all these considerations, one should not lose sight of privacy. University hospitals enjoy a special trust as institutions of public law. After all, maximizing profits is not one of the principles of these houses, but research, teaching and the further development of cutting-edge medicine. In the future, however, the latter will no longer be able to be developed without data-based research via cognitive computer systems.
However, the regulations established by data protection also impede patient-oriented approaches at various points. In other words, this means that the digital transformation is much slower than it could be. It remains to be seen what effect the directive on basic data protection (DSGVO) , which will be applicable from 25 May 2018, will have on the rules governing the processing of personal data by private companies and public authorities throughout the EU be standardized.
When it comes to data protection, of course, not only the special situation of a hospital is to be considered. Especially outside of clinics and practices, the amount of data increases. Thus, more and more patients, or even healthy people, especially the digital natives, are pushing for the integration of their own data, which they have generated via self-measurements, into their medical care. This also includes the vital data collected via wearables, which you would like to provide to trustworthy authorities if it serves your health.
This acceptance will grow in broad sections of the population as the spectrum of vital signs captured by digital devices grows. Even for many older people, the quality of life increases if, for example, after an operation or in the course of a treatment quite conveniently, blood pressure, heart rate, oxygen saturation, blood sugar and other values are regularly measured, analyzed and thus events worthy of treatment are identified, although at the time the data collection still have no complaints at all.
Pioneering work
The use of digital technologies in the healthcare sector is growing rapidly. From a technological point of view, it is also possible to do incredible things in hospitals today. In many cases, the rapid introduction of the financing, but also the person, especially the employees of a company, contrary. Aversion to changes and / or worries about the development of one’s own workplace, which will also change as a result of digitization, are explanations for this.
So the way to the Smart Hospital first and foremost means pioneering work. The first hospitals, such as the Essen University Medical Center, see the digital transformation as a great opportunity. Using this not only requires courage, but also a great effort to get everyone on the path of digitization.
Therefore, it is probably not even a technology or a particular innovation that makes the path successful. It is probably the companionship organized by the Institute for Patient Experience that is necessary to create a smart hospital that patients will experience as a place of personal and warm-hearted care with top-notch medical care.
In order for this to succeed, all those involved, and in particular the clinic directors, further managers and the committee representatives are to be closely involved in the change process.
