Tag: healthcare

I was recently part of a virtual session with my fellow Ecosystm analysts, discussing what transformation will look like for various industries. One of the points that emerged is that the one industry that has had to transform itself completely, without having the luxury or time to think about it is Healthcare. Healthcare will emerge from this a transformed industry – in their rapid tech adoption; in their business processes and; in the mindset of the clinicians and administrative staff who’ve been at the frontline of this crisis. Will this be a revolution, or will the industry have to step back, once the immediate crisis is over?

Here are my thoughts on what is happening to the industry now and where we might be headed.

#1 Are we closer to our remote care dream?

I know I don’t sound very futuristic when I say that the biggest win from this crisis for the Healthcare industry will be the widespread adoption of telemedicine. We have heard the term bandied around for more than half a century now and over the years we have coined terms such as eHealth, digital health, mHealth and remote care, with the evolution of technology. Several healthcare providers in the Asia Pacific have implemented teleconsultation facilities to provide healthcare to remote, underserved regions and to out-of-country patients (especially those that actively seek to serve in the medical tourism space). Even for healthcare organisations that have the technology capabilities, it did not always make financial or regulatory sense to push for widespread adoption.

They have had to rush into it now, often throwing caution about cybersecurity and compliance to the winds. I am not saying that their hesitation will not return once this immediate crisis dies down – but what will happen is that governments will work with cybersecurity and legal experts to mandate it better. Once these guidelines are clearer, healthcare providers will be forced to create workflows and assign responsibilities. So, remote care where your healthcare provider will liaise with the data from your personal devices is not far off.

#2 Will we see a second wave of health and wellness apps?

With the rise of the use of smartphones, the last decade has seen a steady rise in healthcare apps. Most of these apps sync with health and wellness devices, but some use data from FDA-approved clinical devices, targeting chronic health conditions. This pandemic and the allied challenges of surviving in uncertain times, locked down in their homes, has also seen a rise of mental and emotional challenges. There will be a consumer uptake of these apps, as people realise that mental and emotional health can be as critical as physical illnesses. We will, therefore, see a proliferation of mental well-being apps.

Several organisations are having to deal with a remote workforce, with no clear visibility on how their employees are coping. It is not too far-fetched to imagine HR practices in some organisations, leveraging wellness apps – if not to monitor their employees’ mental state (that would be unethical), but – to engage with their remote employees and motivate them. These communications will largely be around the business, but some will use gamification to keep employees connected to the organisation’s visions and goals.

#3 Will healthcare providers realise the importance of evolving their supply chain management?

The healthcare industry, for all the cutting-edge research, that it represents has been remarkably slow to transform. The common perception of healthcare transformation is better clinical outcomes, genomics etc. But the reality is that most tech adoption in hospitals happens in Operations. The earliest impact of this crisis, when it was still confined to China was the disruption of the supply chain. Can you imagine how hard it must have been for the Healthcare industry to not be able to halt operations because of lack of resources? Premier healthcare institutions, mostly in the US, had realised the importance of better supply chain management long back – some implementing Lean and Six Sigma. Now healthcare organisations the world over – even in emerging economies – will adopt more technology in managing their supply chain.

However, what the COVID-19 crisis has exposed is the need for better collaboration and better visibility of external resources, to handle unprecedented scenarios. Countries that have done well to manage the crisis are those where the government took the vital step of encouraging and being the hub for cross-agency collaboration. Horror stories of US states outbidding each other for PPEs have emerged. On the other hand, we have had countries where governments have been able to guide healthcare providers on bed availability – across the public and private sector – so that affected patients could move seamlessly from one facility to another without any impact on the clinical outcome. Having a siloed view of your supply chain may not be sufficient in combating larger challenges – some healthcare organisations at least will opt for a more collaborative supply chain.

#4 Did super specialisation leave us underprepared?

Healthcare professionals have also been impacted in hugely different ways. On the one hand, we have nurses and doctors working 7-day shifts (without breaks), and healthcare systems looking to bring back retired clinicians to counter the shortage of healthcare staff. The Irish prime minister re-joined the healthcare workforce, making international headlines. On the other hand, we have several specialists who have practically no patient volume. Many of them are using teleconsultations to give basic healthcare advice and to guide patients on when to actually go into a hospital and when not. Several of these doctors actually want to help combat the COVID-19 crisis. But they will be the first to acknowledge that they are hesitant because they may have lost the skills needed to handle emergency situations.

While specialised knowledge in a particular disciple has helped improve clinical outcomes and often keep healthcare costs down – the rise of speciality hospitals in India is a good example – does it also leave doctors unprepared in times of crisis? Many doctors across the globe get subsidised education – partly funded by citizen taxes. Is it time for countries to look at a process where these doctors, irrespective of their specialisation, have to get re-trained in emergency services for a fixed period every year?

#5 What happens when the focus shifts to re-building other industries?

While the Healthcare industry has undoubtedly transformed, one must bear in mind that often transformation is a slower, steadier and more detailed journey. A transformation that rises out of disruption may not be successful in the longer term. Moreover, every healthcare provider organisation has had to evolve their processes almost in an isolated manner. Once the immediate crisis is over, the industry needs to take a pause (if they are able to) and take stock of the new practices and processes and evaluate what can continue and what has enormous associated risks.

But realistically, the Healthcare crisis is far from over. Once the threats from COVID-19 subside, healthcare providers will have to focus on elective procedures and other healthcare issues that are being put on hold now. People will visit hospitals more to consult about the health issues that they have been ignoring during these times. This will also coincide with when governments focus on re-building other industries – so Healthcare may not have access to emergency funds that they have now.

While we are all focused on handling the current crisis, now is also the time for healthcare policymakers to think ahead on how to sustain and evolve the Healthcare industry.

Yes and no. If we look at the history of the ERP solution, as an example, we find that it was initially meant for and deeply entrenched in Manufacturing organisations. In fact, the precursor to modern-day ERP is the Manufacturing Resource Planning (MRP II) software of the 1980s. Now, we primarily look at ERP as a cross-industry solution. Every business has taken lessons on inventory and supply chain management from the Manufacturing industry and has an enterprise-wide system. However, there are industries such as Hospitality and Healthcare that have their niche vendors who bundle in ERP features with their industry-specific solutions. This will be the general pattern that all tech solutions will follow: a) an industry use case will become popular; b) other industries will try to incorporate that solution, and in the process; c) create their own industry-specific customisations. It is important, therefore, for those who are evaluating emerging technologies to cast their net wide to identify use cases from other industries.

AI and automation is one such tech area where organisations should look to leverage cross-industry expertise. They should ask their vendors about their implementations in other allied industries and, in some cases, in industries that are not allied.

For cybersecurity, their approach should be entirely different. As companies move on from network security to more specific areas such as data security and emerging areas such as GRC communication, it will be important to evaluate industry experience. Data protection and compliance laws are often specific to industries – for example, while customer-focused industries are mandated on how to handle customer data, the Banking, Insurance, Healthcare and Public Sector industries have the need to store more sensitive data than other industries. They should look at solutions that have in-built checks and balances in place, incorporating their GRC requirements.

So, the answer to whether organisations should look for industry expertise in their vendors is that they should for more mature tech areas. An eCommerce company should look for industry experience when choosing a web hosting partner, but should look for experience in other industries such as Banking, when they are looking to invest in virtual assistants.

Are some industries more focused on industry experience than others?

Ecosystm research also sought to find out which industries look for industry expertise more than others (Figure 2). Surprisingly, there are no clear differences across industries. The Services, Healthcare and Public Sector industries emphasise marginally more on industry expertise – but the differences are almost negligible.

There are some differences when we look at specific tech areas, however. For example, industries that may be considered early adopters of IoT – Transportation, Manufacturing and Healthcare – tend to give more credit to industry experience because there are previous use cases that they can leverage. There are industries that are still formulating standards when it comes to IoT and they will be more open to evaluating vendors that have a successful solution for their requirement – irrespective of the industry.

The Healthcare Industry Example

Ecosystm Principal Analyst, Sash Mukherjee says, “In today’s fast-evolving technology market, it is important to go beyond use cases in only your industries and look for vendors that have a demonstrated history of innovation and experience in delivering measurable results, irrespective of the industry.” Mukherjee takes the example of the Healthcare industry. “No one vendor can provide the entire gamut of functionalities required for patient lifecycle management.  In spite of recent trends of multi-capability vendors, hospitals need multiple vendors for the hospital information systems (HIS), ERP, HR systems, document management systems, auxiliary department systems and so on. For some areas such as electronic health records (EHR) systems, obviously industry expertise is paramount. However, if healthcare organisations continue to look for industry expertise and partner with the same vendors, they miss out on important learnings from other industries.”

Talking about industries that have influenced and will influence the Healthcare industry in the very near future, Mukherjee says, “Healthcare providers have learnt a lot from the Manufacturing industry – and several organisations have evaluated and implemented Lean Healthcare and Six Sigma to improve clinical outcomes. The industry has also learnt from the Retail and Hospitality industries on how to be customer focused. In the Top 5 Healthtech trends for 2020, I had pointed out the similarities between the Financial and Healthcare industries (stringent regulations, process-based legacy systems and so on). As the Healthcare industry focuses on value-based outcomes, governments introduce more regulations around accountability and transparency, and people expect the experience that they get out of their retail interactions, Healthtech start-ups will become as mainstream as Fintech start-ups.”

It is time for tech buyers to re-evaluate whether they are restricting themselves by looking at industry use cases, especially for emerging technologies. While less industry customisations mean easier deployments, it may also hamper innovation.

Authored by Mervyn Cheah, Aga Manhao and Sash Mukherjee

In January we wrote a blog on How Technology is Helping to Combat the Coronavirus – since then the COVID-19 outbreak has fast become a global threat, disrupting healthcare systems and economies. As the world struggles to contain the spread, Singapore’s response to the crisis shows how governments can use policies and technology to combat emergencies. While it is true that Singapore’s size is its advantage, and most of what it was able to do cannot be replicated in larger, more spread-out countries, there are still lessons there – in the simplicity and responsiveness of the measures. The threat is by no means behind us and the Government will need to implement many more policy changes in the near future. But it is worthwhile to look at what Singapore has done so far to contain the spread.

#1 Identifying and acknowledging the threat early

Like other Asian countries, Singapore suffered during the SARS outbreak in 2003. While the number of people infected during SARS was less at 238, at the end of the outbreak the country had recorded 33 deaths. Having learnt from that experience, Singapore knew that early response is key. Acknowledging the threat early allowed Singapore to have test kits made available to all major hospitals through the Agency of Science, Technology and Research (A*STAR). A*STAR is a statutory board under the Ministry of Trade and Industry, Singapore. The agency supports R&D that is aligned to areas of competitive advantage and national needs. By the time the first case was reported on 23rd January, health professionals were equipped with testing capabilities. Health authorities and biotech companies have continued to modify and launch newer testing technology – like the fast-track swab test kits launched in early March – as global research continues.

#2 Focusing on contact tracing

Right from the start, Singapore has been focused on contact tracing. Following the chain of the virus allows government agencies to identify and isolate people at risk, including their close contacts. This became more important as the virus spread into the local community with the first reported case on the 4th February. The contact tracing process has been a concerted effort using technology, manpower and dedication. As Singapore faces a second wave of spread from returning travellers, the Government launched Trace Together, an app that records distancing between users and the duration of their encounters. Individual consent is required to share the data which is encrypted and deleted by the Ministry of Health (MOH) after 21 days. This allows the MOH to contact citizens in the case of possible contact with an infected individual.

#3 Keeping the citizens in the loop

The speed in imposing border controls, meticulous tracing of known carriers and aggressive testing are all positive steps in combating a crisis like this. But arguably the most productive strategy was to get citizen buy-in. The need was felt most when the country’s Disease Outbreak Response System Condition (DORSCON) level was raised from yellow to orange on 7th February. With the raised DORSCON level, buildings and public facilities with a high volume of people were required to do fever screening and collect personal details for further communication and alerts, if required. Simultaneously, the Government started sharing clear, transparent, daily public communication through mobile phones. The messages contain anonymised details of the patients (to make people aware of their own possible exposure), as well as an update of the number of patients being treated and released. The 2 deaths were also reported promptly – but enough details were shared to avoid panic. Demonstrating cross-agency collaboration, the information disseminated comes from multiple government agencies – the same channel is also used to drip-feed hygiene guidelines and the evolving government policies on travel, trade and so on.

The message from the leadership has also been clear and timely, and an economic stimulus package was announced fairly early. The Government is currently working on a second stimulus package, as the threat to the economy continues.

#4 Dispelling misinformation

Taking this daily communication to the next level, the Government has been prompt in stopping the spread of rumours. Not only does the MOH website share all the latest details, any spread of misinformation (usually through social media) is being quelled by official statements. It is extremely important to be able to address issues such as these, because it impacts trust in the government and the healthcare system. The daily updates are now a ‘single source of truth’ on all COVID-19 related information. The Cyber Crime Portal has also been activated with the intention to track unverified messages especially regarding the treatment and cure of COVID-19.

#5 Empowering healthcare professionals and citizens with digital tools

Unfortunately, the community spread appears to be happening in waves, especially as Singapore has a high volume of returning travellers. Healthcare facilities continue to be stretched. Although Singapore has adequate healthcare facilities to cope with the number of current cases, the Government is also prepared with additional quarantine facilities. Meanwhile, hospitals have set up makeshift triage centres in their car parks to deal with the growing number of patients needing to get tested. To counter the need for more infrastructure and the cost to get additional facilities ready, the use of digital health, remote patient monitoring and online care planning is being explored to limit patients presenting themselves to providers. KK Women’s and Children’s Hospital has launched UPAL – Urgent Paediatric Advice Line – as a pilot online consultation channel. It is expected that more healthcare facilities will offer services such as these. Being cloud based, these solutions can be deployed within days and high-risk patients can be immediately onboarded, easing the burden on the healthcare system and providing relief to patients and families. Telemedicine and remote monitoring are not new, having been proven and tested by several healthcare systems. In these extraordinary times, technology will help the healthcare system keep all in Singapore safe.

#6 Having a strong Data and Digital infrastructure

Singapore’s data and digital services infrastructure is the overarching factor that has allowed the Government to act quickly and efficiently to fight this community threat. While this is not linked directly to the current response measures against COVID-19, it is the true enabler. Firstly, the electronic health record system has access to records of all patients who have availed of the public healthcare system (private, primary care organisations have also started contributing to the system – enabling the vision of complete longitudinal health records). This is the backbone of the Government’s healthcare measures in these difficult times. Secondly, the network infrastructure allows the introduction of online consultation services. Moreover, people are able to work from remote locations seamlessly using collaboration tools such as Zoom, Skype and WebEx. This allows the Government to encourage people to work from home, to stay away from healthcare facilities and other measures to reduce overcrowding of public spaces to prevent the spread. And finally, Singapore has a strong access to eCommerce and online platforms, allowing people to access almost anything they choose to, online.

While the battle against the pandemic is far from over, Singapore has so far managed to avoid complete disruption by using technology to be responsive to the community’s needs.

The combination of computational and biotechnology is accelerating the development of new cures, augmenting R&D and improving health outcomes. Deep Tech in healthcare has multiple applications from the manufacturing of affordable medical devices to redefining healthcare. Vibrosonic, has designed what they call a “contact lens for the ear” which can be directly placed on the eardrum. Unlike other hearing aids speakers are not used to transport sound through the ear canal but the eardrums are stimulated through electric impulses. A Singapore-based biotech company X Zell has patented a “liquid biopsy”- detecting cancer from a 10ml blood sample by measuring the presence of tumour-derived Circulating Endothelial Cells (tCEC) – which reduces the need for invasive cancer detection processes.

Food and Agriculture

Food crisis is a reality today with factors such as overpopulation, urbanisation, decreasing land per capita, extreme climates and so on impacting the food and agriculture industry immensely. Deep Tech companies are working to bring us sustainable food options and building climate resilience. Cell-based meat options are being researched globally, and companies such as foodtech start-up Shiok Meats is producing meat by harvesting cells from animals with a view to be environmentally friendly and to reduce the impact on biodiversity. In agriculture, Deep Tech companies are working on technologies to develop better farming methods to improve yield and precision sensors for weather forecasting. Examples such as UbiQD, that has worked on a greenhouse quantum dot film that improves crop quality by optimising sunlight spectrum for plants to improve production, show how Deep Tech will continue to transform the industry.

Environment and Energy

Deep Tech continues to come up with solutions that will help us in climate change mitigation, development of sustainable energy and energy efficiency. Innovations include Carbon Upcycling Technologies’ solution to capture and neutralise carbon dioxide. The carbon dioxide-enriched nanoparticles are used to make commercial construction materials and even consumer products such as jewellery. Celadyne Technologies has developed hydrogen fuel cells and electrolysers with nanocomposite membranes for a more efficient, cost-effective and eco-friendly energy source.

Advanced Computing

As technology evolves, there will be a need to support even greater compute and data-intensive tasks.  Deep Tech has impacted and will continue to impact advanced computing. The semiconductor and microchip industry is getting disrupted by cutting-edge global research, many by the top universities. MIT, for example, has developed a process called “remote epitaxy” to manufacture flexible chips. Potential use cases include VR-enabled contact lenses, electronic fabrics that respond to the weather, and other flexible electronics. Atom Computing is working on scalable quantum computing that will be able to scale millions of qubits using individual atoms – without scaling up the physical resources – in a single architecture.

Communication and Security

Communication and connectivity have seen a sea change in the last decade. As we wait for 5G to take off, this industry has become a playground for inventions. Aircision, is working on making 5G more accessible using its laser-based communications technology. The technology is developed to enable high-bandwidth communication and beam data between buildings thus aiming to eliminate the need for optical fibre installations and microwave. Another area that will keep getting a lot of attention from Deep Tech firms is communication security. Speqtral is working on space-based quantum networks to deliver secure encryption keys.

Examples such as these are an indication that Deep Tech is a reality today and has the potential to disrupt several industries and impact the lives of millions.

Where is Deep Tech Headed?

Government Interest in Deep Tech

Since Deep Tech is aimed at leveraging technology and engineering for sustainability and greater good, several countries are promoting Deep Tech R&D and initiatives. From emerging to mature economies, governments are supporting their Deep Tech industry. The New Zealand  Government has formed a Deep Tech Incubator program. The program is headed by the Government’s innovation agency to help Deep Tech companies and to create new tech jobs.

Singapore has created a strong Deep Tech ecosystem leveraging the funding ecosystem, the presence of global corporations, research and higher learning organisations and the Government that promotes innovation and entrepreneurship. Agencies such as SGInnovate and Enterprise Singapore are working with Deep Tech startups in advanced manufacturing, urban solutions and sustainability, and healthcare and biomedical sciences. Partnerships between universities, industry bodies and research organisations further fuel this ecosystem – the Critical Analytics for Manufacturing Personalised-Medicine (CAMP) is a partnership between Singapore-MIT Alliance for Research and Technology (SMART) and A*STAR for cell therapy manufacturing. The Government also funds and incentivises Deep Tech startups. The 2020 budget announced additional funding to support Deep Tech companies under the Start-up SG Equity scheme.

As global governments get serious about the quality of their citizens’ lives and sustainability goals, they will invest in Deep Tech research.

Challenges of the Deep Tech Industry

While Deep Tech has enormous potential, mainstream adoption is still some way off. There are some unique challenges that the industry faces today. Future uptake will depend heavily on how fast the industry can circumvent these challenges. The key challenges are:

• Securing Finances. Despite initiatives by several global governments, Deep Tech projects often find it difficult to secure funding. Very often the research duration can stretch without any real guarantee of success. Funding is likelier to go to organisations developing consumer products as the ROI are seen earlier and are easier to quantify, especially in the early stages.
• Identifying Market Opportunities. Researchers who develop Deep Tech solutions and products might not be able to identify opportunities to present their development from a marketing as well as an economic perspective. Very often these companies rely on other channels or third-party services for a proper marketing and planning strategy. This is where working with incubators or government bodies becomes crucial – countries that give that opportunity through a well-defined ecosystem, will lead the Deep Tech revolution.
• Scalable Development. Many Deep Tech innovations get stuck at the proof-of-concept stage – not because they are not innovative enough, but because they are not scalable to mass production. That requires the right infrastructure as well as a deep understanding of how the products and services can be commercialised.

There are several global companies trying to disrupt entire industries with their inventive offerings. We are witnessing some novel innovations in autonomous vehicles, foodtech, computer vision, AI, weather predictions, Clean Energy solutions  – the list continues – that we will benefit from in the future.

Let us know which Deep Tech companies have impressed you in the comments below.

One of the success stories to emerge from this disaster is the speed at which the risk of the outbreak was detected. 10 days before the WHO announcement, BlueDot, a healthcare monitoring platform had already detected the epidemic, from intelligence gathered from news reports, disease networks and official sources. The same platform – and a few others – are also predicting the global spread of the virus by mining global airlines ticketing data. This is a reassuring outcome of how technology and human analysis can effectively come together to improve health outcomes.

Research

While the current global concern is the speed of containment of the disease, eventually there will have to be more proactive measures to prevent another outbreak and to even eradicate the disease. To be able to understand the full nature of the pathogen and to come up with a vaccine, it is important that the virus is isolated. Scientists from the Peter Doherty Institute for Infection and Immunity in Melbourne successfully grew the Wuhan coronavirus from a patient sample. While the Chinese authorities had released the genome sequence to help with the diagnosis, this ‘game-changer’ can be potentially used to detect the virus in patients who do not yet display the symptoms and eventually to develop a vaccine. Cutting-edge research in healthcare has always been conducted by such research and pharmaceutical organisations.  They have consistently pushed the adoption of new technology in healthcare, especially in their R&D practices.

Management

As mentioned earlier, any outbreak taxes the front-line healthcare providers the most. They have very little time to change their triage and protocols to combat a disease that they have possibly never encountered. This is where clinical decision support systems that can incorporate these new protocols into the workflow comes in handy. Epic, the EHR provider has pushed a software update that does just that. According to Epic, this update was developed in collaboration with biocontainment experts, infectious disease physicians and the US Centers for Disease Control and Prevention (CDCs). Collaborations such as this will be required if we have to devise a global protocol for epidemic management and containment.

There have been several other initiatives during this outbreak that show how different technologies can come together to benefit healthcare, especially to handle a crisis. Technology has always played a huge role in spreading the message in times of disaster, especially in emerging economies – with technologies such as AI, the potential of technology benefitting healthcare increases exponentially.

5/5 (5) Authored by attending Ecosystm analysts, Sash Mukherjee (Principal Analyst, Government & Healthcare) and Sid Bhandari (Director, Consulting & Advisory Services)

The recently held AWS Public Sector Summit in Singapore showcased some of the regional AWS implementations, and how organisations are leveraging the Public Cloud differently.

In her keynote address, Teresa Carlson, Vice President, Worldwide Public Sector set the tone for the industry show cases by saying that a successful Digital Transformation (DX) starts from a radical rethinking of how an organisation uses cloud computing technology, people, and processes to fundamentally change business performance.

AWS Empowering the Public Sector

Carlson is clear on what Public Sector organisations must do and where AWS can help them:

• Define what Cloud refers to in the organisation. The first step in bringing about a Cloud First transformation is to be clear on the true definition of cloud computing.
• Create a “Cloud First” policy. To adopt a Cloud First policy, it is imperative to have leaders with a clear vision who really drive technology initiatives forward for all the right reasons like security, cost reduction, scalability, privacy and rapid acceleration of citizen services.
• Focus on Security & Compliance. AWS has global compliance certifications with 200+ services and key features focused on security, compliance and governance. New services such as the use of AI for threat detection have been implemented and  are quickly evolving into a mainstream feature.
• Modify your Procurement vehicle. A formal cloud procurement model must be adopted instead of creating ad-hoc processes and a rush to adopt cloud to meet the specific needs of individual departments. AWS has the expertise to assist government IT leaders in selecting the right acquisition approach for their agency.
• Do not ignore Skills Development. Investing in cloud skills development – whether at the central IT level or in the individual business units in the Public Sector – is imperative, as roles evolve and new roles emerge. AWS has over the years offered free courses and industry certifications to Public Sector employees interested in learning the foundations of cloud computing, storage, and networking on AWS to advanced skills courses in emerging technologies such as AI.

Ecosystm Comment:

While cloud may have started off as a means of offsetting CapEx, its role has since evolved into being a major vehicle for DX. Several governments across the world have adopted Cloud First policies to spearhead innovation, increase agility, and improve citizen services. Cloud is increasingly seen as a foundation for many emerging technologies that governments are experimenting with and implementing such as AI, automation, Big Data analytics and Smart Nation initiatives.

The skepticism around Public Cloud security seems to have diminished over the years, with the perception that cloud providers use state-of-the-art technologies to protect their environment and continue to upgrade their security features in the face of new and evolving threats.  However, the Ecosystm Cybersecurity study finds that nearly 53% of Public Sector and allied organisations that use Public Cloud feel that the security measures offered are sufficient. Leading cloud providers such as AWS should make it clear that essentially it is a shared responsibility and impress on organisations that the responsibility to secure their own applications and the interface with the Public Cloud ultimately lies with the deploying organisations.

Industry Use Cases

There were several industry use cases presented over the 2 days and it was heartening to see so many Asia Pacific examples of transformation. Tan Kok Yam, Deputy Secretary, Smart Nation & Digital Government Office shared that the key to a successful Smart Nation initiative is to build user-centric services rather than having an agency-centric approach, in his presentation on Singapore’s “The Moments of Life” app. Edwin H. Chaidir, IT Manager at WWF Indonesia presented on how AWS’s machine learning capabilities has helped the organisation to automate identification of specific orangutans in the wild, freeing up resources (money and time) to reinvest in other wildlife protection initiatives.

One of the implementation stories that impressed the Ecosystm analysts was the one shared by Rookie Nagtalon, Consultant for Digital Transformation at the Chinese General Hospital and Medical Center (CGHMC) in the Philippines, where he spoke about how they were able to bring about transformation in their patient life-cycle management. Healthcare in Asia Pacific is a diverse and disparate market with organisations at different levels of IT and business maturity – against a backdrop of different country-level goals and healthcare policies. It was encouraging to hear about a transformation project in a not-for-profit organisation from an emerging economy.

The challenges that healthcare organisations face are unique in many ways:

• Legacy systems that still work and hence there is no business case for replacing them
• Approximately 2/3^rd of the IT budget going into running the basics, leaving limited resources for emerging technology adoption and transformation projects
• The shift to value-based healthcare and the need for data-driven insights to support it
• The unpredictability of the workload and the need for an agile IT infrastructure
• Security and compliance mandates that protect patient data and require storage of records over extended periods

Working with these challenges, how does a healthcare organisation bring about Digital Transformation?

Nagtalon’s team was assigned the task to bring about this transformation within a 10-month timeframe.

• The key challenge. An awareness that no one vendor can provide the entire gamut of functionalities required for patient lifecycle management.  In spite of recent trends of multi-capability vendors, hospitals need multiple vendors for the hospital information system (HIS), ERP, HR system, document management systems, auxiliary department systems and so on. Each of these vendors have their own development team and infrastructure requirement, which stresses the internal IT resources. DX involving multiple legacy systems requires a step-by-step approach. The challenge is to identify the right systems to start the journey with.
• Vendor selection criteria. The need to find one solution that would enable seamless data sharing across the disparate systems. The vendor selection criteria that were used focused on ease of use and speed especially when working with multiple data sources. In keeping with the industry, the ability of the vendor to support mission-critical applications was put through the filter of what was referred to as ‘Code Blue’.
• The solution choice. A cloud solution that can empower teams and remove worries about the infrastructure. The hospital chose AWS as their transformation partner, who used a system interface blueprint to integrate data from their SAP ERP system, Medcurial’s MeRx HIS, 128 HR system, Canon’s documentation system and multiple diagnostics systems.
• The future roadmap. Enabling the organisation to be a Digital Hospital. The solution was implemented in 7 months and hit the right ROI requirements, reducing billing time and impacting the bottom line in terms of both recovery and revenue. It has created the base foundation for future plans such as device integration and the provider is well set on its journey of Cloud, IoT and Robotics.

Ecosystm Comment:

Nagtalon raised an important point when he was asked the key reason for the success of the project – executive buy-in. Transformation projects work best when it is enterprise-wide and senior management sponsorship is a must to enable that. However, he also mentioned humorously that he had become extremely unpopular during the implementation. This is where a centre-of-excellence with ‘champions to the cause’ from each key department helps. Organisations should look to engaging with the stakeholders early and to get their buy-in as well as the executive’s.

AWS’s marketing message to healthcare providers includes allowing them to focus on their mission and create their differentiation, and enabling them to incorporate new and emerging technologies. This implementation certainly ticked those boxes. What was particularly positive was the big thumbs up the AWS implementation team received. Organisations will increasingly partner with platform providers in their transformation journeys and implementation capabilities and best practice guidance will be the key differentiators for vendors.

4.6/5 (5)

Globally, the HealthTech innovation ecosystem has many startups working at the intersection of IoT and AI to solve some of the tough problems faced by patients and other stakeholders in the healthcare space. Several factors have led to a proliferation of a class of devices in the health, fitness and wellness space – such as, miniaturisation of sensors, advancements in microcontroller design and power management, low cost and flexible circuit design The ubiquitous availability of smartphones and always-on connectivity has enabled real-time access to cloud-based AI capabilities to transform IoT data into meaningful insights that can be used anywhere and anytime.

The key objective of healthcare provision is to engage the multiple stakeholders involved within an ecosystem to deliver better and holistic clinical outcomes.

 

The Key Challenges to Widespread Stakeholder Acceptance

Despite the promises and great potential of IoT and AI in the healthcare industry, there are major gaps in adoption by stakeholders, especially clinicians. I believe there are three main reasons for the gap:

• The Principle of Conservatism in Medicine

The basic premise of medicine is “Do NO Harm”. Due to the relative newness of both devices and apps, there is only a small body of knowledge and precedence for a clinician. This is too small to take a risk with using “new” data to make decisions, even though the new data may be better than other available “time-tested” options on hand.

Clinical diagnosis is based on years of medical training, time-tested knowledge and practice and clinician “Gestalt”. More often than not, the way an AI system performs the predictions is not fully understood by the clinician. Because of the relatively new field, any new AI-based prediction system will need to establish its credibility that it will NOT do any harm to the patient. Clinicians value their ability to do the right thing for the patient more than anything else.

Establishing the trust between the clinician and the black-box algorithm is critical for any successful adoption.

• Features vs. Function

There is a lack of a common language and understanding between clinicians and technologists, especially when it comes to what “innovation” means for the other party. For a technologist, innovation lies mostly in the features and capabilities of the technology. Their mindset is that innovative technology can be easily adapted to healthcare, similar to the way mobile phones have been adopted by consumers. Their belief is that people and practices will change quickly when presented with better technology and insights. For a technologist, innovation is what transforms a practice in leaps and bounds.

For a clinician, innovation is incremental to start with, and it evolves with time. There is a widely-held belief that if a new technology is not easy to understand, then it probably will not be good. Features and capabilities do not mean much to them. Innovation MUST be simple to understand, reliable, repeatable and MUST solve a problem that they cannot solve by themselves. The arguments in the public domain whether or not AI will replace clinicians adds to the skepticism.

• Evidence through Clinical Trials

Perhaps the biggest factor of all is that clinicians demand evidence of safety and efficacy of new technology through the lens of time-tested processes of randomised clinical trials. Unless there is evidence created by the technologists through well-designed and robust clinical trials, adoption of new technology will be a hit and miss. Technology companies interested in transforming healthcare should have a solid understanding of the clinical trials process and should create adequate scientific evidence to positively influence clinicians.

The most important aspect of gathering clinical evidence is to identify the relevant data for decision making. Many clinicians do not readily utilize the data collected from connected healthcare devices into their diagnosis and decision processes due to the lack of connections between data and clinical practice. While 10,000 steps a day might be a good benchmark for exercising right,  that number means nothing if it is not connected to a clinical decision framework.

The Way Forward for Stakeholder Adoption

Healthcare leaders predict that the implementation of healthcare IoT and AI solutions on a scale will transform their industry. The next few years will see more interconnected IoT devices and reliable applications based on deep learning. To achieve adoption and impact of new technology, the innovators and healthcare stakeholder ecosystem leaders should address the need for trust and evidence. Real World Evidence and Randomised Clinical trials are effective ways to bridge the gap and to establish a common framework to address the user adoption issue.

Arun Sethuraman, Principal Advisor MedTech, Ecosystm is also the founder and CEO of Crely Healthcare, a MedTech startup based in Boston and Singapore. Infection of the surgical site, post-surgery, if not detected and treated early, leads to high incidence of mortality in patients, poor health outcomes, poor patient experience, higher healthcare costs, and loss of reputation and reduced profitability for healthcare providers. Crely’s mission is to provide an early warning and clinical decision support system for surgical site infections (SSI), post-surgery. Crely generates an early warning of SSI by algorithms based on biomarker data collected from patients using an IP-protected, secure, non-invasive, continuously wearable, clinical grade medical device.

• But Diagnostics will Sneak in as the Gateway to AI Investments
  The two key areas where AI will see the easiest application in healthcare are in diagnostics and clinical decision support. Diagnostics using machine learning, predictive analytics and pattern recognition can be utilised effectively for clinical decision support. IoT sensor analytics, image analytics and machine learning, will start getting used to improve the efficiency and the reliability of the diagnostic processes. Algorithms can be applied to large data sets, especially in auxillary departments such as Radiology, Pathology and Cardiology, to augment clinician inputs.
• Security will Play Spoilsport for Investments in Clinical Intelligence
  As health management software gets more and more networked, security has to keep pace with the functional aspects of deployed applications and implementing organisations will ignore this aspect as their peril. The data breach in Singapore is not by any means an isolated episode, and especially mature economies with well-defined health data protection laws will pause before using cloud options for clinical data management. This is true across industries as my colleague points out in the cloud predictions for 2019.