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Augmenting healthcare in Asia Pacific:
AI and data to the rescue?

AI can undertake time-consuming tasks like diagnosis and prediction and help reduce acute emergencies

From diagnosing skin cancer to transcribing clinician notes and automating hospital workflows, artificial intelligence and data analytics tools are enjoying a heyday in healthcare. The maturity and real-world implementation of advanced digital technologies comes at a welcome moment when healthcare systems are battling multiple concurrent challenges including ageing populations and the continual threat of infectious diseases, new and old.

296 million

Of the 296 million people with chronic hepatitis B infection, 116 million live in the Western Pacific and 18 million in Southeast Asia

In the Asia Pacific region, public health dynamics are especially daunting. Infectious diseases continue to take a heavy toll. Of the 296 million people with chronic hepatitis B infection, 116 million live in the Western Pacific and 18 million in Southeast Asia.¹ Nearly half of the world’s tuberculosis burden is in South-east Asia.² The continent is at the epicentre of the rise of antimicrobial resistance ³ and is vulnerable to climate change ⁴ and its attendant healthcare risks. At the same time, non-communicable disease (NCD) incidence is growing as populations age and lifestyles change. Nearly half (47%) of all deaths in Asia are attributable to NCDs.⁵ Advances in AI and data could, experts hope, help Asia Pacific’s health sectors confront these tidal threats.

Data governance, interoperability, regulatory evolution, and workforce engagement are just a few of the systems-level reforms needed to make full use of frontier digital technologies.

“AI is just a tool like all the mathematical models that we've been using in the past. The difference is that it can look at more data and have a different angle. Machine learning methods can be trained with beautiful accuracy,” says Dr Denis Bauer, bioinformatics team leader at Australia's national science agency, the Commonwealth Scientific and Industrial Research Organisation (CSIRO). But “we are still on that journey,” adds Dr Bauer, who is also associate professor at Macquarie University's Department of Biomedical Science. Data governance, interoperability, regulatory evolution, and workforce engagement are just a few of the systems-level reforms needed to make full use of frontier digital technologies.

Augmented intelligence

However, some experts are preferring to frame AI as offering “augmented” rather than artificial intelligence, like Kee Yuan Ngiam, who is group chief technology officer and deputy chief medical information officer at the National University of Health Systems in Singapore. “It acts as a clinician decision support tool to help treat patients,” he says. Deep learning and neural networks can, for instance, model disease progression and make predictions about patients at higher risk. “This could mean a doctor will be alerted to a patient coming into the clinic with an increased risk of breast cancer and would order a mammogram even when the patient is coming in for a completely different [clinical condition],” he says. “This is the dream that we want to achieve - without a clinician even having to click a button or put in new data.”

The CSIRO is applying AI to genomics to spot individuals at risk of heart failure or motor neuron disease, for instance, and for that they had to invent machine learning approaches that can handle high dimensional data. Dr Denis Bauer associate professor at Macquarie University's Department of Biomedical Science

Tim Shaw, professor of digital health and director of research in implementation science and the e-health group at the University of Sydney in Australia, envisions a bright future in which “clinicians have fingertip-touch access to information about their patient population, their outcomes, how they compare to peers and how care is managed.” That is still a far cry from current realities, though. “At the moment, clinicians are largely flying blind about the care they deliver and the outcomes. I think that's a big revolution we're going to have.”

Prediction is one of the most coveted capabilities that AI and data modelling offers. The CSIRO is applying AI to genomics to spot individuals at risk of heart failure or motor neuron disease, for instance, and for that they had to invent machine learning approaches that can handle high dimensional data, according to Dr Bauer ⁶. CSIRO also recently completed a trial of smart home sensors to detect changes in older people’s daily activities, helping enable them to remain living in their own homes for longer and for medical intervention in the case of a potential emergency⁷.

In the Singaporean context, Kee Yuan Ngiam thinks AI could provide continuous nudges and support for those with chronic conditions like hypertension to manage their condition through, for instance, timely reminders about medication and the need for blood pressure checks. Singapore’s government has “made a very deliberate investment into AI to ensure that we can leverage AI’s capability to help manage the increase or indeed reduce the incidence of chronic disease in the community”. A cost-benefit analysis makes investing in AI “one of the easiest choices for any government to make”.

While Singapore and Australia are leading markets, AI technologies are reaching patients in lower income geographies. In the Philippines, it has been used to interpret chest X-rays to aid diagnostics during the covid-19 pandemic. ⁸ In Vietnam, Vinbrain, an AI software company, has developed an AI model for diagnosing and screening TB.⁹

Cost control

By carrying out important but time-consuming tasks like diagnosis and prediction, AI and data science can reduce both the number of acute emergencies¹⁰, thereby lowering the burden on hospitals¹¹, which are a major driver of overall healthcare costs. Other such tools can optimise resource allocation, workflows, and scheduling, further improving the logistics of the hospital sector. ¹² “Every 15-minute block of time in an operating theatre costs thousands of dollars,” observes Kee Yuan Ngiam.

In Indonesia, there are less than 100,000 doctors for a population of 260 million, so they [the government] believe AI will increase productivity, Dr Hananiel Widjaja director and co-founder of Kortex Indonesia

Healthcare providers in Singapore are already using cutting-edge technology to optimise services based on population modelling. For instance, Tan Tock Seng Hospital has built an ‘artificial brain’ to assign and prioritise beds, crunching through over 300 rules. This frees up staff to focus on caregiving rather than manual processes and documentation.¹³ The newly built Woodlands Health Campus will apply automation, AI, and robotics to everything from diagnosis to logistical management of food, housekeeping, and equipment.¹⁴

less than

100,000

doctors for a population of 260 million

Tech-enabled efficiencies could be a boom to countries in the Asia Pacific region with over-burdened workforces. “In Indonesia, there are less than 100,000 doctors for a population of 260 million, so they [the government] believe AI will increase productivity,” says Dr Hananiel Widjaja, director and co-founder of Kortex Indonesia. The region has too few medical professionals for its vast population: 1.3 physicians per 1,000 people¹⁵, just within the WHO’s benchmark of 1.15 per 1000.¹⁶

Healthcare AI: a systems problem

While the proliferation of AI and data technologies in healthcare is a welcome trend, experts continually warn that progress is slow and uneven. The challenge, they argue, is that any individual gadget or tool must be embedded into a wider technological, economic, and cultural context.

AI and digital technology need to be aligned to the workforce. “Our challenge at the moment is that all of the fresh graduates in our hospital system need to be trained with AI and technology for six months, so they cannot handle the patients or work in the hospital before they do the training for that area,” says Dr Widjaja. Singapore is focusing heavily on training and certification programmes that integrate with medical degrees. “We teach students how to go through the entire process of building an AI tool including ethics, guidelines and regulations,” says Kee Yuan Ngiam.

Cost is a constraint, which could lead to deepening inequalities if countries cannot afford upfront investments in technologies. A poll by Hospital Management Asia revealed that only 12% - mainly healthcare executives - were using some sort of AI in their department, although 98% agreed that AI has the potential to transform healthcare and 90% would be open to using it. The reasons were mainly perceived costs (87%) and lack of infrastructure (66%) – whether their IT systems could support the technologies, or the availability of trained personnel to maintain and manage them.¹⁷

What covid has done, in my mind, is really exposed the weaknesses in these processes, forced us to actually need to share data to look at decision support across organisations and we suddenly realised that we really have some fundamental flaws Tim Shaw professor of digital health and director of research in implementation science and the e-health group at the University of Sydney in Australia

Efficient digital infrastructure - the plumbing allowing data to be gathered, moved, processed, and acted on - will unlock the potential AI has to offer in real world settings. “Amidst the digital revolution, what is missing is smart data integration and sharing for the right reason, at the right time will speed the impact of public policies and healthcare on the lives of people we serve,” says Dr Samira Asma, assistant director-general for data, analytics, and delivery for impact at the World Health Organisation.

Fragmented data systems became evident during the pandemic. According to Dr Bauer, large tracts of genomic data were collected during the covid-19 pandemic, but the vast majority had no patient information attached, reducing the potential of AI to be used.¹⁸ “What covid has done, in my mind, is really exposed the weaknesses in these processes, forced us to actually need to share data to look at decision support across organisations and we suddenly realised that we really have some fundamental flaws,” says Professor Shaw.

Of course, connectivity creates new risks. Hackers have already entered health infrastructures across multiple contexts and geographies, from the WannaCry attack on the NHS^19,20 to ransomware attacks in Singapore^21,22 and nefarious actors could seek to access personal health information for purposes including targeted marketing or blackmail.

Having clarity of the needs in countries and pairing solutions with trusted governance and equitable digital literacy is going to be crucially important. Dr Samira Asma assistant director-general for data, analytics, and delivery for impact at the World Health Organisation

But risks can be managed - and the benefits are worth the work. Professor Shaw warns against “sticking our heads in the sand and saying we're just not going to digitise because it's too hard, it's too risky. We would lose all the benefits. It would be like financial services saying we can't risk breaches of financial data and therefore we're going to go back to not having e-banking.”

Others acknowledge the challenge of balancing individual data protection with appropriate levels of openness and data-sharing. Dr Boonchai Kijsanayotin, chair of the Asia E-Health Information Network, describes “a delicate balance between how much we can [use in the] public good, and how much you protect for privacy. Data shared for marketing, for insurance, that is very dangerous for the individual. If we don't protect that individual privacy or confidentiality, then we cannot build or create attractive systems for sharing data.”

For Professor Shaw, the goal is “flexible consents and variable consent processes to allow people to access and use data.” For the WHO’s Dr Asma, scaling innovation in data and AI can accelerate progress to protect and improve health and save lives. “We are going at about a quarter of the pace to reach the Sustainable Development Goals by 2039.The key is to build sustainable systems. Having clarity of the needs in countries and pairing solutions with trusted governance and equitable digital literacy is going to be crucially important.”

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Seven key success factors for digital
transformation in healthcare

A surge of innovations is driving digital transformation in healthcare, with 81% of healthcare executives saying that digital transformation in their organization has accelerated in the wake of the COVID-19 pandemic [1]. However, technology is only part of the equation. For digital transformation in healthcare to move from isolated pockets of innovation to an integrated enterprise effort, it needs to address people, processes, and other factors as well as data and technology. Here are seven critical success factors that can make or break digital transformation in healthcare.

1. Designing digital health solutions for better human experiences

At its heart, digital transformation in healthcare is really about people, not technology. With digital health solutions, we can take the friction out of care experiences. That means healthcare professionals get to focus on what they do best, without getting bogged down in complexity and inefficiencies that are contributing to alarming rates of burnout. And it means consumers and patients get to take an active role in their health and wellbeing, with easy to use and intuitive tools that help them stay healthy and prevent disease to take the pressure off healthcare systems.

But as we know from the early days of electronic medical records, digital technology can also become a source of frustration if detracts from the patient-provider relationship. As one doctor lamented in the Scientific American: “we physicians entered the profession to connect with and help patients – not to stare at a screen.” [2] Similarly, patients may be reluctant to adopt digital health technology if it creates more hassle than convenience. Or their interest in using the technology may wane over time if it doesn’t add enough value, as we have seen with some first-generation fitness and health tracking wearables [3].

To ensure that digital transformation in healthcare is embraced by patients and healthcare professionals alike, it needs to be rooted in human-centered design. Co-creation sessions with patients and healthcare professionals can help to uncover their needs and pain points, and tools such as experience flows can help to understand the practical and emotional context in which digital technology is used. Equipped with such insights, we can develop solutions that truly improves people’s lives – whether it is through augmenting the skills of physicians to help them manage ever-increasing workloads, or by empowering patients and care providers to better manage chronic disease at home.

2. Bringing everyone on board through effective change management

As the scope of digital solutions expands – often impacting multiple stakeholders across departments – change management becomes increasingly critical to successful and sustained transformation.

For example, as healthcare providers seek to better orchestrate patient transitions from one care setting to the next, new digital innovations using predictive analytics can help to forecast and manage patient flow. This allows healthcare providers to manage patient transitions more effectively, and rapidly adapt to fluctuating patient demand.

But in tandem with the adoption of such technologies, senior leaders will also need to agree with clinical care teams on enterprise-wide KPIs that reflect patient flow across departments. This may represent a big cultural shift from previous, more siloed ways of working. In addition, implications for frontline staff need to be well thought through. Predictive insights should support physicians and nurses in their daily decisions and integrate into their workflows, without adding to existing information overload.

Only by involving all stakeholders from the start will such large-scale digital transformation in healthcare live up to its full potential.

3. Training staff to help them get the most out of digital technology

As digital transformation in healthcare takes hold, new skills will also be required to get the most out of burgeoning technologies such as AI, IoT, and virtual care. The Philips Future Health Index 2021 report revealed that 32% of healthcare leaders consider lack of training to fully utilize digital health technology a barrier to its adoption in their hospital or healthcare facility.

To keep pace with digital transformation in healthcare, national health systems must prioritize the latest developments in AI, data science, and digital health in their education curricula.

In addition, on-the-job training and guidance can help healthcare professionals raise their skill levels. One way of doing this is through real-time video collaboration, which enables remote education and on-demand support. For example, in minimally invasive image-guided therapy, virtual collaboration lets interventional physicians look over their peer’s shoulder via webcams mounted on the ceiling of the interventional room.

Similarly, hub-and-spoke models supported by virtual collaboration can help to make expert knowledge more widely available throughout a health network – with experienced specialists in a central hub remotely guiding their less experienced peers in satellite locations. Such models are already showing their value in radiology and ultrasound, where specialized staff may be in short supply, particularly in remote regions.

4. Taking an inclusive approach that leaves no patient behind

While the pandemic has demonstrated how digital transformation in healthcare can make a real difference to patients and providers alike, it has also shone a harsh light on long-standing disparities in access to quality care. To prevent a growing digital divide, digital transformation in healthcare should take an inclusive approach that promotes access to care for all – no matter where patients live.

Virtual collaboration between care providers is part of the answer because it can help to make specialist knowledge more widely available. Expanding telehealth options for patients can also lower the barrier to access. But given the fact that people in remote areas and low-income regions often lack access to robust internet, we need to be mindful that an increased reliance on digital technology can actually exacerbate existing health inequities. Differences in digital literacy can further compound this issue.

That means virtual innovations need to be accompanied by new physical access points – for example, in the form of virtual care stations that allow patients to connect with care providers through convenient neighborhood locations. In addition, digital patient engagement initiatives should cater for the needs and preferences of different patient groups. And when trying to reach underserved communities, healthcare leaders should work closely with local partners and stakeholders to understand how they can best serve patients and design solutions accordingly.

5. Adopting cloud-based platforms for data access anytime, anywhere

Data is the lifeblood of digital transformation in healthcare. But today, it is often locked away in different systems and devices that don’t speak to each other. The result is a patchwork of point solutions. In our Future Health Index 2021 report, healthcare leaders cited difficulties with data management (44%) and lack of interoperability and data standards (37%) as the biggest barriers to adoption of digital health technology in their hospital or healthcare facility.

As healthcare becomes increasingly distributed, extending from the hospital into the home and local communities, having an end-to-end data strategy that spans the entire patient journey will become even more important. What’s needed for digital transformation in healthcare are digital platforms that enable the fast and secure exchange of data across settings, offering a comprehensive view of the patient wherever they are being diagnosed, treated, or monitored.

During the COVID-19 pandemic, healthcare providers have experienced firsthand how cloud-based solutions provide flexibility, scalability, and speed – both in adopting new innovations and in adjusting resources to meet fluctuating demand. In 2022, 66% of healthcare executives expect to move their technology infrastructures to the cloud – a number that is set to rise to 96% two years from now [4].

At Philips, we’re enabling this transition with Philips HealthSuite: an open, secure, cloud-based platform that collects, compiles, and analyzes clinical and other data from a wide range of devices and sources. Through a combination of AI and deep clinical knowledge, we can then translate those data into insights at scale that support healthcare professionals at the point of care.

6. Building digital trust by safeguarding data privacy and security

Because health data is among the most sensitive personal information, trust is paramount for digital transformation in healthcare. When asked what would keep consumers from using digital devices for healthcare, 41% ranked “concerns about my privacy or data security” as the number one barrier [5]. Similarly, for healthcare CIOs tasked with keeping patient data safe across a growing plethora of channels and devices, data security is as big a concern as ever [6].

More than ever, cybersecurity requires a systematic approach that considers where and how devices are used. At Philips, we take an end-to-end ‘Security Designed in’ mindset that puts security considerations front and center all the way from product design and development to testing and deployment – backed by robust policies and procedures for monitoring, effective updates, and where necessary, incident response management.

Similarly, we are committed to responsible data stewardship through ‘privacy by design’. This approach aims to embed privacy and data protection controls throughout the entire data lifecycle, from the early design stage to deployment, collection, use and ultimate data disposition and disposal. By being transparent about how we deal with personal data, we can help foster the trust needed for further digital transformation in healthcare.

7. Joining forces through strategic partnerships and ecosystem collaboration

As digital transformation in healthcare picks up speed, healthcare leaders recognize the need to forge long-term strategic partnerships with healthcare informatics companies that can help develop and implement a roadmap to digital maturity. According to our Future Health Index 2021 report, 41% of them believe their hospital or healthcare facility needs to prioritize strategic partnerships to successfully implement digital health technologies.

But no single partner will be able to “do it all”. Healthcare is too complex for that. Instead, the future of digital healthcare will be built in collaborative ecosystems, with solutions from multiple vendors working in concert on open and interoperable platforms.

For example, in radiology, this can take the form of software marketplaces. With the rise of AI, there’s a plethora of apps coming from start-ups and universities. However, hospitals may find it hard to put these apps to use if they lack a common underlying platform that is integrated with their workflow at the point of care. A curated software marketplace allows radiologists to download validated apps from third-party developers via one common platform – without having to worry about point-to-point integrations. It will then be the role of healthcare solution providers like Philips to ensure that such apps run seamlessly on the consoles and mobile devices used by hospital staff.

By combining the strengths of technologies from different vendors, in a way that is easy to access and implement for healthcare providers, we can further accelerate innovation and deliver on the full promise of digital transformation in healthcare.

Download our position paper on digital transformation in healthcare.

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Staff burnout in healthcare is growing. Can AI help ease the burden?

After a prolonged battle with the COVID-19 pandemic, healthcare providers now face the next crisis that has been brewing even longer: staff shortages and an increasingly exhausted workforce. Early 2022, almost one in two (47%) healthcare professionals reported feeling burned out, up from 42% last year.¹ Many consider leaving the field, adding to the worries of employers who see growing demand for care without enough hands at the bedside to cater for their patients.² Can AI be part of the solution by helping healthcare professionals reclaim the joy in their work?

The signs of a pending burnout crisis were already there before COVID-19 wreaked havoc with health systems worldwide. And the causes run deeper than the stress inflicted by the pandemic. In many ways, the past two years have magnified what was ailing healthcare professionals all along: the draining repetitiveness of routine tasks, a growing deluge of data that leaves them scrambling for relevant insights, and widespread frustration about workflow inefficiencies that get in the way of attending to patients. As one physician expressed in the 2022 Medscape Physician Burnout and Depression survey: "Where’s the relationships with patients that used to make this worthwhile?"³.

Healthcare providers face exodus of staff

It should come as no surprise, then, that healthcare has been among the top three industries impacted by the Great Resignation, with many healthcare professionals quitting their positions to find improved work-life balance⁴. And for healthcare organizations facing increased turnover, the worst may be yet to come. According to a new study by the American Medical Association, one in five physicians and two in five nurses intend to leave their current practice within the next two years⁵.

As a result, staff shortages are now the number one concern keeping American hospital executives up at night⁶. Other countries around the world – from the UK and Germany to Singapore and Australia – are seeing a similar exodus of healthcare professionals, fueling fears about the potential impact on quality of care^7-10.

Simplifying workflows through AI-based automation

What we’re witnessing is an increased urgency to liberate healthcare professionals from the strain of tedious and repetitive tasks, so that they can focus on what drew them to medicine in the first place: caring for patients. It’s exactly what AI can help to make possible. By shifting the burden of tedious manual work from human to machine, AI allows healthcare professionals to apply their time and energy to the patient rather than to cumbersome processes.

Take medical imaging technologists, for example. Ranked #2 by hospital CEOs as the profession that is seeing the largest shortage of qualified staff¹¹, technologists have the daily challenge of achieving best-quality, first-time-right scans, with high workloads being the #1 contributor to job-related stress¹². Patients are often anxious, too, which adds to the pressure on technologists to get the exam done effectively. Variability in training and experience levels of staff can further impact outcomes.

By automating many of the time-consuming tasks that technologists traditionally had to perform manually, we can free up their focus to interact with the patient, while improving consistency of results at the same time. Research shows that imaging staff welcome such support from technology – they believe that almost a quarter (23%) of their work is inefficient and could be automated¹³.

Getting the patient in the right position for an exam is a case in point. In an imaging modality like CT, patient mispositioning is a common challenge, with unwanted consequences such as increased radiation dose to the patient or image noise¹⁴. That’s where new AI-enabled camera technology can make a difference. Mounted on the ceiling above the patient table, the camera uses algorithms that can automatically detect anatomical landmarks in the patient, supporting fast, accurate and consistent patient positioning.

Smart and touchless patient sensing technology is also saving technologists manual work in MR imaging, where it can automatically monitor a patient’s breathing – allowing the setup of routine MR exams to occur in less than a minute¹⁵, even for less experienced operators, while helping them keep a caring eye on the patient. In addition, smart AI-enabled systems can suggest the most appropriate protocol for each MR exam, as well as automate exam planning, scanning, and processing.

Thanks to such AI-based automation, technologists have to worry less about equipment settings and can dedicate more attention to the patient, making their work less stressful and more rewarding.

Providing relevant insights at scale at the point of care

In the face of growing information overload, AI can also ease the burden on healthcare professionals by supporting them with relevant insights at the point of care.

For example, one of the biggest challenges facing critical care teams in intensive care units (ICUs) is the sheer volume of data collected on every patient. Each patient in the ICU may generate up to thousands of data points per day, leaving physicians and nurses feeling overwhelmed as they struggle to separate signal from noise¹⁶.

Using predictive analytics, we can help critical care teams cut through the clutter by alerting them to relevant trends in patient data that call for urgent intervention, or which may indicate that a patient is ready to be transferred to a lower-acuity setting. The physician or nurse remains in control of all decisions. But with the support of AI, they may be able to make these decisions more easily.

In the future, AI-enabled patient monitoring solutions will increasingly be extended from the hospital into the home, allowing healthcare providers to keep a caring eye on patients and thereby prevent avoidable hospital (re)admissions. This could alleviate some of the pressure on overstretched emergency and critical care teams, while also giving patients greater peace of mind in the comfort of their homes.

The need for human-centered AI

Of course, technology can only be one part of effective staff retention and burnout mitigation strategies. But as these and other examples demonstrate, AI could go a long way towards enhancing the human experience in healthcare – both by improving workflow efficiencies and by augmenting clinical expertise.

Most importantly, to curb burnout and revive the joy in medicine, we need to ask how we can develop digital tools that support the patient-provider relationship rather than get in the way of it. Studies have consistently shown that lack of workflow integration is one of the main barriers to wider adoption of AI in healthcare, pointing to a need for human-centered design.

By putting people front and center, we can develop AI-based solutions that act as an unobtrusive assistant, supporting healthcare professionals at a time when they are under more pressure than ever before. Because if there’s one truth that the growing staffing and burnout crisis in healthcare is bringing to the fore, it’s that there is no healthcare without healthy and engaged healthcare professionals.

https://www.medscape.com/viewarticle/966996
https://www.sciencedirect.com/science/article/pii/S2542454821001260
https://www.medscape.com/viewarticle/966996
https://www.bls.gov/news.release/jolts.nr0.htm
https://www.sciencedirect.com/science/article/pii/S2542454821001260
https://healthexec.com/topics/healthcare-administration/hospital-ceos-workforce-shortages-challenging
https://www.theguardian.com/society/2022/feb/26/stressed-nhs-staff-quit-at-record-rate-of-400-a-week-fuelling-fears-over-care-quality
https://www.iamexpat.de/career/employment-news/germanys-shortage-nursing-staff-continues-worsen
https://www.smh.com.au/national/pandemic-triggers-mass-exodus-of-critical-care-nurses-20211116-p5998i.html
https://www.straitstimes.com/singapore/politics/more-healthcare-workers-in-spore-resigning-amid-growing-fatigue-as-covid-19-drags
https://healthexec.com/topics/healthcare-administration/hospital-ceos-workforce-shortages-challenging
https://www.usa.philips.com/healthcare/medical-specialties/radiology/improving-radiology-staff-and-patient-experience/staff-research
https://www.usa.philips.com/healthcare/medical-specialties/radiology/improving-radiology-staff-and-patient-experience/staff-research
Habibzadeh MA, Ay MR, Asl AR, Ghadiri H, Zaidi H. Impact of miscentering on patient dose and image noise in x-ray CT imaging: phantom and clinical studies. Phys Med. 2012;28(3):191-199. http://doi:10.1016/j.ejmp.2011.06.002
Based on in-house testing. Results may vary.
https://hbr.org/2018/03/how-mayo-clinic-is-combating-information-overload-in-critical-care-units

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The digital innovation wave is coming to the Asia Pacific Region

Virtual care and wearables are paving the way, but where do hospitals stand - and is the workforce ready?

Like many sectors, healthcare has been undergoing a period of rapid transformation. Advances in data and technology, new consumer needs, shifting demographics and the pandemic have meant that the world is turning to digital solutions and remote care now more than ever. Healthcare providers are assessing the role of options such as wearables, digital diagnostics, digital therapies, remote monitoring and telemedicine. Digital health is on the rise, and it seems that much of the Asia Pacific Region may be ready to embrace it - the value of digital health in Asia was $37 billion in 2020, and is estimated to reach $100 billion by 2025.¹ With this recent push to accelerate greater integration of technology into health, it is crucial to understand the future role of physical hospitals in the broader healthcare ecosystem.

A virtual revolution?

Asia seems keen on digital technology. In a 2019 survey, 78% of respondents from Asian countries said they were willing to use digital healthcare, compared with 66% globally² , so it was not surprising that when the pandemic hit telemedicine apps in many markets saw enormous spikes in demand. Health technology companies headquartered in the region and offering this service saw the number of active users rise substantially in March 2020 compared to 2019^3,⁴. The pandemic also saw many markets establish “virtual hospital wards”, a hospitalisation-at-home system where wearable devices were used to monitor patients’ vital signs (e.g. blood oxygen levels, temperature and pulse), and telehealth was used to oversee therapy. At Singapore’s National University Health System (NUHS), these virtual wards saved patients ill with covid-19 more than five thousand overnight stays in the hospital⁵, therefore bringing in huge cost-savings. “I think covid actually helped a lot in that change management, for people to be more open to remote delivery of services in general,” says Benedict Tan, Group Chief Digital Strategy Officer & Chief Data Officer for Singapore Health Services. “I think the challenge now is how to keep up with this momentum - we may have to re-examine the whole end-to-end experience, improve it, enhance it, make it seamless, and make it much easier for doctors to engage and continue with virtual and remote care.”

I think the challenge now is how to keep up with this momentum - we may have to re-examine the whole end-to-end experience, improve it, enhance it, make it seamless, and make it much easier for doctors to engage and continue with virtual and remote care. Benedict Tan Group Chief Digital Strategy Officer & Chief Data Officer for Singapore Health Services

Some health systems have started to incorporate a hybrid model, bringing together the best of telehealth and in-person treatment, to try to deliver the same clinical outcomes with a better patient and staff experience. This is being implemented in Indonesia for example, according to Dr Ben Widaja, President Director of Mandaya Hospital Group in Jakarta. “We have our own mobile application where patients can book their appointment and have a tele-consultation. But we also give the opportunity for patients to speak with our nurses or our administration staff after their consultation to really answer their questions or address any worries, to provide that personalised care even if they are not within the hospital itself.” Virtual care has also been shown to make healthcare more efficient, with telehealth solutions saving costs for both doctors and patients by optimising clinical procedures and reducing travel expenses to hospitals.⁶ Digital tools should be seen as complementary to face-to-face care, as a way to enhance it. Dr Louise Schaper, CEO of the Australasian Institute of Digital Health, views productivity as one of the strongest benefits: “If we enable healthcare through the appropriate digital means and manage information better, we can actually spend more time with patients, making those connections and really understanding them, because we're not wasting 30% of our shift on the hospital ward looking for information that really should be readily available.”

We have our own mobile application where patients can book their appointment and have a tele-consultation. But we also give the opportunity for patients to speak with our nurses or our administration staff after their consultation to really answer their questions or address any worries, to provide that personalised care even if they are not within the hospital itself. Dr Ben Widaja President Director of Mandaya Hospital Group in Jakarta

Delivering the digital

1.5 per 1,000

Countries in Asia Pacific have some of the lowest densities of skilled health professionals in the world, with an average of 1.5 per 1,000 population across the region compared to the OECD average of 3.4.

Countries in Asia Pacific have some of the lowest densities of skilled health professionals in the world, with an average of 1.5 per 1,000 population across the region compared to the OECD average of 3.4.⁷ And not only is the workforce shrinking due to an ageing population, low fertility rates and migration of health professionals from low- to high-income countries⁸ , it also needs to adapt to new digital technology and better understanding of data in day-to-day work. Technology has also been identified as potentially addressing the lack of skilled health professionals⁹ , but at the same time there is growing evidence of digital literacy and skills shortages among this group¹⁰ - a classic chicken and egg scenario.

It is crucial therefore to find new ways to support healthcare workers. One option could be to view the workforce in broader terms, and include those who can support digital literacy. “Health professionals already have an incredible knowledge and skill base that we need to make sure we don't lose,” says Kylie Woolcock, Chief Executive of the Australian Healthcare and Hospitals Association. “And so sometimes it may be about having another workforce that sits around them and supports them to use these technologies. Some of them will need to sit within our clinical workforce but I think there is a lot of potential for other roles that can support our [healthcare professionals] to do what they do best.”

But digital literacy is not the only focus. Kwang Cheak Tan, CEO of the Agency for Integrated Care (AIC) in Singapore thinks that technology should be leveraged to improve the quality of care and productivity, and also to support the transformation of the models of care going forward. “At the organisational level, it's important to support our partners and our service providers to recognise the potential of digitalisation and how it can be incorporated as part of their overall business strategy in delivering healthcare and social care services. This requires not just understanding the digital technology, but also how it can be used in processes and care models, and how it can be optimised for the care of our clients and seniors in the future.”

Education is another crucial way to ensure relevant skills and knowledge are acquired. “Whether it is the existing workforce, those already working, or the future workforce, there must be programmes to train them,” says Fabian Bigar, former undersecretary in the Malaysian Ministry of Health and now CEO of MyDigital, a government initiative to transform Malaysia into a regional pioneer in the digital economy. “The medical universities have already introduced courses such as data analytics in healthcare into undergraduate and graduate programmes, it's already happening. But of course, I do want to see more,” he adds. Ms Woolcock agrees, “I think there's strong awareness that there is a need for this and I think the way that our education is structured it is still relatively profession siloed. The potential though is to embed [digital skills] within programmes, and that will increasingly happen as courses are rolled out.” But of course it's not all about the learning, as Dr Schaper points out: “To make use of the digital tools and virtual solutions, we don't just need to train people about how to use pieces of technology, it's a cultural shift, we really have to redesign how we think about healthcare service delivery.”

To make use of the digital tools and virtual solutions, we don't just need to train people about how to use pieces of technology, it's a cultural shift, we really have to redesign how we think about healthcare service delivery. Dr Louise Schaper CEO of the Australasian Institute of Digital Health

From the hospital to the home

This redesign is being seen throughout the healthcare sector; not only in its people, but also in its facilities and infrastructure. Hospitals have traditionally been the centres of healthcare delivery, but we know that new technologies and innovations have altered consumer expectations, which are moving away from viewing hospitals as a ‘one-place-serves-all’. Dr Zubin Daruwalla, Health Industries Leader at PwC Singapore believes that patients are key to this redesign. “The healthcare sector and all its stakeholders as a whole need to see a mindset shift towards patient centricity and towards embracing the power of consumerism.” he says. “We need to provide our patients (the consumers) the experience and convenience that they're getting from all other industries such as the ease or seamlessness of shopping or booking their flights and hotel accommodations online. Consumer behaviour and expectations are changing, and the industry needs to address this, to figure out what patients or consumers want today, and build and function our hospitals and clinics to address that.” This change in consumer behaviour has particularly been seen in the Philippines, where a large market research study found that hospital outpatient and inpatient numbers have completely changed. Dr Harish Pillai, Chief Executive Officer at Metro Pacific Hospital Holdings in the Philippines has seen this firsthand. “People have realised during the covid lockdowns that you don't necessarily have to go to a hospital for your mild issues. You have a tele-consultation, you can use e-pharmacy platforms or diagnostic platforms and make use of all services in the comfort and security of your home.”

Consumer behaviour and expectations are changing, and the industry needs to address this, to figure out what patients or consumers want today, and build and function our hospitals and clinics to address that. Dr Zubin Daruwalla Health Industries Leader at PwC Singapore

Keeping people out of hospitals can have huge cost-saving implications, as well as health implications. On average, OECD countries spend 28% of total health expenditure on hospital inpatient care but hospital resources are used more than is clinically necessary. For instance, the data suggests unnecessary hospital stays in Asia: patients admitted to hospitals in Japan or Korea spend on average 15 days, three times higher compared to less than five days in Denmark, Turkey and Mexico.¹¹ And according to the World Health Organization, seven out of every 100 patients who are hospitalised develop a healthcare-related infection each year, even in developed countries.¹² Opportunities may therefore exist for countries in the Asia Pacific region to embrace a new approach to healthcare delivery, by transitioning care outside of hospitals.¹³ “As you look at leveraging technology, you can look beyond delivering services inside the four walls of a facility, and begin to connect to the community to deliver services and provide training out in the field,” says Shez Partovi, Chief Innovation & Strategy Officer at Royal Philips. “What I think we will start to see is the combination of all these technologies, where the things that occur in person and require large equipment in a facility will become more decentralised, and begin moving more to the home. It's really this idea of enabling care at a distance that carries both diagnostic and therapeutic advantages,and how digital can tie this all together, allowing patients to receive optimal care where it's best for them. Not always in a hospital, but possibly coordinated and orchestrated by hospitals.”

The landscape is changing rapidly and a hybrid model may be the way forward. Dr Daruwalla sums it up: “Telemedicine services, brick and mortar services and physical care in the community and home. Any provider looking to be future ready is going to have to provide all three.”

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Creating climate-friendly health systems in Asia Pacific: a multifaceted problem

Healthcare must upgrade both its physical and digital infrastructure in order to reduce carbon emissions

Both climate change and healthcare have been dominating headlines over the last few years, but they usually only appear side-by-side in relation to the dire effects of increasingly severe weather, like wildfires and heatwaves, on health outcomes. The role the healthcare sector plays in causing or combating global warming remains relatively under-explored. So too is the role that digitalisation could play in the sector’s adaptation and mitigation measures.

A few initiatives are attempting to bridge the first gap, most notably the COP26 Health Programme, a group of nations convened by the World Health Organisation that aims to embed climate considerations into healthcare systems¹. Although the programme lists 60 countries on its membership roster², only nine are in Asia Pacific—and these are mostly small economies in South Asia.

This leaves the vast majority of healthcare emissions in the region unaccounted for. This is an alarming condition for a sector which is responsible for almost 5% of global emissions³.

Half of the world’s population, many of whom live in the Asia Pacific region, lacks access to quality health care. Digital solutions may hold the key to extending health care access to communities in need while reducing our carbon footprint and minimizing the impact on the environment. Robert Metzke global head of sustainability, Philips

“Half of the world’s population, many of whom live in the Asia Pacific region, lacks access to quality health care. Digital solutions may hold the key to extending health care access to communities in need while reducing our carbon footprint and minimizing the impact on the environment” says Robert Metzke, global head of sustainability at health technology company Philips.

Scoping out the problem

Tackling this challenge requires understanding the various sources of emissions, or “scopes”, which fall broadly into three categories. Scope 1 emissions encompass those caused directly by healthcare facilities and equipment—fuelling ambulances with petrol, burning kerosene to keep the power humming at rural hospitals and so on. Scope 2 emissions emerge through the consumption of electricity, gas for heating and other indirect forms of energy. Finally, scope 3 emissions represent everything else: carbon dioxide produced from the various activities that surround the sector, from manufacture of medical supplies to disposal of drugs and supplies.

Tackling this challenge requires understanding the various sources of emissions, or “scopes”, which fall broadly into three categories.

This huge diversity of emissions sources makes it hard for healthcare decision-makers to know where to begin. Even agreement on unified standards to report and publish emissions data remains elusive. Some progress is occurring in the region—corporate greenhouse gas reporting platform CDP says that Asia comprises nearly 30% of its set of global responses⁴—and regulators are considering forcing some sectors to disclose their carbon footprint⁵. Still, experts agree more needs to be done, especially in healthcare.

“You can’t manage what you don’t measure,” says Dr Renard Siew, Climate Reality Leader for the Climate Reality Project, and Climate Change Adviser at the Centre for Governance and Political Studies. “Asia Pacific healthcare sector leaders really [need to] step up to the plate to improve maturity of carbon reporting.”

You can’t manage what you don’t measure. Dr Renard Siew Climate Reality Leader for the Climate Reality Project, and Climate Change Adviser at the Centre for Governance and Political Studies

Health Care Without Harm, a group pushing for healthcare decarbonisation, has laid out a roadmap for the sector, starting with transitioning to renewables like wind and solar to power operations⁶. This may be more difficult than it seems: healthcare organisations are relatively constrained when it comes to where they get their energy from, typically needing to plug into local grids like everyone else.

Where they can affect change, however, is at the policy level: Dr Renzo Guinto, chief planetary health specialist at Sunway Centre for Planetary Health, Malaysia and director of the Planetary and Global Health Program at St. Luke’s Medical Centre in the Philippines, says that the weight of the sector in political circles gives them leverage over questions of energy investment and the shift to greener forms of generation across the broader economy. “The healthcare system does not have full control over the electric grid, but it certainly does have power,” he says.

A thorough accounting of greenhouse gases may uncover emissions from unexpected corners of the healthcare landscape. Dr Guinto notes that executives in hospitals around the world are examining how to reduce the impact of gases that anaesthetise patients during surgery, which, when vented into the atmosphere, can cause significant warming. With Asian healthcare systems poised to boost their use of such gases more rapidly than elsewhere, according to forecasts^7,8, this slice of the market may come under greater scrutiny.

A thorough accounting of greenhouse gases may uncover emissions from unexpected corners of the healthcare landscape.

Dr Siew says that more mundane tweaks like renovating facilities to meet stricter energy efficiency standards can make a big difference. Health officials are taking note: in 2021 the US Green Building Council awarded Malaysia’s Ministry of Health a Leadership Award for the green retrofit of a major hospital⁹.

But Dr Siew notes these kinds of upgrades are not mandatory in most places and that more must be done. “This is an area we have to push for, because I think it would result in huge emissions reductions directly from hospitals,” he says.

Can digital health save the planet?

The rapid adoption of digital technology in healthcare could help forge creative solutions to the decarbonisation puzzle. Asia Pacific is embracing this trend wholeheartedly: one 2021 survey found that 65% of hospitals in the region are boosting their investment in digitisation¹⁰, while McKinsey declared that “Asia is paving the way for digital health ecosystems¹¹”.

Dr Guinto notes that digital solutions like telemedicine can help patients in far-flung parts of the Philippines, his home country of many islands, access care over computers or smartphones without needing to step inside a fuel-burning car or other vehicle. This form of carbon-light provision of healthcare services to those who might struggle to find care otherwise can also boost resilience against climate disasters like typhoons, which are likely to grow fiercer in a warmer world¹².

“In this way, digital health is not only contributing to mitigation; it also can be a climate adaptation response of the health sector as well,” he says.

Mr Metzke agrees, noting that digital technology can help to optimise the patient’s “journey” through their care pathway, reducing resource and energy needs, both on the client and caregiver side.

In this way, digital health is not only contributing to mitigation; it also can be a climate adaptation response of the health sector as well. Dr Renzo Guinto chief planetary health specialist at Sunway Centre for Planetary Health, Malaysia and director of the Planetary and Global Health Program at St. Luke’s Medical Centre in the Philippines

“If you can treat patients outside of hospitals, which are very energy intensive, and help them to recover in their home with the appropriate level of monitoring so that you can intervene or get them back if needed—this can have a significant impact on your environmental footprint,” he says.

The relative lack of “hard” healthcare infrastructure in Asia Pacific compared with the West gives the region an opportunity to leapfrog in terms of digitisation, says Mr Metzke, in a way that can also lessen the burden on the planet. With nearly half of the population in the Asia Pacific region lacking adequate internet access¹³, the benefit of digitization extends beyond climate change and health equity and into broader societal benefits such as education and economic inclusion.

The relative lack of “hard” healthcare infrastructure in Asia Pacific compared with the West gives the region an opportunity to leapfrog in terms of digitisation. Robert Metzkeglobal head of sustainability, Philips

Bridging digitization gaps can unlock a variety of innovative ways to decrease carbon emissions, but it will not solve the problem on its own. Only a concerted effort between healthcare executives, care providers, policymakers, the general public and other stakeholders can truly tackle a problem this large and thorny. Dr Guinto, for one, is optimistic that the next generation of healthcare leaders will take the initiative to accelerate progress.

“There is a huge paradigm shift that is happening in healthcare, and it’s the young people that are igniting and advancing this course,” he says. “That’s definitely an important source of hope.”

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How technology can improve the patient healthcare experience

While we’re a long way from robots running human health services, the internet of things (IoT) has the capability to transform the patient healthcare experience experience – for good. The new post-COVID reality presents an ideal opportunity for healthcare services to implement technology in a way that places patients front and centre of their health journeys.

Great strides have been made, but there is still room for improvement. As KPMG’s Connected Health: The new reality for healthcare survey (1) discovered, 80% of healthcare leaders listed a customer-centric strategy as a high priority, but only 10% believed they were consistently exceeding patient expectations. Furthermore, digital barriers, such as difficulties sharing patient data and analytics, were cited as the most significant gaps.

Connections improve the patient healthcare experience

By enabling devices and systems to connect and share data, the IoT facilitates a 360-degree view of a patient’s health, allowing clinicians to make faster decisions. The ability of technologies such as artificial intelligence (AI) and machine learning to derive insights from data offers significant potential for improving patient care.

From preventative health to critical care services, these tools can facilitate a seamless, patient-centred health experience across the care continuum and support the healthcare industry’s transition to a value-based care model.

How technology supports the patient healthcare experience

While its name may imply otherwise, the IoT’s real power lies in its ability to help people. There are few, if any, places where this is more evident than in healthcare.

For patients, healthcare technologies allow people to enjoy greater access to quality healthcare services delivered in alignment with their needs and preferences.

Healthcare technology allows patients to:

receive care in their environment of choice (such as home) at a convenient time
undergo remote monitoring to support preventative care and provision of timely interventions
benefit from a continuous and collaborative care approach as key data is gathered, analysed and shared between practitioners
benefit from receiving personalised health insights and coaching through connected health devices.

The West Moreton MeCare initiative offers a good example. In this program – a partnership between Philips and West Moreton Health in Queensland – patients living with challenging health conditions use remote monitoring to measure and record health targets (such as blood pressure) and speak with a nurse each day, all from the comfort of home. This gave patients greater control over their health and facilitate early intervention from practitioners (such as GPs or nurses) when needed. This patient-centred approach saw a 35% drop in potentially preventable hospitalisations, while patients reported improved confidence and mental health.

The flexibility of this care delivery model allowed West Moreton Health to scale the program to support COVID-19 patients recovering at home, reducing demand for hospital services and mitigating the risk of spread. As of August 2021, the program has expanded to include mental health virtual care for patients with borderline personality disorder.

On the other side of Australia, Philips is partnering with East Metropolitan Health Service in Western Australia to deliver a care model designed to enhance the patient experience and improve health outcomes, while lowering care costs and improving the work life of care providers. Based at Royal Perth Hospital, the Clinical Command Centre solution oversees inpatients in step down units and higher acuity wards. It uses machine learning and predictive analytics to predict patient deterioration and prioritise patients most in need of intervention, helping to reduce length of stay, complications, avoidable transfers, and mortality.

Studies have shown this technology leads to improved patient experience and outcomes including:

26% reduction in mortality (2)
30% reduction in length of stay (3)
15% of patients being discharged home faster (4)

How technology assists clinicians and healthcare leaders

For clinicians, the IoT enables real-time and longitudinal data capturing, along with integration of data from various medical devices. AI and machine learning can transform this data into useful insights which, when combined with clinical knowledge, facilitate decision makingn.

Technology can also offer insights into operational performance and identify issues before they escalate, allowing healthcare providers to optimise workflows, continuity of care, and cost efficiency.

For healthcare leaders and policy makers, technology can connect health networks and provide insights that foster evidence-based and data-driven strategy and policy making. For example, data analysis can identify the need for increased investment or resources across different communities.

Making digital healthcare mainstream

Digital transformation is top of mind for many healthcare leaders as they seek to build resilient and future-proof healthcare systems. According to Accenture’s Digital Health Technology Vision 2021 report (5), technology is driving an “accelerated exponential transformation” that is reshaping industries and the human experience. They urge the healthcare industry to become skillful at change and “recognize there is no leadership without technology leadership”.

As KPMG note (6), successful digital transformation requires several critical capabilities including responsive supply chains and operations, digitally-enabled technology architecture, and an integrated partner and alliance ecosystem.

Philips Virtual Care solutions enhance patient experience in healthcare by offering the right care, in the right place, and at the right time,

Australia has the technology and capabilities to enable a digital healthcare future. Our health system can take a leading role in overcoming barriers and turning pockets of digital innovation into a sustained and integrated scheme.

This can be assisted by:

implementing public policies such as access to healthcare innovation grants and improved practitioner training and education
prioritising investment in healthcare technology solutions
enhancing patient onboarding and immersion in digital health
fostering partnerships to supercharge innovation.

At Philips, we believe the future of digital health will be built in collaborative ecosystems, centered around people and driven by partnerships.

Patient experience at the heart of healthcare innovation

As partnerships coalesce into networks and new technologies are increasingly integrated into healthcare, patients can expect a fundamental shift in the healthcare experience. Technologies such as remote monitoring will facilitate an enhanced experience by enabling patients to receive care at a time and place that suits them, while fostering better outcomes through early recognition of warning signs and faster access to interventions.

Meanwhile, emerging technologies like AI and machine learning will support the practitioner experience. Their ability to transform raw data into actionable insights can help practitioners make informed health decisions and therefore deliver informed treatments, leading to better health outcomes.

Increased investment and stakeholder engagement can ensure Australia’s healthcare potential is realised, and the future of care delivers the outcomes both patients and practitioners seek. At Philips, we’re committed to developing solutions that improve the patient experience and give healthcare providers access to critical insights to guide clinical decision making.

https://assets.kpmg/content/dam/kpmg/au/pdf/2020/connected-health-the-new-reality-for-healthcare-au.pdf
Lilly CM, et al. A Multi-center Study of ICU Telemedicine Reengineering of Adult Critical Care. CHEST. 2014; 145(3): 500-7.
Lilly CM, et al. Hospital Mortality, Length of Stay and Preventable Complications Among Critically Ill Patients Before and After Tele-ICU Reengineering of Critical Care Processes. JAMA. June 2011; 305(21) 2175-83.
Impact of an Intensive Care Unit Telemedicine Program on a Rural Health Care System. Zawada, et al. Postgrad Med J, 2009; 121(3):160-170.
https://www.accenture.com/_acnmedia/PDF-156/Accenture-Digital-Health-Tech-Vision-2021.pdf
https://assets.kpmg/content/dam/kpmg/au/pdf/2020/connected-health-the-new-reality-for-healthcare-au.pdf

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Three ways digital transformation is accelerating the shift to preventive care

Amid a global pandemic, health systems are under more pressure than ever before. Hospital waiting lists have never been so long, with six million patients awaiting treatments in the UK [1], queues of 75 people awaiting each hospital bed in India [2], and similar backlogs being seen elsewhere around the world. The question is: how can today’s health systems relieve all this pressure, at scale, for good? Is a shift towards preventative care the answer?

According to a recent study by the World Economic Forum [3], the global economic impact of the five leading chronic diseases – which includes cancer, diabetes, mental illness, heart disease and respiratory disease – could reach US$47 trillion over the next 20 years. At the same time, the World Health Organization predicts that the global deficit of skilled healthcare professionals will reach 18 million by 2030 [4].

Clearly, even without the added chaos that a global pandemic brings, the burden of chronic disease – which also carries long-lasting impacts for patients’ social and psychological wellbeing as well as their physical wellbeing – will soon be too much for our health systems to handle.

All of this is why many healthcare organizations are now transitioning away from a model of intervention towards one of prevention: a model where resources are dedicated to detecting and forestalling medical issues before they have a chance to cause symptoms, develop into chronic diseases or trigger life-threatening events. For many parties across the healthcare ecosystem, from healthcare professionals to tech players and government bodies, the hope is that a preventive care model will be the solution to lifting the burden of chronic disease on our health systems, and ultimately, to delivering higher-value care that’s focused on enabling the healthiest outcomes.

Preventive care: three real-world examples

The concept of preventive care isn’t new – annual check-ups and immunizations are two examples of how preventive care has already been embraced for decades. But within the last few years, the digital transformation of healthcare has led to groundbreaking innovations that are rapidly accelerating the shift towards preventive care at scale. Here are three powerful examples:

1. Predictive analytics

Driven by the rise of Artificial Intelligence (AI) and the Internet of Things (IoT), many healthcare organizations now have algorithms at their disposal that can be fed historical as well as real-time data on their patients, so they can make meaningful, timely predictions about potential outcomes and treatment options. In many cases, these insights can inform decisions on both a cohort and population level.

For example, in cardiology, integrated diagnostics platforms enhanced with predictive analytics are now giving cardiology care teams the power to anticipate outcomes with greater accuracy, make faster clinical decisions, and (thanks to those insights) assign more effective treatment pathways to their patients, lowering the risk of unexpected events and interventions down the line.

2. Remote patient monitoring

Remote patient monitoring refers to a wide range of solutions that allow care teams to assess and sometimes even treat patients outside of conventional clinical settings, for more controlled management of chronic conditions, greater oversight over patients between visits, and fewer hospital readmissions.

For example, remote cardiac monitoring solutions such as wearables and implantable devices can give care teams round-the-clock oversight on their patients from any location, collecting data on vital signs in real-time and flagging any signs of impending cardiac issues at the earliest opportunity. Solutions like these mean individuals with complex co-morbidities can finally emerge from cardiac events or procedures and go on to live independently, confident in the knowledge that their precious health data is being continually and securely communicated with their care teams.

3. Digital patient engagement

Digital patient engagement methods such as health-tracking apps and patient portals empower people to take a more active role in managing their health and wellbeing. They also help patients to maximize treatment compliance for existing conditions, and start dialogues with their care teams, for faster reporting of symptoms and greater access to information and advice.

For example, pre-surgery health coaching apps help patients get in optimal condition before having elective surgery, so they can maximize the chances of shorter hospital stays while minimizing the chances of readmission. Collaborative patient-provider platforms are helping hospitals reduce the need for physical consultations – by as many as three per patient per year. And in oral health, electric toothbrushes coupled with health-coaching apps are helping both adults and children to monitor their brushing habits, learn more about the link between oral and systemic health, and stay engaged in developing healthy habits for life.

How can we keep up momentum for preventive care?

With around one in three adults being treated for complex chronic conditions globally [5], many of which have been identified as avoidable, lifestyle-related conditions, the need for a more preventive care model is all too apparent. The pandemic has spurred on much of the digital transformation that’s facilitating the shift to preventive care today – but these advances are long overdue.

To make preventive care a success in all markets and alleviate the burden of chronic illness that’s been felt across the industry for years, we need to go further: breaking down the barriers between departments and specialists, eliminating the obstacles separating patients from caregivers, and bridging the boundary between healthcare settings and people’s homes.

British Medical Association. NHS backlog data analysis (bma.org.uk)
The New Zealand Herald. India Covid-19 appeal: 'Up to 75 patients waiting for each hospital bed' - NZ Herald
The World Economic Forum. WEF_Harvard_HE_GlobalEconomicBurdenNonCommunicableDiseases_2011.pdf (weforum.org)
Clinton Health Access. There is a global shortage of nurses. COVID-19 is making it worse. - Clinton Health Access Initiative
Science Direct. https://www.sciencedirect.com/science/article/pii/S2211335518302468

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Healthcare has long been a place you go to. What if it came to you instead?

For decades, healthcare has been delivered primarily in centralized facilities such as hospitals, enabling huge strides in the diagnosis and treatment of disease – but capturing only intermittent snapshots of our health, while not always being accessible to patients in remote or underserved communities. Today, thanks to digital health technologies, we see the rapid emergence of a new paradigm: one in which we can bring care much closer to the patient, whether that is virtually or physically, at home or in the community. Here’s why we believe distributed care is the future of healthcare.

The trend towards out-of-hospital care was already well underway before the pandemic accelerated the adoption of digital triaging, telehealth, and remote patient monitoring. As this year’s Philips Future Health Index report reveals, healthcare leaders now view extending care delivery beyond the hospital as their highest priority after staff satisfaction and retention [1]. Like them, we believe that building more hospitals cannot be the only answer to meeting the growing demand for accessible and affordable care.

Distributed care flips the traditional hospital-centric care paradigm on its head. Instead of having patients come into a central location, distributed care brings care to the patient. Increasingly, we will see healthcare being delivered through a decentralized network of ambulatory clinics, retail settings, and home-based monitoring, coaching, and treatment. The glue that binds this network together is the end-to-end experiences of the patients it serves, throughout their care journey.

Why distributed care is the way forward

The reasons for this paradigm shift are more urgent than ever.

Health systems worldwide are coming under increased financial pressure, with healthcare expenditures taking an ever-bigger chunk out of countries’ GDPs [2]. In many countries, hospital care accounts for the largest share of those expenditures, amounting up to more than 1 trillion dollars in costs in the US alone [3]. There’s a growing awareness that in order for healthcare to remain affordable and sustainable, it needs to move into lower-cost settings whenever possible to address people’s health issues at a much earlier stage and ideally prevent them.

Adding to the challenge for hospitals is that they are not staffed to keep pace with the rising demand for care, while chronic conditions such as diabetes, heart disease, and cancer continue to proliferate. Globally, a shortage of 6 million nurses pre-COVID plus 4.7 million set to retire in the next few years has been exacerbated by an exodus from pandemic-related burnout, leading to an estimated shortfall of 13 million nurses by 2030 [4]. The outlook for physician shortages is equally concerning [5], prompting healthcare leaders to ask how they can divert care away from labor-intensive hospitals to more labor-efficient home and community settings.

Meanwhile, patients expect more digitalized healthcare experiences that don’t require them to spend precious time and money on travelling when – in some cases – they could just as well connect with their doctor remotely. Having become familiar with the benefits of telehealth during the pandemic, 60% of patients say they find virtual care more convenient than in-person care [6].

The pandemic also shined a harsh light on long-standing inequities in access to care in many parts of the world. In the 2022 Philips Future Health Index report, we see how this has kindled an increased sense of social responsibility among healthcare leaders to improve access to quality care for all patients, irrespective of location or background [7]. This is still a far cry from today’s reality in which half the world’s population lack access to the health services they need [8]. We can and must do better.

So what exactly does a more distributed and accessible healthcare system look like? We find it helpful to distinguish between four care delivery models, as shown in the graph below that follows a patient’s care journey along different touchpoints. Let’s explore each model in more detail, starting with the one that has seen the most explosive growth in recent years: virtual care.

Connecting the hospital to the home with virtual care

When Australian healthcare provider West Moreton Health was faced with disproportionately high numbers of emergency department visits and potentially avoidable hospitalizations, they sought new ways of making quality care accessible for high-need, chronically ill patients.

Remote patient monitoring turned out to be a vital part of the solution. In partnership with Philips, West Moreton Health developed a virtual patient engagement program called MeCare, which uses home-based medical devices to collect patient-reported outcome data and biometric indicators including blood pressure and oxygen levels. Outcomes are reviewed in real time to proactively engage participants with personalized health coaching. Early results were significant, showing a 28% reduction of potentially preventable hospitalizations in chronically ill patients. West Moreton has since expanded the MeCare program to include more patients and more use cases, including COVID-19 monitoring, medication management, and mental health.

It’s a great example of how virtual care can offer healthcare professionals a window in patient’s day-to-day health. No longer do they have to rely on episodic measurements. They can now follow the patient’s health over time and provide ongoing care management, wherever that patient is located. In this case, that means patients in small rural communities in the West Moreton area also get to benefit, making the local healthcare system more equitable and inclusive.

Another way in which we are pioneering home-based patient monitoring is through wearable patches that support the early detection of heart rhythm irregularities to prevent (repeat) strokes. Such patches are becoming more and more unobtrusive, allowing patients to keep an active lifestyle while extending the line of sight of physicians from the hospital into the home. Add to that the power of cloud-based AI that can spot early signs of heart rhythm disturbances based on more than 20 million ECG recordings, and we can give care teams the insights they need to intervene preemptively.

Clinical-grade home-based ECG monitoring can also offer a boon to research. Rather than having patients come into a research site multiple times over the course of a trial, decentralized clinical trials equip patients with the tools to record and share data at home. Not only does this improve the patient experience, it can also help curb the attrition that often plagues clinical trials. Just as importantly, it can make clinical trials accessible for those who have traditionally been underrepresented. Typically, 70 percent of potential participants live more than two hours from trial sites. Decentralization broadens trial access to reach a larger and more diverse pool of patients, thereby contributing to better-quality outcomes that are more representative of the population at large [9].

Bringing specialist care to the heart of the community

Of course, not all clinical care or research can take place remotely. In-person interaction remains essential to many facets of healthcare. But that doesn’t mean it always needs to be tied to a fixed location that requires patients to travel. What if care moved out on wheels to travel to patients instead?

That’s exactly the premise of mobile healthcare services. For example, during the first wave of the COVID-19 pandemic in India, we launched a first-of-its-kind mobile Intensive Care Unit (ICU), equipped with nine beds, which can be deployed in one day to rapidly increase ICU capacity where it’s needed and enhance community outreach. Such highly flexible solutions can help mitigate the impact of future disasters and pandemics to improve access to care and avoid hospitals from being overrun.

As another example of mobile care, we have been piloting the use of health trucks in the Japanese city of Ida, bringing on-demand primary care services to patients in underserved communities where qualified healthcare professionals are in short supply. Coupled with telehealth facilities, mobile health trucks allow patients to connect with a remote clinical expert. The clinical expert, in turn, can offer virtual guidance to assist a local healthcare worker in using advanced mobile equipment such as a handheld ultrasound scanner.

While much work remains to be done to scale the use of such mobile diagnostic solutions, we believe they hold great promise for the future. Enhancing them with AI would make it even easier for local healthcare workers to acquire the right images and then interpret them correctly. That’s why we’re excited to be working with the Bill & Melinda Gates Foundation on an AI-based ultrasound application that will be designed to help nurses in low- and middle-income countries identify potential pregnancy complications at an early stage, thereby giving expecting moms a better chance of bringing a healthy child into the world. Especially in areas where the nearest hospital may be many miles away, mobile healthcare solutions can make a real difference right in the heart of the community.

Lowering the barrier to access with walk-in care

In lockstep with the rise of virtual and mobile care, we will see more and more healthcare services being delivered in walk-in settings such as department stores, shopping malls, gyms, and airports. During the pandemic, pop-up clinics have played a pivotal role in relieving the strain on overwhelmed healthcare systems by providing testing and vaccinations on a large scale [10]. There are many other routine exams and medical procedures that could also be delivered in community-based settings to relieve hospital resources, improve access to care, and support early detection and diagnosis of disease.

For example, the NHS in England is planning to build one community diagnostic center for every 300,000 people – amounting to up to 150 diagnostic hubs. As the vision video below shows in more detail, these “one-stop shops”, which are located away from hospital sites closer to patients’ homes and often on the high street or in retail locations, will provide specialist services for cardiovascular patients, people with cancer, and those with respiratory illnesses – supported by expert teleconsultations where needed.

Similarly, in the US, where people in rural or remote areas make up one fifth of the population, we have designed virtual care stations that allow patients and providers to connect remotely through a secure, clinical-grade environment. In addition, we are bringing innovations in image-guided therapy closer to patients through out-of-hospital settings such as office-based labs or ambulatory surgery centers, which can perform routine procedures at lower cost while offering patients greater convenience.

The future of hospital care in a distributed network

Where does this leave the role of the hospital?

As healthcare becomes increasingly distributed, hospitals will continue to play a critical role. But it will be different from the one they have played traditionally. Most hospitals will no longer provide all services under a single roof. Instead, they will focus on delivering a narrower set of specialized services and acute care, while simultaneously taking a more prominent role in managing population health in the community and at home. Hospitals without walls will emerge, serving both as a central physical hub and as an orchestrator of a wider ecosystem of care.

At the same time, hospitals will be forced to operate much more efficiently to keep delivering high-quality care with increasingly scarce resources – all while offering a seamless patient experience before, during, and after hospital visits, taking an end-to-end view that spans the entire continuum of care. It is a truly transformational challenge, which we will explore more deeply in our next blog post.

The promise of anytime-anywhere care has been a long time coming. There’s no going back now. The future of healthcare doesn’t center around a location – it centers around the patient, wherever they live, and however they can best access the care they need in the moment.

HEALTHCARE

REDEFINED

PODCASTS

Episodes

Episode 8

No planet, no patient: healthcare going green

Speakers

Moderator

Episode 7

What works in healthcare? Value, value, value

Speakers

Moderator

Episode 6

Redefining the patient journey: the role of hospitals in the future

Speakers

Moderator

Episode 5

Knowledge boost: rewiring the healthcare workforce

Speakers

Moderator

Episode 4

The right care at the right time: getting serious about virtual healthcare

Speakers

Moderator

Episode 3

Connecting the dots: unlocking insights from data in healthcare

Speakers

Moderator

Episode 2

Precise and predictive: the coming of age of artificial intelligence in healthcare

Speakers

Moderator

Episode 1

Focus on what matters: patient centred care through digital transformation

Speakers

Moderator

ARTICLES

Creating climate-friendly health systems in Asia Pacific: a multifaceted problem

Healthcare has long been a place you go to. What if it came to you instead?

Three ways digital transformation is accelerating the shift to preventive care

How technology can improve the patient healthcare experience

The digital innovation wave is coming to the Asia Pacific Region

Seven key success factors for digital transformation in healthcare

Staff burnout in healthcare is growing. Can AI help ease the burden?

Augmenting healthcare in Asia Pacific: AI and data to the rescue?

VIDEOS

What do we need for a successful digital transformation in healthcare?

What is the future of healthcare delivery, and how is the role of hospitals changing in the Asia Pacific region?

How is artificial intelligence playing a role in the digital transformation of healthcare?

How is digitalisation shaping up the healthcare space?

Augmenting healthcare in Asia Pacific: AI and data to the rescue?

Augmented intelligence

Cost control

Healthcare AI: a systems problem

Seven key success factors for digital transformation in healthcare

1. Designing digital health solutions for better human experiences

2. Bringing everyone on board through effective change management

3. Training staff to help them get the most out of digital technology

4. Taking an inclusive approach that leaves no patient behind

5. Adopting cloud-based platforms for data access anytime, anywhere

6. Building digital trust by safeguarding data privacy and security

7. Joining forces through strategic partnerships and ecosystem collaboration

Staff burnout in healthcare is growing. Can AI help ease the burden?

Healthcare providers face exodus of staff

Simplifying workflows through AI-based automation

Providing relevant insights at scale at the point of care

The need for human-centered AI

The digital innovation wave is coming to the Asia Pacific Region

A virtual revolution?

Delivering the digital

From the hospital to the home

Creating climate-friendly health systems in Asia Pacific: a multifaceted problem

Scoping out the problem

Can digital health save the planet?

How technology can improve the patient healthcare experience

Connections improve the patient healthcare experience

How technology supports the patient healthcare experience

How technology assists clinicians and healthcare leaders

Making digital healthcare mainstream

Patient experience at the heart of healthcare innovation

Augmenting healthcare in Asia Pacific:
AI and data to the rescue?

Seven key success factors for digital
transformation in healthcare