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How digital is the great enabler in healthcare

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Global Health Exhibition concluded with a look at tech's role in transforming public health learning, quality management and healthcare itself, among other sessions.

Harnessing the digital workplace to deliver value

In a session delivered in partnership with HIMSS, moderated by Dr Taghreed Justinia, Asst. Prof. Health Informatics and Regional Director IT Services, Technology & Health Informatics at King Saud bin Abdulaziz University for Health Sciences, experts from KSA and Germany looked at delivering value through the digital workplace. 

Dr Valerie Kirchberger, Consultant to the Chief Medical Officer and Head of Value-Based Healthcare at Charité Hospital, described how Charité Hospital’s path to VBH is focused on quality measurement, cost measurement and integrated care.

Yet while there is a good measurement system in place, integrated care remains a challenge (Germany having an historically fragmented care system) and there is no exchange of data. The provider decided to proceed electronically, she explained, and looked around for best practices. Charité’s vision is to have a fully integrated dashboard, with Patient-Reported Outcomes (PRO) data as part of the electronic record of the patient (she used the example of Memorial Sloan Kettering). 

Dr Kirchberger caveated that while digital tools can help accelerate towards VBH, the paradigm shift - from volume to value - is more important, and everything else will follow. She explained that they were still incentivised “in the old world” - to deliver care on a short-term basis.

According to Eng. Abdullah Al-Sharqi, Chief Digital Transformation Officer at CCHI, there is a major transformation in the health sector in Saudi Arabia, and there is a new program approved as part of Vision 2030, and enabling e-health solutions is part of that.

Unifying health records will help to analyse and understand diseases, and in planning for healthcare and hospitals. He clarified that data ownership lies with the patient, while the exchange of data is the responsibility of government (SDAIA government body).

Management of non-COVID 19 public health issues during the pandemic

According to Prof Dr Scott JN McNabb, Research Professor, Emory University, Rollins School of Public Health, Emory University, U.S., it is time to modernise public health learning for the 21st century. Prof McNabb directs the King Abdullah Fellowship Program (KAFP), a joint effort between KSA and the Rollins School of Public Health and also has an adjunct appointment at King Saud Bin Abdulaziz University for Health Sciences, Riyadh.

At the session, he said that multi-communication and e-learning is the future and that the pandemic has accelerated digital transformation and the public health sector needs to look at how they can improve public health training using latest tools.

Prof McNabb said that in the past, educational institutions were intentionally modelled on factories to standardise teaching and testing. “It has been a challenge on how to do online training that is engaging and effective,” he emphasised. “We use text messaging tools and learning management systems. Moreover, most institutions are offering online learning, but they haven’t disrupted the model. COVID-19 has presented a new model to replace old methods. It is a moment in time to rethink about platforms and training and provide the best possible service that is affordable and accessible to students.”

Below are some of the drivers for e-learning that Prof McNabb highlighted:

  1. The rise in demand for cost-effective training and learning techniques in corporate and academic sectors
  2. A shift towards flexible education solutions
  3. Increased effectiveness of animated learning
  4. Increased internet penetrations and surge in the number of smartphones with mobile learning technology
  5. Micro-learning for specialised training
  6. Increased emphasis on online content development and blended learning
  7. A growing interest in the flipped classroom and adaptive learning
  8. Increasing government participation

Furthermore, he shared that there are four characteristics shared by digital disruptors – customer obsession, exceptional service design, cross-disciplinary collaboration, and focus on love for metrics. “The strategic growth areas that public health institutions should keep in mind include scaling impact, ensuring sustainable growth and adapting to changing needs,” he concluded.

Getting digitally connected to transform quality management

In the last nine months, healthcare has seen an acceleration in digital technology, said Dr Peter Lachman, CEO, The International Society for Quality in Health Care (ISQua), Dublin, Ireland, however, this was done not out of desire but out of necessity.

At the session, he said: “In healthcare, we have been a little behind the curve. For instance, when it comes to telemedicine, we still really haven’t worked out what the standards for it are. The rest of my world is digital – I buy newspapers online and don’t go to the bank, but the only thing I can't do digitally is getting access to my health records. COVID-19 has told us where we have fallen and where we should go from here and the potential to learn from it is immense.”

While, Paula Wilson, CEO, Joint Commission International (JCI) highlighted that one of the interesting areas is how digital health can help in mitigating social determinants of health. “Governments need to digitalise countries to ensure connectivity for all citizens,” Dr Lachman added.

Wilson said: “However, the use of technology creates a new list of things we need to worry about when it comes to patient safety. One of the most serious ones is cybersecurity issues pertaining to patient’s information. Therefore, we will be adapting quality management standards to reflect the new reality.”

Moderator Dr Abdullaziz Abdulbaqi, Assistant Deputy Minister for Planning & Organisation Excellence, Ministry of Health, KSA, concluded: “COVID-19 has been an opportunity that needs to be taken seriously for public health and awareness as well. In diagnostics, the role of AI will create a huge transformation and create an efficient system that will increase the quality of diagnostics and add more value to patients by building a centralised database to create benchmarks that will improve quality of care.”

Lab session: Molecular diagnosis of COVID-19: Current situation and trend

At this session, Prof Julian Hiscox, Chair in Infection and Global Health Infection Biology, University of Liverpool, UK, highlighted that COVID-19 has a case fatality rate of 1.4 per cent. He said: “It is characterised by air hunger in severe cases and pulmonary thrombus (blood clots) is observed in severe cases in the lung.”

He stressed that one of the major questions is why people get severe COVID-19? “To understand that we have used genetic sequencing to understand the sequence of the virus and how much virus is in people. We use a similar sequencing approach in host response and how people and animals respond,” he explained.

Prof Hiscox said that his laboratory was able to offer the ability to sequence the virus quickly as they used an amplicon-based approach to identify SAR-CoV-2 and to sequence the virus from clinical samples.

To study the distribution of SARS-CoV-2 in post-mortem tissue from patients with COVID-19, his team conducted an analysis of patients who died in ICU or in hospital wards. They examined the extent and nature of pulmonary immune infiltration and the presence of the virus at an organ and cellular level. These examinations confirmed SARS-CoV-2 infection and evidence of lower respiratory tract disease at a median of 19.3 hours after death. The patients had a mean age of 77 years.

He added: “In people who are severely ill there is a sustained inflammatory response to COVID-19. As soon as people died, with family’s permission, we conducted a rapid post-mortem. We found SARS-CoV-2 all over the body but it was particularly focused on the respiratory organs. It is primarily a disease of inflammation of the lungs.”

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