LUCIANO BRUSTIA, Regional Managing Director Asia Pacific InterSystems

Asian hospitals have learned the value of data from the pandemic. Delivering world-class care and the best patient experience is now the minimum standard. The race is on to go fully digital with leading providers moving to digitally engage their patients inside and outside the hospital for the best virtual experience.

COVID has given digital health technology a huge boost. It has spurred investments in telehealth, patient engagement via mobiles, and electronic medical record systems.

With fewer hospital visits, healthcare providers are looking to technology to fill the gap. Strategies include empowering patients to take more responsibility for their care and finding ways to provide care virtually, not just in the hospital or clinic.

We spoke with Luciano Brustia, Regional Managing Director, Asia Pacific at InterSystems1, about the latest developments in digital patient engagement, the challenges that hospitals face, and how the company is working with leading hospitals in the region.

The digital patient engagement trend shouldn’t surprise anyone in the healthcare industry, says Brustia. “Digital engagement is already part of life in almost every other industry. Consumers expect to interact with their trusted suppliers digitally, particularly through their smartphones, and healthcare is now catching up.”

But healthcare is not like every other industry. The “customer” data that providers collect about patients is far more complex and difficult to interpret. This gives rise to many challenges. For example, while hospitals want to move quickly to engage patients digitally, the services they roll out must also do no harm.

“There is a great advantage in encouraging patients to take responsibility for their care,” says Brustia. “The Value of Engagement Research shows that engaged and activated patients have higher satisfaction levels and use fewer resources. Combined with telehealth, clinicians can see more patients, and providers can maintain closer relationships with their customers.”

Personal Community2 patient engagement solutions from InterSystems, for example, provide a range of capabilities. These include reviewing care records, uploading data from personal medical devices, scheduling appointments, completing forms for care providers, receiving alerts and notifications, and accessing thirdparty SMART on FHIR apps.

Many Asian hospitals have already pressed ahead with digital engagement strategies focused on patient communications. These have already proven valuable in maintaining relationships with patients that were making fewer hospital visits because of the pandemic.

Patients expect clinical data access

Brustia says these initiatives have been a significant first step. Hospital management teams have moved quickly to develop new business strategies and invest in technology to implement them. But they run the longer term risk of not meeting patient expectations.

“With digital engagement, healthcare providers need to think about their brand. Are they an organisation that promotes medical treatments, or do they provide the best care for each patient? If you want to be known for patient-centred care, clinical data has to be part of the equation.”

“We need technology to be a bridge between healthcare providers, patients and clinicians,” says Brustia. “But we also need to do that in a clinically safe and simple way that benefits the patient and the clinicians, and meets the business objectives of healthcare providers.”

Providers that have invested in digital clinical systems have a massive advantage over those that rely on paper-based systems. The need to capture clinical data and make it available for sharing with patients and clinicians makes an electronic medical record (EMR) system a must-have.

While provider organisations want to move quickly, digital patient engagement should be approached like any other new clinical process, says Brustia. “Hospitals should start with some simple use-cases. You need to try them, test them and prove that they work before releasing them into the world.”

While every hospital will have a different strategy, the most popular use-cases include booking appointments online, reviewing lab results, and checking medication lists. More advanced strategies include medication refills. A mobile app may alert patients when medications need replacing and set up a telehealth consultation with a doctor.

Before implementing these strategies, you need to involve each stakeholder group, says Brustia. “You need to meet patients’ expectations, but you also need buy-in from clinicians and a commitment from hospital executives to an ongoing digital engagement program.”

Thinking strategically, healthcare organisations should look at digital engagement as the lens through which patients view and benefit from the digital transformation of hospitals.

Delivering hospitals’ future vision

“While patient engagement is the goal, it is just one part of digital transformation. We are only at the beginning of a long transformation journey for healthcare. While we can provide the technology to deliver the hospital’s vision for the future, you cannot achieve everything at once.”

Brustia says that while InterSystems offers a wide range of technologies for the digital transformation of healthcare, the real value lies in how they are used. That is one reason why InterSystems prefers to work in partnership with healthcare providers. “We want our customers to move as quickly as they can.” But healthcare is not an industry where you can ‘move fast and break things’, as Facebook founder Mark Zuckerberg said.

“Digital patient engagement involves more than technology,” says Brustia. “You need to consider many issues to develop the best solution. These include clinical safety, social safety, security and privacy. How are you going to verify the identity of the patient? How will you protect against the potential for medical information to be stolen or misused and avoid potential liability for the hospital and the clinicians?”

He says that InterSystems has invested in large clinical safety and information security departments to keep abreast of these issues and advise its customers. “We pour millions of dollars into the things that make up a complete solution. We tell our customers that you should trust us to work together in a true partnership to succeed.”

Start small, achieve wins and build one step at a time

InterSystems believes that healthcare providers should win their patients’ trust one step at a time when it comes to digital engagement. The company is currently working with several Asian hospitals on digital engagement. In almost every case, the strategy is to start small, achieve some wins, and build the program from there.

For example, Bumrungrad International Hospital3 in Thailand recently implemented InterSystems TrakCare 4 Personal Community. Another leading hospital group, Rumah Sakit Pondok Indah5 (RSPI) in Indonesia, is also working with InterSystems to make digital patient engagement a reality.

“We are working to help RSPI achieve HIMSS EMRAM Stage 7 validation, and patient engagement is central to their strategy,” says Brustia. “In particular, they are looking to leverage InterSystems TrakCare’s ability to integrate EMR data with mobile apps.”

Starting small may mean enabling patients to book appointments and access lab results from the TrakCare EMR. But the long-term goal would be to give patients the information they need to manage their health. That might include reminders for vaccinations or regular appointments to manage a chronic health condition.

Both Bumrungrad International Hospital and RSPI are building patient engagement on top of mature EMR systems. But organisations implementing new EMR systems are also building patient engagement into their digital transformation plans.

“One of our customers is implementing InterSystems TrakCare at a new hospital,” says Brustia. “As well as digitising their patient records and providing clinical support from day one, one of their objectives is to build interoperability for digital patient engagement.”

Patient engagement driving need for interoperability

TrakCare can integrate with mobile apps, Brustia points out, and the new hospital wants to leverage its EMR data for patient engagement. “This organisation already has some home-grown mobile apps for patients, and they are looking to increase the richness of the engagement with clinical data.”

Asian hospitals have long seen EMR systems as desirable in supporting world-class levels of healthcare. Now, digital patient engagement is driving the need for other advanced technologies, including interoperability and data analytics.

This is something that has already happened in other industries, says Brustia. “If you look at the financial or the travel industries, you see the ability to combine multiple sources of information into a single customer service using Internet technologies. When you search for the best airline flight on a booking site, you see information from multiple databases that have been combined in a meaningful way.”

The healthcare industry is also making rapid advances in interoperability, driven by new standards for exchanging healthcare information like FHIR (Fast Healthcare Interoperability Resources). Another new standard, SMART on FHIR6, builds on FHIR and other Internet standards to provide secure data interchange with EMR systems like InterSystems TrakCare.

When it comes to digital patient engagement, FHIR offers a standard way to integrate mobile apps, for example, with a hospital’s information systems. Organisations can also take advantage of a healthcare data platform, like InterSystems IRIS for Health™,7 to develop FHIR apps, provide advanced interoperability, and orchestrate digital services.

“Learn to walk before you can run”

Likewise, data analytics, artificial intelligence and machine learning will also be essential capabilities as digital patient engagement evolves. Healthcare providers could potentially analyse engagement patterns, for example, and correlate them against healthcare outcomes to make informed recommendations to individual patients.

Building the technology capabilities to support future enhancements is essential. Right now, however, Asian hospitals need to develop a digital patient engagement strategy and go after the low-hanging fruit, says Brustia in conclusion.

“How many healthcare providers have a strategy to care for their customers’ whole families, for example. How do we help them become responsible for not only health but also wellness? How can we look after our patients remotely, so they don’t need to visit the hospital? Many of these strategies are achievable, but you must learn to walk before you can run.”



--Issue 57--

Author Bio


LUCIANO BRUSTIA is Regional Managing Director, Asia Pacific at InterSystems, a provider of innovative data solutions, including cloud-first data platforms which solve interoperability, speed and scalability problems, as well as the world’s most proven electronic medical record which supports advanced data management in hospitals.

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