In this interview, author shares his perspectives on how we have moved from the ‘face-to-face’ age to the information age of healthcare and shares practical advice on how healthcare organisations can use simple and uncomplicated technology solutions to improve patient-care delivery in an increasingly digitalised world.
Communication as a whole is changing. Consumers now expect a frictionless and fast experience regardless of the organisation they might be engaging with. The introduction of mobile phones, especially smartphones, have changed the way people communicate and there is a paradigm shift in service delivery as people are integrating new technologies in communication. In the case of healthcare organisations, this might be something as complex as accessing test results and medical updates via a secure online interface or as simple as checking into the doctor's office or hospital more quickly.
The daily business of health relies on information and communication and increasingly on the technologies that enable it. In the last five years, we have moved from the ‘face to face’ age of healthcare to the ‘information age of healthcare’. Healthcare Information and Communication Technology (ICT) has the potential to modify the way in which people use health services. Consumer expectations has also changed as a result. Now, there are patients who want to determine their own health needs via advice on the internet or other technological interface and increasingly want faster and more person-centred services from healthcare providers. Our desire for ‘more’: be it better and easier communication processesor an overall improved customer engagement experience is only going to increase in the years to come.
The term ‘automation’ tends to be conflated by the technology we see in sci-fi films and TV. However, we don’t need to let our imaginations get too ahead of us. Automation does not need to be unnecessarily complicated and can bring about practical benefits. Take Short Messaging Service (SMS) for instance, it is ubiquitous, customisable, rapid, automated, and relatively low cost. SMS is regarded as relatively nascent but it has become a focus of healthcare researchers and recommended to use by leading healthcare organisations such as the World Health Organisation1.
By implementing very basic messaging systems to remind patients of pending appointments, we have seen some of us healthcare customers reduce no-shows by up to 30 per cent. This is a massive improvement in time allocation for their in-clinic staff which can be redirected to focus on other parts of the patient-care delivery process. Non-attendance for appointments in healthcare results in wasted resources and disturbs the planned work schedule.
Another prime example of useful implementation of automated messaging systems are automated reminders for older patients to take their medication at set times throughout the day. As more people live longer, levels of multi-morbidity have increased, leading to more complex medication regimes. Non-adherence can have serious consequences, including hospitalisation and death. Forgetting what to take and when is a commonly cited reason2 for non-adherence. The significance of having these reminder systems as interventions grows bigger given that Asia is dominated by ageing populations. Asia is expected to be home to over 60 per cent of the total population aged 65 years and older worldwide by the 2030s.
A narrative literature review in 20183 systematically reviewed the aggregate impact of these automated SMS reminders on health outcomes and it was found that the text messages are an effective reminder mechanism to improve patient appointment and medical compliance.
These aforementioned concepts are very straightforward that can have an immediate impact on hospitals, clinics and patients alike. On a base level,automation with an impact does not need to be complicated or scary.
In our opinion, the next step in patient-facing automation would be the chatbot technology which will open up a world of healthcare solutions such as ongoing health monitoring, assisting healthcare professionals retrieve patient records as well as providing information and support to patients.
Healthcare IT trends are largely tied to major shifts in technology, concerns of cost, quality and access, changing needs and preferences of patients or market incentives. A key role of healthcare ICT is through enhancing care delivery and engagement with patients.
The year 2019 will begin to see a blur between healthcare and IT providers as they work hand in hand to ensure accessibility and affordability of care. One particular trend in the field of communications are voice solutions. We already witness tech titans such as Amazon and Google developing targeted voice technologies that could be used well in a healthcare setting. Practical voice solutions in the healthcare industry will gain increasing prominence due to aggressive competition in Research & Development (R&D) from these tech giants. Singapore itself is encouraging innovation in targeted voice technologies from chatbot providers so that these chatbots can be customised to understand the Singapore healthcare system.
However, the healthcare industry still has a long way to go in terms of optimising its communication engagement with customers whether it is through some of the previously discussed base level concepts or more high level chatbot and AI type solutions. We’re thrilled as we see a lot of willingness from healthcare professionals to engage with us on these discussions. There also appears to be a deep understanding within the industry about the benefits these solutions can bring both to them and their patients. We expect to see healthcare institutions continue to seek out ways to give their patients a personal, informative, secure and pleasant experience through automated communication platforms.
Take it step-by-step! Having the right partners on board to be a change agent is key in restructuring health information management systems. Work with these partners to understand where your pain points are and find out what solutions are available to address these pain points. Ask yourselves a series of questions, ‘Is it efficient?, Is it convenient?, How do we connect to it?’ and ground these conversations in the context of the healthcare industry you are in as well as the objectives of the organisation. The best way to move forward is to tackle foundational issues first that can be resolved on a base level before discussing more complex topics such as chatbots and digital security. It is best to guard against adopting any new type of technology before knowing the true capacity of your healthcare IT systems now.
Implementing a mobile healthcare system is complex and requires ongoing discussions and multiple levels of review. It is best to tackle it one level at a time.
One of the biggest problems with chatbot adoption is that it has become a buzzword, as you said, and with that comes a lot of hype. Chatbots are not here to solve all of our problems yet as that’s simply not how the technology works. Chatbots and Artificial Intelligence (AI) are just like a newborn baby; they need time to absorb information, learn from that information and generally become smarter. As a retail and enterprise industry, we are at the newborn stage of chatbots and AI in terms of its capabilities. Instead of trying to convince our partners that these platforms can solve all of their problems, we are focused on initial point of engagement with customers and patients.
Communication flows such as appointment scheduling / rescheduling, general FAQ about the clinic or about a particular condition and other such Q&A type processes can absolutely be accomplished by chatbot technology and this is the initial point of engagement we are encouraging our partners to focus on. It gives customers and patients easy access to important information and flows while allowing the healthcare staff on the other side to better allocate resources to more critical tasks.
As the technology matures, we will be looking at deeper implementations. For now, there is a lot that can be accomplished in terms of reducing friction and improving efficiencies within the various daily contact points for both patients and healthcare staff.
There is an increasing awareness of the importance on cybersecurity but there needs to be practical steps beyond just awareness.
While there is no bulletproof solution for all cyber security issues, there are various strategies that can be implemented and, at the very least, minimise the likelihood of victimisation. This is especially important in the field of healthcare which also follows the adage that ‘prevention is better than cure.’ Two-Factor Authentication (2FA) is an easy to implement solution in various points of the healthcare process that can offer patients and healthcare professionals a greater sense of security while limiting some cybersecurity attacks that the industry is faced with.
As is the case with all technology, 2FA does not need to be expensive or complicated. In fact, I would argue that it is the responsibility of service providers to make it as easy and cost effective as possible so much so that the healthcare industry is able to justify making this part of their larger cybersecurity strategy.
Simply put, there is no silver bullet that will guarantee protection against any and all future hacking attempts. The unfortunate reality is that hackers are working to improve their breaching tactics in spite of the best efforts of service providers and enterprises to secure these systems. This is an on-going fight that is expected to escalate in the years to come as our world becomes increasingly digital. That said, consistent and frequent reviews of an organisation’s systems are critical in identifying potentially weak areas so that strategies to secure the system can be developed. It is absolutely critical to keep up with the latest news and updates, be it from other successful hacks or industry events, as part of an ongoing learning process.
I would recommend working with industry professionals to understand where and how 2FA is able to be implemented to improve base level security issues. It is critical to understand that 2FA is simply one layer in what must be a much larger cyber security strategy. Nevertheless, there are implementation options for this technology so that it can be made as frictionless as possible for patients while eliminating some of the more common hacking and breach issues. There is no ‘one size fits all’ approach so it is best to work with those around you to understand what this technology can do, how it can fit your organisation and implement some of the best strategies to shore up defences.
References:
1 http://apps.who.int/iris/bitstream/handle/10665/75211/9789241548465_eng.pdf;jsessionid=9830BC589B71C5003D2BCB6EF15BCB22?sequence=1
2 https://www.ncbi.nlm.nih.gov/pubmed/15175485
3 https://www.sciencedirect.com/science/article/pii/S2214782918300022
