Nalin Amunugama, General Manager, Boge Kompressoren, Asia Pacific Pte Ltd

Riding the second wave of the digital revolution, the global healthcare industry is already intersecting across other sectors, witnessing a hike in investments for transformative technologies. A report by the PwC Health Research Institute estimates global healthcare to hit a spending of US$ 18.28 trillion by 2040, driven largely by ageing and growing populations, market expansion, clinical and technological advances.

Healthcare stakeholders are under constant pressure to deliver high quality care at the lowest cost. Faced with the potential shortage of 12.9 million healthcare professionals by 2035, the industry is struggling to cope with limited capital resources. The need to provide quality healthcare while ensuring a balanced ratio of patient to doctor is no longer a demand but a requirement.

Over the past decade, huge sums have been spent on healthcare technology to improve the administrative efficiency of the health system, and to provide greater access and coverage. However, in keeping with the changing healthcare landscape, the primary focus has since shifted to providing innovative and cost-effective ways to deliver patientcentric, technology-enabled healthcare-beyond the hospital setting.

The advent of digital communication and portability of testing devices has made it easier for patients to connect and interact with physicians. Patients now have easy access to information about their conditions, and can benefit from the speed at which tests are conducted. These developments empower patients to have more influence over the course of treatments, and at the same time, provide doctors with new pathways to reach patients with pertinent information, monitoring and guidance.

From robotics to smart hospitals, health record and data analysis, to decision-making optimisation, predictive tools and seamless operations continue to be unlocked by technological innovations to deliver better patient outcomes with greater efficiencies.

A Holistic approach with EHRs

Electronic Health Records (EHRs) have revolutionised the practice of medicine, benefitting both clinicians and patients as society moves further into the digital era. Studies in Singapore have shown that one in five smartphone users have one or more health-related apps on their phone, highlighting the shift towards greater awareness and health consciousness among the general public. As consumers demonstrate greater interest and proactivity in their health, the switch to EHRs is the logical step forward as patients demand greater transparency and continuous updates on their health status. Epic, an America-based company, holds the largest electronic health record system in the US, with the use of their software in integrated care delivery networks, rehabilitation centres and hospitals across the country.

Epic’s health records make it easier for doctors from various specialisations to have a holistic understanding of a patient when treating other non-related illnesses, especially in cases of emergencies where such records can provide critical life-saving information. This EHR software is used from the point a patient first steps into a medical facility to register at the administrative counter, to the nursing stations and into the patient room. Chronicling a patient’s healthcare over time, doctors and patients are presented with accurate, up-to-date, and complete information on a patient’s health at the point of care, rather than a brief overview collected at every visit. EHRs enable greater accuracy, reduce medical errors, and encourage more in-depth analysis and evaluation. The system promotes coordinated and efficient care, removing the communication barrier between patient and doctor as more visuals are used to explain comorbidities.

Assistive Care Robots

It is estimated that by 2050, one in six people in the world will be over 65 years old, and the number of people aged 80 and over will triple to 426 million. This growing population is going to require more care, which in turn, puts greater demands on healthcare resources. In view of global workforce shortages, it is critical for healthcare providers to look into alternative sources to support patients and caregivers.

At a hospital in Milan, a robot is already transforming patient care and hospital management, thanks to a collaboration between Konica Minolta and the scientific research centre, Istituto Italiano di Tecnologia. In the design of the assistive care robot, simply known as R1, designers and neuroscientists worked together to first understand types of shape and movement to make the robot more “human.” Another interesting feature is the LED-screen on the face of the robot which allows it to communicate more naturally with patients by altering its facial expressions. With the combination of Artificial Intelligence (AI) and 5G connectivity, R1 can read human body language and speech, and respond quickly.

Interestingly, this humanoid robot is able to move and interact with people in a personalised way. For example, R1 can help patients and visitors with useful information on the hospital and its services, and provide directions to facilities, like the X-Ray department or cafeteria.

R1 also makes for a remarkable companion. For long-staying patients, the robot can help by reading to them and taking food orders. With AI, R1 can use data such as food preferences to further streamline hospital processes and create better menus for patients.

Looking to the future, AI is expected to play a more prominent role in hospitals. The technology could be deployed for a range of functions, from performing critical tasks such as interpreting various scan results for accurate diagnosis, to powering automation processes to take on repetitive tasks such as dispensing medications.

Virtual and Augmented Reality

Virtual reality (VR) and augmented reality (AR) are already making inroads into the healthcare industry. The scope of VR and AR is wide as the imagination as the technology has the ability to deliver convenient and effective healthcare services to patients. In addition, VR and AR can assist surgeons, doctors and nurses with diagnosis, treatment, surgery and longterm management of illnesses.

For people travelling abroad, finding access to quality healthcare can be difficult, particularly in certain countries. However, wearable devices and mobile or web-based apps are helping individuals to monitor their health levels, including creating a direct line of communication with their doctors. Visual healthcare is especially useful in place of direct, face-to-face consultation. A video-link is an excellent platform for medical professionals to remotely manage and treat patients, and at the same time, reduce costs. One can also rely on virtual assistants like Siri for advice on a course of action, say, for a simple skin rash. And it is even possible to show the rash in a VR environment! For patients, the use of VR not only reduces unnecessary appointments to the doctor’s office but also makes it more convenient for those with minor ailments to get the appropriate medicine from a neighbourhood pharmacy instead.

AR differs from the VR experience in that it augments and overlays the real clinical environment rather than stationing a surgeon in a virtual world. There are currently a range of technologies on the market, including mobile apps like Pokemon Go and holographic headset displays like HoloLens. In February, Philips demonstrated an AR concept for imageguided minimally invasive surgeries at MWC Barcelona, one of the largest mobile events in the world. Based on the company’s Azurion image-guided therapy platform and Microsoft’s HoloLens 2 holographic computing platform, the AR applications include those for image-guided minimally invasive therapies. Philips has also announced the development of an AR solution for spine, cranial and trauma procedures, a combination of 3D X-ray imaging and optical imaging to provide surgeons with an AR view of the inside and outside of a patient during surgical procedures.

Another exciting development is the use of AR headsets during surgery which can collect video data from the operating room, with the assistance of machine learning. The data is used to make automated recommendations, identify critical structures to ensure they are not damaged, and help assess surgical skills during a procedure.

Intelligent Control System

According to the World Health Organization (WHO), 65 million people suffer from chronic obstructive pulmonary disease (COPD) with 3 million dying from it each year - making it the third leading cause of death worldwide. With the rise of chronic respiratory diseases, patients are dependent on a supply of medical-grade air.

Medical air compressors play a vital role in aiding artificial respiration, and the operation of numerous surgical tools used within the various healthcare units. In day-to-day operations at hospitals and other primary care facilities, a reliable source is necessary to filter medical-grade air to sedated patients under anaesthesia or to those having difficulty with breathing. Contaminated, moisturised air, on the other hand, could potentially put patients at risk. For surgical instruments, medical air compressors provide functionality to tools used for puncturing, dissecting, and drilling. Tools can also be dried at constant intervals before, during and after surgical operations.

In hospitals, an entire health system consisting of medical air compressors, receivers, dryers and filters is required for the production of air that is clean, dry and odourless. BOGE’s airtelligence provis 3 is already setting new standards for network control with its latest version of its intelligent control system. Nominated for the 2019 UX design awards (which recognises user experience as a key asset in connected life and work), the airtelligence provis 3 has the ability to control different compressed air networks. This is especially important to the healthcare sector where separately controlled networks need to operate alongside a sterile air network. Equipped with unique monitoring features, a simulations-software for comparing systems, a surveillance and alarm function that is user-friendly, the BOGE airtelligence provis 3 offers total control over the different compressed air networks. In addition, it provides webbased visualisation of all the operating ystems via an intuitive touch display or remotely, from a mobile terminal.

With the connection of holistic data from an unlimited number of compressors and components, including processes, status values, communication is directly condensed into a network that can be controlled and managed proactively, based on consumption. For healthcare facilities, BOGE’s compressed air systems offer optimal patient care in real time, from anywhere.

Digital Therapeutics

A new trend is emerging from the fastgrowing mobile or mHealth market for life sciences is digital therapeutics, where software products are used in the treatment of medical conditions. Digital therapeutics, as defined by Wikipedia, “is a health discipline and treatment option that utilises digital and online health technologies to treat a medical or psychological condition. The treatment relies on behavioural and lifestyle changes usually spurred by a collection of digital impetuses.”

The field of digital therapeutics is starting to gain momentum across the healthcare sector, with an increase in innovative apps and digital solutions to provide at-home management of specific conditions. A number of start-ups and established technology companies have brought to market, innovative applications designed to enable patients to take better control of their care. While similar to other wellness apps, the difference is that digital therapeutics focus on delivering clinical outcomes. Besides addressing the different medical conditions, digital therapeutics can also track various stages of the patient’s healthcare journey the collection, integration and analyses of patient data. Such data allows clinicians to personalise treatment and work with the patient to avoid complications.

Singapore company Holmusk designed Glycoleap, a patient-facing application that monitors a user’s diet, weight, and glucose levels, as well as physical activity with an in-built pedometer. Serving as a “health coach”, Glycoleap is part of the company’s larger digital therapeutics platform that strives to actively and passively track, monitor and treat patients - making healthy choices a lifelong habit. With their signature one-to-one personalised coaching with certified dieticians, the mobile app is packed with other features, including real time feedback on daily food intake. By utilising evidence-based medicine, clinical practice is optimised with Glycoleap’s data contribution to the real-world efficacy evaluation of drugs prescribed to patients through a blend of AI and data analytics.

Towards a Smarter Continuum of Care

Digitalisation of the medical industry works much like a continuous feedback mechanism, with the active and passive recording of patient data through electronic devices which are then uploaded onto electronic health databases. McKinsey and Company attributes US$2 trillion worth of healthcare costs are a result of poor health habits such as sleep deprivation, lack of exercise, consumption of alcohol, and other harmful substances. The over-expenditure on healthcare services can be reduced drastically with the use of wearable technology as they promote drug adherence with in-built timers, increase awareness of comorbidities, and encourage patient proactivity among its other features. It is a method of diagnosis that doctors and patients alike embrace and recognise as a need for better patient outcomes. With a better understanding of patient symptoms and disease trajectory, wearable technology evolves into a future with wearable healthcare as a solution for the delivery of better medical care.

In the grand scheme of things, the healthcare industry has advanced, with efforts combined from both healthcare providers and healthcare seekers. With the growing awareness of health risks and the cautionary impact it brings, users of healthcare technology have turned proactive, encouraging healthier lifestyles as part of an effort to reduce the strain on global healthcare systems and promote independence in healthcare diagnosis. By harnessing the power of technology and the knowledge it brings to healthcare providers and consumers, patients are better able to understand their own conditions, and more importantly, empowered to take charge of their own health.

--Issue 46--

Author Bio

Nalin Amunugama

Nalin Amunugama is the General Manager of BOGE Kompressoren Asia Pacific with over 26 years of experience in the air compressor business, including its applications in digital healthcare, medical and pharmaceutical sectors. As a global leader in compressed air systems, BOGE’s focus is on creating seamless, cost-efficient and sustainable energy solutions to benefit customers and the planet.

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