Dec 15, 2020

Defining a successful clinical engineering transformation

Clinical engineering
William Girling
3 min
Defining a successful clinical engineering transformation
Healthcare Global takes a look at e-health best practice and how best to implement clinical engineering...

In our preceding article, we explored how clinical engineering (CE) is transforming the paradigm for tech-driven healthcare.

Offering patients 24/7 care, an optimised clinical experience and a more efficient way of deploying facility services, CE, particularly when applied to critical areas such as intensive care units (ICUs), puts forward a strong business case for exploration.

As this is true for one aspect of hospital care, it is not unlikely that a similar transformation in the field of healthcare tech equipment is also possible. 

E-health best practice

In many ways the examples of best practice in e-health are comparable to pre-existing standards. Although there is a shift in emphasis towards technology, hospitals must still ensure the following:

  • Access, efficiency, safety must be monitored.
  • An adequate pre/post-visit plan must be adhered to.

However, there is still a discernible difference and a particular set of challenges to navigate. Namely:

  • Hospitals must avoid simply becoming ‘customer support’ for the technology they choose to employ.
  • Hospitals should consider a more integrated approach to system planning. This will save cost, increase ease of use and optimise technological agility.

Therefore, before proceeding with such a plan, it is important to consider what the ‘keys to success’ might be for implementing CE across multiple aspects of healthcare.

The keys to success

#1: Buy-in

Although the expansive nature of CE-driven optimisation might make it seem like parochial issues would be minimised, some commentators emphasise the importance of end-to-end organisational buy-in.

“Human relations and buy-in play a very important role in the success of any new technology,” state Scurlock and Becker. “The statement ‘All politics are local’ could not be truer than in the world of telemedicine, and it is apt in all other clinical work areas as well.”

Both nurses to physicians must be provided with adequate knowledge, training and support frameworks to develop the necessary trust for CE innovations to take root.

#2: Patient engagement

Directly linked to #1, patient engagement should be a natural consequence of hospital staff buy-in. 

An article from Harvard University’s ‘Lean Forward’ quotes Anthony Orsini D.O. as saying, “Communication is the number one factor influencing the patient experience, and one interaction can change the course of someone’s life.”

By creating a positive impression of CE’s potential and demonstrating its benefits across healthcare, hospitals encourage patient interest and therefore drive positive clinical outcomes.

#3 Engage with process improvement

With increased digitisation come richer data streams, and leveraging these can be invaluable in the quest for ever-better patient outcomes.

Medical errors constitute the third-largest cause of death in the US, meaning that systemic improvements to tech infrastructure could make a significant impact on healthcare generally.

Moreover, real-time feedback can be transformative for time-critical areas of healthcare, as is the case with ICUs, as they facilitate in-situ improvements that can save lives, time and money.

Find out more in LTTS' white paper: download here 

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Jun 14, 2021

Long haul Covid, the brain and digital therapies

4 min
Neuroplasticity expert Ashok Gupta tells us about the symptoms of long Covid, how it affects the brain, and digital therapies

It is estimated that around 10% of people who get Covid-19 develop long haul Covid, a debilitating condition that can last many months and cause breathlessness, exhaustion and pain. 

Research is underway to find out who is more likely to get it and how to treat it. Here neuroplasticity expert and owner of Harley Street Solutions in London Ashok Gupta tells us how the condition affects the brain. 

What is long Covid exactly? 

Long Covid is when patients who have experienced Covid-19 go on to have continuing symptoms for weeks and months afterwards. These symptoms can include breathlessness, exhaustion, brain fog, gastric issues, pain, and post-exertional malaise. It is estimated that around 10% of Covid-19 infections may result in developing long haul symptoms, and in the USA, this may be affecting over 3 million people.

How does it affect the brain?
Here at our clinic, we hypothesise that it is due to a malfunction in the unconscious brain, creating a conditioned response that keeps the body in a hyper-aroused state of defensiveness. At the core of this hypothesis is the idea that we are here because our nervous system and immune system have evolved to survive. We are survival machines!

When we encounter something such as Covid-19, the brain perceives it as life threatening, and rightly so. And in the era of the pandemic, with more stress, anxiety and social isolation, our immunity may be compromised, and therefore it may take longer for the immune system to fight off the virus and recover. 

If the brain makes the decision that this is potentially life threatening and we get to the stage where we’re overcoming the virus, a legacy is left in the brain; it keeps over-responding to anything that reminds us of the virus. Even if we’ve fought off the virus, the brain will react in a precautionary way to stimuli reminiscent of the virus. 

The brain may get stuck in that overprotective response, and keeps stimulating our nervous system and our immune system, just in case the virus may still be present.

What symptoms does this cause? 

These signals cause a cascade of symptoms including breathlessness, extreme fatigue, brain fog, loss of taste or smell, headaches, and many others. And these are caused by our own immunes system.

In the case of long-haul Covid, symptoms in the body get detected by a hypersensitive brain which thinks we’re still in danger. The brain then chronically stimulates the immune and nervous systems, and then we have a continuation of a chronic set of symptoms.

This isn’t unique to long-haul Covid. Many patients develop chronic fatigue syndrome, sometimes known as “ME”, for example, after the flu, a stomach bug, or respiratory illness. Covid-19 may be a severe trigger of a form of chronic fatigue syndrome or ME.

How does long-haul Covid affect mental health? 
Anxiety is a very common symptom in long haulers. It can be frightening to wonder about what may be happening in your body, and what the prognosis is going to be for one’s long term health. Reaching out for support for mental health is crucial for long-haulers.

How does neuroplasticity treatment work for long-haul COVID patients?
We have been working with patients for two decades with a brain retraining programme using neuroplasticity or “limbic retraining.” 

We believe that through neural rewiring, the brain can be “persuaded” that we are no longer in danger and to come back to homeostasis. But to be very clear, we are not saying it is psychological in any way, but we believe there are novel ways of accessing the unconscious brain. 

We recently worked successfully with a 56-year-old male with long-haul Covid, who prior to contracting Covid-19 in March of 2020 was running half-marathons and cycling, but afterwards he struggled to get off the sofa for months. Within 3 months he’s now back to 100% and  running half marathons again.

At our clinic, we train the patient to be able to recognise those subtle unconscious danger signals on the periphery of consciousness. This, coupled with supportive techniques and the natural hallmarks of good health such as sleep and diet help prepare the patient to respond to perceived threats that might trigger the response. 

The natural state of our brain is to default to protection. The brain prioritises survival and passing on our genes to the next generation, over any other impulse. It cares more about that than you feeling healthy and well. Protective responses are evolutionary, and are the right thing for the brain to do – it’s survival. 

What digital therapies or apps are proving effective at treating long-haul Covid? 
It seems that long haul patients are availing themselves of many online therapies and services, including meditation apps and wellness websites. We have an online neuroplasticity “brain retraining” video course called the “Gupta Program” which hosts 15 interactive videos and many audio exercises. This is proving very popular with long haul patients, and we are currently conducting a trial to test the effectiveness of this therapy. 

What is the danger of leaving long-haul Covid untreated?
The longer it goes untreated, we hypothesise that it may become more entrenched in the brain, and  become chronic in the longer term. Therefore we advise all patients to get help and advice as soon as possible.

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