Delivering patient-centred care in a post-COVID world
Using technology to optimise care delivery isn’t a new concept. In recent years it has been a key contributor to the design of healthcare environments that enable efficient patient-centred care. However, the COVID-19 crisis has elevated the importance of bringing patients, clinicians, and technology together to create a ‘Triangle of Care’ that promotes increased interaction, safety, and efficiency for all.
Optimising patient care and outcomes
Mobile medical carts have long made it possible to deliver the resources healthcare teams need to document and treat patients at the point of need. Utilised in medical dispensing and a variety of other workflow scenarios, these workstations on wheels enable doctors and nurses to use computers directly at the point of care to instantly access patient information and update care notes.
Enabling both data capture and recall in real-time, this optimises how clinicians make best use of their time while ensuring that patient records are accurate and up-to-date.
Requiring no extension cords or generators, today’s customisable medical carts support the installation of vendor-agnostic barcode scanners, printers, monitors and keyboards that are needed to facilitate efficient patient interactions.
Importantly, this also makes it easy for healthcare organisations to create triage locations and guarantee uninterrupted runtime for laptops and computers when staff are working in a non-hospital setting like a car park. For example, mobile carts and charging solutions are currently being used to power the UK’s speedy COVID-19 vaccination roll-out.
Utility at the point of need
Supporting temperature detection and facilitating access to equipment that maximises workflow activities, today’s mobile carts are enabling medical teams to undertake the efficient vaccination of people outside clinic walls, and in non-traditional locations like car parks and drive-through facilities.
These lightweight mobile solutions ensure that medical teams can undertake data access and data capture in real-time while providing access to vaccination materials. All of which makes it possible for frontline personnel to deliver joined-up safe care to the population in the most efficient way possible.
Ensuring everything care workers need is within arms reach is proving valuable in new care delivery models such as telemedicine, which have rapidly risen to prominence during the COVID-19 crisis.
Optimising remote-care capabilities
More and more clinics and GP surgeries are deploying telehealth technologies that make it fast and convenient to deliver human-centred care. At the height of the coronavirus crisis, video and telephone consultations in primary and specialist care settings proved key to maintaining care delivery as clinicians strove to keep patients away from overstretched and potentially infectious hospitals and GP surgeries. Indeed, Matt Hancock, the UK Health Secretary recommended that “all consultations should be teleconsultations, unless there’s a clinical reason not to.”
As a result, in the four weeks leading to 12 April 2020, 71% of routine GP consultations were delivered remotely – up from around 25% the previous year.
Indications are that the game-changing potential of telehealth means that once the crisis ends, healthcare providers will be looking to expand their remote care capabilities and monitor patients with long-term conditions, so they can intervene early to prevent a medical emergency.
However, the successful acceleration of telemedicine capabilities depends on rethinking how best to organise the physical spaces that clinicians use when remotely interacting with patients.
Evaluating the needs of all stakeholders
The key to transforming healthcare facilities for the delivery of telemedicine begins with bringing together all stakeholders to assess the needs and goals of users. That will mean convening representatives from IT and administration, as well as caregivers and even patients, who will regularly interact with technology in different ways.
During initial meetings, discuss how telemedicine might be expanded across the care environment to connect patients to loved ones outside the facility and foster enhanced communication between clinicians from different specialities or at different sites.
From a practical perspective, clinicians will need private quiet spaces where they can engage with patients in virtual consultations and undertake remote care visits in a professional and secure way. That means considering everything from the connectivity and materials that will be needed – such as speakers, good lighting, and enough bandwidth to ensure a jitter-free discussion. Finally, the seamless integration of technology and equipment will be key to bringing everything together in an effective and optimised way.
Reconfiguring spaces with people in mind
Introducing technology into care settings has a physical impact on both caregivers and patients. For example, using products configured for multiple monitors will ensure clinical staff can quickly access patient information from multiple systems in one location.
Similarly, adjustable equipment that provides relief for staff that want to switch between sitting and standing during virtual visits will be key to ensuring they are able to work effectively throughout their shifts.
As spaces at facilities may need to be easily reconfigured to support different clinical needs at the drop of a hat, products will also need to be easy to move in and out of rooms and through crowded hospital corridors. Finally, utilising workspace solutions that feature ultraviolet (UV) light to neutralise surface contamination on medical equipment will be essential if that equipment is going to be used by multiple caregiving teams.
Finetuning the telehealth delivery setting
Acting on feedback will help ensure that your organisation’s long-term adoption of telehealth models of care is successful. Post initial implementation, undertaking regular evaluations will help identify any training needs or and gaps that will need to be addressed.
When appraising new equipment, don’t just take into account if it offers an appropriate way to manage the physical constraints imposed by the facilities within which caregivers operate. Focusing on the ergonomics and workplace comfort needs of the healthcare workforce should also be a top priority.
The past 12 months have presented healthcare organisations with some significant challenges. As a result, they’ve had to innovate at speed to deliver care in a variety of settings and modes. Plus, to cope with demand, they’ve had to ensure that caregivers and clinicians can easily access the tools and information they need to deliver streamlined optimised care in a highly personalised way.
Today’s ergonomic medical carts and telehealth equipment solutions are making it easier for healthcare organisations to flex their facilities and their workflows to enable a new era of efficient, and digitalised, healthcare delivery.
Driving sustainability in medical device production
Environmental protection and stewardship are rapidly rising to the top of the corporate agenda and medical device businesses are no exception. The healthcare sectors of the United States, Australia, Canada, and England combined emit an estimated 748 million metric tons of greenhouse gases each year, an output greater than the carbon emissions of all but six nations worldwide. In order to curb this situation various European standards have been introduced.
The Waste Electrical and Electronic Equipment (WEEE); Restriction on Hazardous Substances (RoHS); Registration, Evaluation, and Authorisation of Chemicals (REACH) and the Energy Using Products (EuP) regulations have all significantly altered manufacturing processes, specific labelling, compliance with disposal restrictions, and creation of instructions for end-of-life management and recycling.
At the moment many medical devices are currently exempt from these regulations but several directives, including RoHS and WEEE, are in the process of being reviewed and could be applicable in future. This is especially relevant for devices that are ‘connected’ and have a digital monitoring component which then brings them under the regulatory purview of authorities that govern devices with electronic components.
Safety, Usability and Sustainability
While medical device manufacturers have been working to respond to increasing demand for environmental sustainability from the market, they also have to contend with a key element of their mission: to ensure safety and usability to healthcare workers and patients. Parenteral and other invasive devices are strictly regulated to help reduce the risk of Healthcare Acquired Infection which typically runs as high as 5% and 8% in most developed countries, according to the European Centre for Disease Prevention and Control. As a result, they typically contain disposable single-use plastic elements.
At the same time, many hospitals and purchasing organisations have started to recognise that sustainable purchasing practices play a pivotal role in reducing costs over time. Many GPOs have appointed and empowered Senior Directors of Environmentally Preferred Sourcing who are successfully implementing the sustainable purchasing business case. In addition global pharmaceutical companies are increasingly creating senior positions with sustainability objectives as key to the role.
Medical device disposal is a particularly burning issue; generally carried out through incineration in the EU, it typically releases nitrous oxide, as well as known carcinogens including polychlorinated biphenyls, furans and dioxins. Some of the strategies trialled by manufacturers to reduce waste matter destined to incineration include sterilisation and reprocessing.
Sterilisation, however, falls short on the environmental front, and may consume more energy and produce more emissions than incineration itself. In the United States for example, 50% of all sterile medical devices are sterilised with ethylene oxide but since this method releases harmful emissions, the US Food and Drug Administration is now encouraging the development of new methods or technologies. Many other established sterilisation methods use glutaraldehyde that is not only harmful to the environment but also tends to be regulated by strict usage and disposal rules such as COSSH guidelines.
Focus on Recycling
The outlook on recycling is changing significantly thanks to new research and technologies enabling, for example, monomer extraction. Recycled polymers can be broken down to their constituent monomers promoting an almost limitless recyclability of some polymers. In addition to this, Polyvinyl chloride (PVC), renewable polyethylene and polyethylene terephthalate (PET) can be recycled several times without losing critical properties.
Reducing the impact of packaging can also significantly reduce the materials that need to be dealt with through either waste or recycling. Packaging manufacturers are decreasing packaging volume by favouring sealed trays instead of pouches, laser-etching instructions directly on to the tray where regulation permits it, or reducing the number of components required overall. In addition to this, for recycling plans to be successful it important to have a full understanding of the practices surrounding device use and to establish, where possible, closed loop recycling systems that recover the waste materials from hospitals or patients and bring them back into the recycling process.
Sustainable Manufacturing: Technology and Research
Greater employment of fast degrading plastics or material from other sources is a key strategy to reduce harmful pollutants both at production and disposal stage. Bio-based materials can in fact offset the carbon emitted during processing as the monomer source grows, and a growing range of sources for bio based monomers -such as wood pulp or sugar cane- is available. However, when assessing the most suitable material for a part, the entire lifecycle of the product needs to be considered. For example: bio-degradable polymers can contaminate a recycling stream and emit methane when incinerated.
The use of environmentally friendly materials should also be supported by an increase in clean renewable energy sources. Lower energy consumption means fewer carbon emissions but also financial savings, making this an appealing measure for manufacturers. New technologies are proving a major gamechanger on this front, helping manufacturers marry their environmental stewardship with cost savings and efficiency. 3D printing, for example, can help develop optimum product moulds more quickly, refining production parameters to minimise raw materials volumes and maximising output productivity.
Similarly, ‘digital twin’ production software uses inline sensors to create a virtual, real-time mirror of the production environment to enable inline refinements. The objective is to achieve “zero defect”, waste-free manufacturing. In addition to this, LEAN manufacturing methodologies are already helping to optimise inventory management and reduce overproduction.
Sustainability by Design
It is increasingly clear that effective environmental sustainability in the medical device sector cannot exist without a full view of the product life cycle from concept development, material selection, design and engineering to manufacturing, packaging, transportation, sales, use, and end-of-life disposal. These evaluations are typically made for factors such as manufacturing efficiency, time to market, or safety and regulatory compliance, packaging and transportation costs, but should be extended to energy efficiency and environmental impact by means such as life cycle analysis.
In addition to this, with devices rapidly becoming more digitally connected, developers need to be aware that the costs of disposable electronics would simply not be viable, or indeed acceptable in the light of electronics disposal regulations. Design therefore should focus on creating a simple, repeatable interface between the two component sections so as not to impair the functionality or efficacy. As reducing waste and harmful emissions continues to exert businesses and governments globally, the medical devices industry cannot stand by. The environmental but also commercial implications of inaction are too serious and the array of solutions now available is exciting and diverse.