May 17, 2020

Moving beyond the boundaries of traditional health care to address the whole person

Health Tech
4 min
Analytics can be used to examine an individual’s health records and personal situation to detect early warnings.
When we think of high-tech healthcare, we may think of hospital operating rooms with beeping electronic monitors and robotic surgery devices. But such c...

When we think of high-tech healthcare, we may think of hospital operating rooms with beeping electronic monitors and robotic surgery devices.  But such clinical health care deals with only a minority of the things that actually affect an individual’s total health.

Technology can -- and should -- play a big role in other aspects of making people healthier. Integrating data about the social world of the patient with the clinical data can have a huge impact on health. It can help caregivers address the myriad issues that affect people’s health outside the acute care provided in a modern hospital by helping provide support in their everyday lives.

RELATED TOPIC: IBM Watson delves deeper into health: 6 initiatives to watch

Together, systems that encourage caregivers to interact and use best practices as well as Big Data analytics and mobile devices linking patients, families and caregivers can change people’s lives. We need to use technology to achieve real collaboration among the many professionals and individuals involved in any person’s care. We need to use analytics to examine each individual’s health records and personal situation to detect early warnings. We need to establish best practices for dealing with genetic, environmental and lifestyle issues that have a bigger impact on overall health than the acute conditions that are treated in a hospital.

What we generally think of as health care -- doctor visits and hospital treatment -- accounts for only 10 to 25 percent of the variance in an individual’s health over time.* Surgeons in a world-class emergency room may save a person’s life after a car accident. But the person’s level of health in the years before the accident and for the years after recovery will be determined by many other issues.

Genetic factors account for 15 percent to 30 percent of health variance. Health behaviors such as smoking, drinking and exercise cause another 30 percent. Social and economic factors, including poverty, marital status and relationships, can cause 15 percent to 40 percent of the variance. And physical environmental factors such as air pollution and housing can have a 5 percent to 10 percent effect.*

RELATED TOPIC: Why India needs to adopt mHealth to enhance traditional models

In creating health policy, political leaders focus on clinical health care because that’s where the money is. However, clinical care isn’t sufficient for the high-cost, high-needs segment of the population. Elderly patients with diabetes or heart disease need to do more than take their medication. They may need help with transportation, meal preparation, and house cleaning. They may need help taking on a landlord who doesn’t repair a broken elevator or clean up mold that causes breathing problems. Treating the whole person goes beyond just their clinical concerns but also considers their social and behavioral needs at the same time.

The goal should be improved health, and achieving that can actually reduce health care costs. Smarter care crosses the boundaries created by different government agencies, private providers, individuals and their families. Combining data from many sources can uncover insights that improve a patient’s wellbeing. Applying collaboration and process automation to those insights increases the impact at the point of care. Providers can coordinate better with each other and the individual by having the insights on hand with applications that support their processes.

Around the world, a number of programs are emerging to care for the broad needs of people with chronic diseases. In Finland, there is legislation to bring social services and the health care system into a single citizen record. In The U.S., 262 hospital systems in 36 states employ lawyers to help patients access the housing or disabilities aid to which they are entitled. A United Kingdom program lets doctors write prescriptions authorizing patients to see a hospital-based income security consultant who can help them with budget, tax and benefits issues. We need to do more of this in the future.

RELATED TOPIC: How Europe is transforming big data into better health

When we think about public health, we need to think more broadly than traditional health care. We need to understand when social factors affect individual health, and how policy can be designed to help. High-tech medicine can extend far beyond the hospital. Applying technology to the broader issues surrounding a person’s well–being by helping manage and coordinate care across a multi-disciplinary team can make a big difference in health care, social care and in people’s lives.

*Source: Institute for Alternative Futures. Community Health Centers Leveraging the Social Determinants of Health, 2012.

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Jun 11, 2021

How UiPath robots are helping with the NHS backlog

6 min
UiPath software robots are helping clinicians at Dublin's Mater Hospital save valuable time

The COVID-19 pandemic has caused many hospitals to have logistical nightmares, as backlogs of surgeries built up as a result of cancellations. The BMJ has estimated it will take the UK's National Health Service (NHS) a year and a half to recover

However software robots can help, by automating computer-based processes such as replenishing inventory, managing patient bookings, and digitising patient files. Mark O’Connor, Public Sector Director for Ireland at UiPath, tells us how they deployed robots at Mater Hospital in Dublin, saving clinicians valuable time. 

When Did Mater Hospital implement the software robots - was it specifically to address the challenges of the pandemic? 
The need for automation at Mater Hospital pre-existed the pandemic but it was the onset of COVID-19 that got the team to turn to the technology and start introducing software robots into the workflow of doctors and nurses. 

The pandemic placed an increased administrative strain on the Infection Prevention and Control (IPC) department at Mater Hospital in Dublin. To combat the problem and ensure that nurses could spend more time with their patients and less time on admin, the IPC deployed its first software robots in March 2020. 

The IPC at Mater plans to continue using robots to manage data around drug resistant microbes such as MRSA once the COVID-19 crisis subsides. 

What tasks do they perform? 
In the IPC at Mater Hospital, software robots have taken the task of reporting COVID-19 test results. Pre-automation, the process created during the 2003 SARS outbreak required a clinician to log into the laboratory system, extract a disease code and then manually enter the results into a data platform. This was hugely time consuming, taking up to three hours of a nurse’s day. 

UiPath software robots are now responsible for this task. They process the data in a fraction of the time, distributing patient results in minutes and consequently freeing up to 18 hours of each IPC nurse’s time each week, and up to 936 hours over the course of a year. As a result, the healthcare professionals can spend more time caring for their patients and less time on repetitive tasks and admin work. 

Is there any possibility of error with software robots, compared to humans? 
By nature, humans are prone to make mistakes, especially when working under pressure, under strict deadlines and while handling a large volume of data while performing repetitive tasks.  

Once taught the process, software robots, on the other hand, will follow the same steps every time without the risk of the inevitable human error. Simply speaking, robots can perform data-intensive tasks more quickly and accurately than humans can. 

Which members of staff benefit the most, and what can they do with the time saved? 
In the case of Mater Hospital, the IPC unit has adopted a robot for every nurse approach. This means that every nurse in the department has access to a robot to help reduce the burden of their admin work. Rather than spending time entering test results, they can focus on the work that requires their human ingenuity, empathy and skill – taking care of their patients. 

In other sectors, the story is no different. Every job will have some repetitive nature to it. Whether that be a finance department processing thousands of invoices a day or simply having to send one daily email. If a task is repetitive and data-intensive, the chances are that a software robot can help. Just like with the nurses in the IPC, these employees can then focus on handling exceptions and on work that requires decision making or creativity - the work that people enjoy doing. 

How can software robots most benefit healthcare providers both during a pandemic and beyond? 
When the COVID-19 outbreak hit, software robots were deployed to lessen the administrative strain healthcare professionals were facing and give them more time to care for an increased number of patients. With hospitals around the world at capacity, every moment with a patient counted. 

Now, the NHS and other healthcare providers face a huge backlog of routine surgeries and procedures following cancellations during the pandemic. In the UK alone, 5 million people are waiting for treatment and it’s estimated that this could cause 6,400 excess deaths by the end of next year if the problem isn’t rectified.

Many healthcare organisations have now acquired the skills needed to deploy automation, therefore it will be easier for them to build more robots to respond to the backlog going forwards. Software robots that had been processing registrations at COVID test sites, for example, could now be taught how to schedule procedures, process patient details or even manage procurement and recruitment to help streamline the processes associated with the backlog. The possibilities are vast. 

The technology, however, should not be considered a short-term, tactical and reactive solution that can be deployed in times of crisis. Automation has the power to solve systematic problems that healthcare providers face year-round. Hospital managers should consider the wider challenge of dealing with endless repetitive work that saps the energy of professionals and turns attention away from patient care and discuss how investing in a long-term automation project could help alleviate these issues. 

How widely adopted is this technology in healthcare at the moment?
Automation was being used in healthcare around the world before the pandemic, but the COVID-19 outbreak has certainly accelerated the trend.  

Automation’s reach is wide. From the NHS Shared Business Service in the UK to the Cleveland Clinic in the US and healthcare organisations in the likes of Norway, India and Canada, we see a huge range of healthcare providers deploying automation technology. 

Many healthcare providers, however, are still in the early stages of their journeys or are just discovering automation’s potential because of the pandemic. I expect to see the deployment of software robots in healthcare grow over the coming years as its benefits continue to be realised globally. 

How do you see this technology evolving in the future? 
If one thing is certain, it’s that the technology will continue to evolve and grow over time – and I believe there will come a point in time when all processes that can be automated, will be automated. This is known as the fully automated enterprise. 

By joining all automation projects into one enterprise-wide effort, the healthcare industry can tap into the full benefits of the technology. This will involve software robots becoming increasingly intelligent in order to reach and improve more processes. Integrating the capabilities of Artificial Intelligence and Machine Learning into automation, for example, will allow providers to reach non-rule-based processes too. 

We are already seeing steps towards this being taken by NHS Shared Business Service, for example. The organisation, which provides non-clinical services to around two-thirds of all NHS provider trusts and every clinical commissioning organisation in the UK, is working to create an entire eco-system of robots. It believes that no automation should be looked at in isolation, but rather the technology should stretch across departments and functions. As such, inefficiencies in the care pathway can be significantly reduced, saving healthcare providers a substantial amount of time and money. 

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