Technology
the likelihood of being admitted to hospital for a chronic condition, and the likelihood of recovering from surgery, is dependent on a range of risk factors. Does the patient smoke? How much alcohol do they drink? Do they have existing conditions? These are questions clinicians have been asking patients for decades, but a harder to define question is emerging in the literature as increasingly important. What does the patient’s cardiorespiratory health look like? Or more simply put: how fit are they? This open question is key to getting a
general picture of a patient’s health because cardiorespiratory fitness (CRF) is one of the best general predictors of health. There is a strong correlation between CRF and general mortality.3
We all know exercising and becoming
‘fit’ is good for us, but only in recent years has peer reviewed evidence demonstrated the link so clearly – and not just for heart health. From prostate cancer4 disease,5
to cardiovascular CRF is a good general indicator of
risk and prevalence. CRF is measured through assessing VO2 max. This refers to the body’s maximal rate of oxygen consumption measured by volume and is most commonly done for elite athletes. It is not currently widely used in healthcare, despite the growing body of literature in support of its importance. The American Heart Association has called for VO2 max to be regularly examined as it is the ‘strongest indicator of health’.6
It is astonishing
what this could do at a system level if managers and planners had access to the prevalence of a range of diseases and conditions within a population cohort. This is especially true from a public health perspective, as small increases in CRF are associated with a 10 – 30% reduction in adverse cardiovascular events.7
An effective
preventative approach to healthcare needs to consider this metric, alongside others, to plan, manage and help those who are more likely to become ill.
Digital solutions When it comes to clinical innovation, the unspoken assumption is that we are talking about material or physical innovations like better
surgical tools or more sophisticated theatre equipment. These innovations are essential to improving care and the effectiveness of operations, but the role of digital technology in helping to improve theatre capacity, outcomes and hospital efficiency is often poorly understood. It is a cliché to say that digital technology can (and is) transforming healthcare. The use of technology in the NHS is not a novel concept, and the improvements in patient care and efficiencies that have followed implementation of various software-based solutions are well documented. As an academic and practising cardiologist with an interest in digital technology, I believe the technology that has the biggest potential to truly transform acute care is often not designed to be used within a hospital. Rather, it is technology that is focused on preventing admission, providing clinicians with better information about a patient and assisting rehabilitation. Personalised medicine is becoming a popular topic in the pharmaceutical world, but it is also interesting to think about how we can start personalising care in hospitals too by giving those delivering care better
I believe the technology that has the biggest potential to truly transform acute care is often not designed to be used within a hospital. Rather, it is technology that is focused on preventing admission, providing clinicians with better information about a patient and assisting rehabilitation.
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information about the health of the patient they are treating. The role of digital technology in supplementing these physical innovations cannot be overstated. The CSJ has been at the forefront of shining a light on digital innovations, from patient flow software to the use of surgical robotics. One underexplored area that I am passionate about is digitised devices. That is, combining the benefits of advanced algorithms and software, with the tried and tested sensor- based technologies in a medical device. As Chief Medical Officer at VentriJect, a Danish medical device company, my work has focused on how to leverage digital technology to deliver insights that healthcare professionals can use to improve the delivery of care. Some of the most powerful innovations are not tools, but data and intelligence solutions. These will be key to delivering care, over the coming years, as the population continues to grow and co-morbidities become more complex and omnipresent. Those developing digital solutions need to
be careful not to develop software or devices that though technically accurate and clinically superior, create process bottlenecks that end up being self-defeating. Involving clinicians in every stage of product development is critical and I would encourage anyone with an interest in this field to get involved in early-stage testing. There are two ways I see digital technology like this playing a role in helping relieve the pressures in acute care and delivering better outcomes and improved capacity. Firstly, technology must be used and exploited
before the patient gets to a stage where they require hospital treatment. Wearable devices and mobile applications can monitor vital signs, symptoms, and activity levels of patients at
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