TECHNOLOGY
Telemedicine
The UK has seen the number of patients admitted urgently to hospitals increase by 42% over the past decade, with the number of patients admitted and then discharged on the same day increasing by 373% over the same period.12
The rising number of
acute admissions makes it clear that the UK could benefit from the right communications channels with patients at home. Telemedicine can help to improve access in both rural and urban settings, reduce the number of avoidable admissions to hospitals and missed appointments by connecting doctors and patients through e-consultations and healthcare apps. In 2.5 years, the number of health apps on IOS and Android has more than doubled in the UK.13
In
2017, for instance, the UK launched a new app, GP at Hand, to cut down waiting time for appointments while enabling remote access to primary care in London through online GP consultations.14 Airedale NHS Foundation Trust also led the implementation of a telemedicine service within a care home, providing residents with 24/7 support, and linking them with a doctor through video consultations, if required.15 Between April and June 2017, 90% of patients using the service stayed in their place of residence, while only 10% (924) requested an ambulance.16
This represents
a 30% decrease in demand for GP primary care services, and a 33% and 25% reduction in Emergency Department (ED) attendances and hospital admissions respectively.17 Telemedicine has come into its own during the pandemic, but digitalised telemedicine is not only linking doctor and patient over the internet; it involves linking diagnostic imaging units, pharmacy, therapeutic clinics and, indeed, consultations between doctors, to provide improved access and efficiency through digital linkage. For instance, a mobile scanning unit might capture patient medical imaging in multiple locations which are then accessed digitally by interpretative specialists in a remote hub. Considering that the NHS deals with one million patients every 36 hours,18
it
comes as no surprise that moving care out of hospitals and closer to people’s homes through telemedicine has been identified as
a priority investment area. It is estimated that the UK will need to invest £1.4 billion in telemedicine over the next five years.19
Smart hospitals The benefits of smart hospitals are well- recognised. Among the many applications of smart hospitals are digitalised asset tracking and predictive maintenance – which both have the potential to dramatically reduce delays and cancellations by ensuring that precious technology and facilities are available when they are needed. Through better management of hospital resources, smart hospitals contribute to freeing up precious time for patient care. The Royal Wolverhampton NHS Trust is the first hospital in the UK to put in place a pilot project which provides real-time monitoring of bed capacities, in some cases reducing surgical cancellations due to lack of beds by 60%. Tele-tracking technologies allows the hospital to track real time bed capacities through bracelets and badges connected to patients, staff and equipment. Patients are allocated to the most appropriate ward first time, ensuring they receive care from a medical and nursing team who are experts in their particular condition. Similarly, eTriage systems can help A&E
departments prioritise patients. One hospital in London found that 99% of patients were able to undergo initial assessment within 15 minutes of arriving at the hospital using
eTriage systems can help A&E departments prioritise patients. One hospital in London found that 99% of patients were able to undergo initial assessment within 15 minutes of arriving at the hospital using their eTriage system, well above the UK’s nationally mandated target of 95%.
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their eTriage system, well above the UK’s nationally mandated target of 95%.20
It also
took 85% of patients less than one minute to check in and time to treatment was reduced by an average of seven minutes per patient.21 These initiatives have helped extend patient care outside of the clinical setting, thereby reducing unnecessary trips to the hospital and creating greater flexibility for both healthcare professionals and patients. Presently, the majority of UK hospitals are in HIMSS Stage 522
of the technology-enabled
hospital scale, with 53 hospitals falling into that category23
and where Stage 7 represents
complete electronic health record (EHR) integration across all clinical areas. For the UK to fully digitalise its hospitals, it will need will to invest an estimated £1.3 billion over the 2013-2019 five-year period.24 Evidently, investing in these three areas alone will require considerable capital investment. which typically goes beyond the normal capital budgets in healthcare which hover around the 5% mark of total operating budgets. If healthcare systems were to buy the technology required for digital transformation outright, this would tie up a high proportion of funds needed for urgent operating expenditure. In today’s pressurised healthcare environment, many healthcare institutions are therefore turning towards private sector financing tools to acquire the necessary equipment. Specialist financiers offer a wide range of financing tools designed to achieve digital transformation, for instance, by allowing healthcare bodies to pay to use the new generation technology rather than having to buy it outright in a one-off capital sum. Even a stand-alone equipment unit will require maintenance and service, but enterprise-wide solutions may bundle these into a single regular charge. Using their knowledge of the healthcare sector and its underlying technologies, they can structure financing arrangements that accommodate equipment, software, integration costs,
OCTOBER 2020
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