Keith Errey, CEO and co-founder, Isansys explores the prospects of building the healthcare cloud
Healthcare providers across the world are proving unable to withstand the pressures being heaped upon them by more populous, longer-living patient communities. They must do more for less. The good news is that an excellent way of reducing cost is to overcome inefficiencies – and that’s where a transformative technology solution is long overdue.
Many systems for ‘digitising’ healthcare have been developed, but the digitisation has really been about the process – Business Process Engineering. Moving forward company’s such as Isansys are taking the next step by digitising the patient. This is leading to efficiency gains in the clinical side of healthcare in remarkable new ways.
Digitising the patient
The company’s Patient Status Engine is described as an “entirely new type of wireless patient monitoring system”, this is designed to harness the key attributes of secure cloud computing to new generation body-worn wireless sensors.
The system works by simply and unobtrusively capturing vital sign data from a patient, analysing it in real-time, transmitting it to a secure server and updating the patient’s electronic health record. The information in the EHR can be securely delivered to any authorised user – anytime, anywhere.
Patients are continuously monitored via ‘cloud-ready’ LifeTouch wireless ECG sensors and other body worn devices. The composition features an ultra-low profile and lightweight sensor measuring and analysing the heart rate, respiration rate and heart rate variability that, along with data from the other sensors, can be viewed directly or forwarded into a secure cloud-based EHR.
The solution has been designed for recyclability and re-use, so that the costs of the system are reduced to a level that enables universal use – regardless of whether patients are in hospital, within care facilities, or at home.
Prediction equals prevention
By pulling the complete system together into a clinical-grade, coherent solution, the company describes its efforts as building a “clinical healthcare cloud” – including key intelligence and data analytics to deliver a complete ‘Vitals as a Service’ solution and new predictive functions to healthcare professionals.
This new approach extends the concept of an automated wireless patient surveillance system into something with the potential to completely change the face of healthcare delivery.
The system collates data points and measurements to which intelligent algorithms can be applied. From this, the company claims it is able to achieve something that has not been possible before: predicting the future status of any patient.
For healthcare providers, the ability to predict deterioration – especially if it is able to be seen hours or even days ahead via ‘early warning scores’ and alerts – means that a clinical intervention can take place which can prevent an adverse event, and avoid the patient needing an emergency response. This has significant implications for improving the safety and quality – and reducing the cost – of healthcare delivery across the board.
Indeed, one of the major efficiency gains from a clinical perspective is to avoid having to do the same procedure more than once on a patient and, crucially, preventing hospital readmissions. The cost of readmissions within 30 days in the UK alone totals £1.6 billion per year1, and the costs in the US are estimated to be reaching $25 billion per year2. The predictive capability offers a powerful set of tools that can massively reduce this unnecessary depletion of the resources of healthcare providers.
Cloud formation – healthcare’s special requirements
The company advises, while the system is built on proven cloud computing principles, this is in essence a new type of cloud structure, designed to serve the unique requirements of clinical environments. Ensuring data integrity, security and provenance is of crucial importance, and the highest level of robustness and standards compliance needs to be designed in from the outset.
One of the other key technical aspects is for the system to be cost-effective to use and highly scalable to deploy. Scalability is an inherent property of a cloud-based system, and the Patient Status Engine can operate as a small cloud (within a single hospital or a hospital group), or it can be extended across a whole country or even across the world. However, in terms of data ownership, legislative and sovereignty issues mean that actual server locations often need to be within national boundaries. So, ultimately, these systems not only need to adhere to stringent clinical regulatory requirements, but also complex data regulation.
Moreover, the needs of clinical staff must be paramount. The intelligence of the system means that lots of data is continuously collected, but this is then processed and delivered back to clinicians and nurses as tailored high-level information. The prediction and processes within the system are focused on extracting the useful clinical information and providing that – and only that – to clinical teams.
From passive recipients to active participants
Once we start to think about patient vigilance systems in terms of cloud-based architectures, inherently the focus shifts from traditional product offerings to services and applications. In this way, we are transforming the idea of a medical device from being a piece of equipment to being a cloud-based process, and that is a fundamental technology and business shift with very exciting possibilities for healthcare delivery and the patient experience.
The company’s Patient Status Engine is designed to work in professional clinical environments and that will be its initial application, however, because it’s a cloud-based system, one of many near-term additional services that can be offered is edited information for patients themselves and their families, delivered anytime, anywhere.
In the future, we will see ‘Granny’ Apps, ‘How’s Mum Doing in Hospital’ Apps and so on. We will become newly empowered in managing our own lifestyle and health via timely and accurate information that previously only our doctors would have known.
It is this ubiquitous and democratised access to quantified physiology that will enable us to understand how to make intelligent choices about our lives and lifestyles in order to optimise our physical beings. This will redefine our relationships with physicians and the clinical community, and will move each one of us from passive recipients of healthcare to active participants – empowered consumers of healthcare.
1. 2012 research by CHKS on UK hospital readmissions within 30 days using Hospital Episode Statistics (HES).
2. PriceWaterhouse Coopers’ Health Research Institute, The Price of Excess: Identifying Waste in Healthcare, 2008.