What Is Interoperability in Healthcare
Interoperability is the extent to which systems and devices can exchange and interpret shared data. In healthcare, effective interoperability occurs when IT and software systems to exchange shared data to create information that can be used to assist clinicians and other medical professions with patient care.
Issues Healthcare Staff Are Currently Facing
“Staff suffer from increasing workload and stricter performance measures with less flexibility. This has caused psychological and physical stress…” Science Daily.com
It’s no secret that digitising healthcare IT systems has been a slow and frustrating process for all stakeholders involved, especially the end users who have the responsibility of delivering safe patient care in a secure manner. This adds further pressure to staff who are already suffering from increased workloads and limited resources.
“We physicians have the longest training time of any profession, yet we now spend roughly two-thirds of our workday as data-entry clerks, tending to digital paperwork and administrative burdens” – WSJ.com
How Is Data Currently Manifesting Itself in Healthcare?
- Notes entered into the EHR (electronic health record)
- Documents that have been scanned as image files or pdf documents
- Discrete data such as lab test results.
“The data arrives from many different sources and systems and in multiple formats. It has to be parsed into a format that everyone understands and has been trained to act upon in an appropriate manner” Alan Brookstone
- The Tech
Data presentation can negatively influence decision making if it is presented in an illogical or intuitive way
- Human Skills
The computer skills of all staff members and knowledge of their EHR has a significant impact on data interpretation. There are many reasons why some people are less digitally literate than others.
- Upgrades and Disruption
According to AmericanEHR one of the most frequent complaints of users is that their EHR does not have the necessary tools or capabilities to perform a certain function. Sometimes the staff are unaware that their EHR has the functionality as they haven’t been trained to use the product properly. In other cases their system may require an upgrade. Upgrades can be complex and entire servers may need to be shut down for maintenance. Consequently, upgrades are often delayed because of the disruption.
How Can We Succeed?
Lack of interoperability leads to poor outcomes, therefore the issue must be tackled to ensure quality control.
We believe merging simple-to-use, reliable technology and adequate human support and training will result in the ultimate success of any EHR implementation.
So a move towards cloud-based systems will have a definite advantage as the software is updated centrally by the vendor with limited need to update technology at the user end.
The most significant impact would become apparent with changes to government regulations. G Cloud is an initiative that assists with the procurement by public sector departments in the UK of cloud based commodity IT services. Traditionally, vendors have to be certified as compliant by the Department of Health which inhibits better products and slows down new system implementation. G Cloud is a way of shifting away from more primitive systems and offers a positive step towards improving the efficiency of EHR software and communication tools.
At Bitjam we pride ourselves on finding continuous ways to improve developer documentation, with cloud-based systems and use of more consistent data design at the forefront of what we do. Our mission is to use technology for social good, so if you have a digital healthcare problem that you’d like to solve, email us at [email protected] to find out more about our previous work.
It seems the UK isn’t the only country frustrated at the state of their healthcare system. American businesses have also voiced their concerns over the rapidly spiralling cost of medical treatment.
This has led to the allegiance of some of America’s biggest corporations, including Amazon, to team up to form their own independent healthcare company for employees, based on data that they’ve gathered themselves (perhaps world domination is next?!)
And if the venture indeed launches and becomes integrated within the company, how long will it be until Amazon rolls out the system to the wider consumer?
Virtual Healthcare Assistants?
Amazon is one of several large tech companies who’ve ventured in to the world of virtual assistants, with the launch of Amazon Alexa in November 2014.
The voice-responsive AI can be called upon to assist with all sorts of digital tasks such as prompting connected apps or ordering products online. Amazon have been able to learn the behaviours and preferences of the consumer, and have drawn data from these statistics that have led them to them confidently moving into the world of healthcare.
Given that many people already “self-diagnose” using websites such as WebMD to validate their symptoms, (you can also activate this site using a virtual assistant such as Alexa or Google Home), it wouldn’t be unthinkable to imagine a time where we seek medical advice from the comfort of our own homes.
Having access to fast, effective medical solutions solves healthcare system issues such as a lack of workforce and wait time, and potentially reduce the spread of disease.
Home health aides are testing the use of Amazon’s Echo platform to assist elderly patients. They are finding this system gives clients more access to family members and assistance to ensure they get their medication on time. Other tech companies are now rushing to capitalise on this opportunity and provide similar services.
But what about the challenges? It would be both illegal and morally wrong to sell prescription drugs next to toys and household products. AI could potentially obtain inaccurate data leading to misdiagnosis or ineffective advice. There’s also the loss of human interaction, resulting in an impersonal experience, a lack of empathy and trust, and potentially increased paranoia around sickness.
“What we’re seeing is going to be a whole new look at privacy. HIPAA regulations … [are] 20 years old — and they don’t even take into account the technology and the data processing capability that we have today. There have to be a lot of adjustments before this becomes part of routine practice.” – Dr Eric Topol Scripps Health.
What the Health Tech Experts Think
Here’s how some experts believe an Amazon healthcare system might be adopted:
“Amazon, for example, might see that a customer has bought cough drops every week for the last month, and went to the doctor for a cold six weeks before but never filled his prescription. Amazon, or an “Amazon-like company” could use that kind of insight to encourage consumers to go back to the doctor, or drop by a nearby clinic for a nurse practitioner to examine them. That could solve the problem of getting the wrong care.” – Gil Irwin PwC
“One day, we could tell Echo our ailments and have recommendations and potentially some drug recommendations, which they could fulfill if they also have doctors available in live chat on an Echo Show device,” – Wendell Potter Tarbell.
AI’s and virtual assistants have been adopted into the mainstream very successfully, so it will be interesting to see how the IoT filters throughout our homes and personal lives to the point of acceptable dependency, even when it comes to our own health. We’ve noticed ourselves at Bitjam that we’re being approached by an increasing amount of businesses and researchers, including NHS, with regards to IoT projects.
What Bitjam are Doing
We have experimented with Alexa building simple question and answer skills based on health information (the core feature of Alexa). We have begun to think ahead with new products we’re developing integrating data design features for a plug and play capability into Amazon Alexa at future dates. It’s better to make small changes in data design earlier on rather than an after-thought.
To get in touch about your own IoT project, contact Carl for a chat at [email protected] (you could even tell Alexa to email him for you!)
Over the past decade we have seen an exponential growth in technology from the introduction of wireless internet, to smartphones, to nanotechnology. One particularly interesting concept is the channel shift that we are seeing in the ways in which we communicate.
What used to be 1:1 interaction has now led to the use of social media where clients are now able to reach out to businesses and social services at a click of a button. However, Social media is still too much like a broadcast channel where only simplistic interaction take place, with deeper interaction required in sectors such as health and social care. Social media may not be the prime channel to reach out to t
hese services as its publicity and lack of security are not ideal.
Therefore as businesses try to keep up with the advancement of technology, it is important that they do more with less. This is where we need to explore tech like chatbots (e.g. Healthbot’s, Edubot’s) to assist our development into the future.
What Is A Chatbot?
Chatbots are computer programmes that imitate human conversation through the use of artificial intelligence and machine learning. They range on a spectrum with simplistic bots who only recognise and respond to keywords found in a huge database, to those that incorporate the use of sophisticated Natural Language Processing systems who are very much indistinguishable from humans.
Chatbots Are Becoming More Commonplace
- ‘DoNotPay’- A robot lawyer that offers free legal aid to refugees seeking asylum in USA and Canada, helping them to fill out immigrant applications and helping people to apply for asylum support in the UK. This benefits people who might find it challenging to get started and empowers legal aid organisations by assisting with large numbers of clients.
- Xiaoice – A chinese chatbot built by microsoft that speaks to over 20 million people, serving as a ‘friend’. Many see her as a friend, just as they would a real human. The conversations with Xiaoice are so human-like, it creates a new goal for artificial intelligence to make people happier.
- Poncho – A Weather Forecaster- A funny and witty bot, capable of sending personalised weather and astrological predictions.
Challenges of Chatbots in Healthcare
Chatbots in healthcare may have to make clinical decisions, requiring stringent measures to maintain safety as it would become classified as a clinical device. For example, a healthcare chatbot may suggest when and how much medication to take. This requires professional advice from a doctor and if given incorrectly by a bot, could pose damage to patients. This then becomes a “human error” issue which someone would have to be responsible for.
There are also issues related to the level of trust between bots and patients as their interaction lacks the physicality and the connection created when patients meet 1:1 with their doctors. Therefore, patients may not feel as content or confident with the advice provided to them.
Lastly, should chatbots become successful and common practice in the medical profession, they could replace jobs such as nurses. Human resource could be replaced by artificial intelligence.
Future of Chatbots
As technology continues to advance, so will the intelligence of our chatbots; they will be used more frequently in a larger range of services to the point where in 2020, it is predicted that 85% of customer interactions will be managed without a human. Modern chatbots will be able to sustain emotional and in-depth conversations with humans in the same way that humans interact with each other, creating personal connections and serving as practical assistants. Chatbots could become our doctors, accountants, and maybe even our personal stylists and friends.
Bitjam is researching and developing chatbots both in healthcare and education with an early version currently being tested in a healthcare setting. We have developed an early version that uses end-to-end encryption with powerful software behind the bot that allows clinicians to programme the logic required for patients to interact and manage their health. However the key focus here is to allow clinicians to programme the chatbots rather than build an artificial intelligence system to make key clinical decisions.