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Sun 15 Feb 2009 04:00 AM

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Healing power

Cutting edge communications technology is being used to help save patients lives and make healthcare professionals’ jobs easier in two very different settings, with vendors reaping the rewards of the growing sector.

Cutting edge communications technology is being used to help save patients lives and make healthcare professionals’ jobs easier in two very different settings, with vendors reaping the rewards of the growing sector.

For those who live in rural areas, gaining access to healthcare can be expensive and time consuming, as the cost of maintaining a hospital or clinic for a small number of people can be prohibitively expensive, sometimes forcing those who need medical attention to travel large distances.

Girish Trivedi, deputy director of Frost and Sullivan's Information and Communication Technology Practice, says that the main costs involved in the provision of healthcare are related to the proximity of the patient in relation to the healthcare provider.

Healthcare is one of the faster growing segments globally for Alcatel-Lucent.

"Most of it is focused on personalised interactions which is not necessary all the time. Also if you see the requirement of a person in need of medical attention in semi-urban areas and rural areas, or even lesser developed urban areas, they may need to travel and incur higher costs than for healthcare payouts.

"Communication infrastructure can play a very important role by providing better bandwidth, and healthcare applications over communications infrastructure such as video monitoring, resulting in less travel and timely healthcare services as well as lower costs for better healthcare facilities," Trivedi says.

The Pakistan Telemedicine Project, a partnership involving Abu Dhabi Group's Wateen Telecom and Motorola enables a "hub" or a central coordinating hospital to communicate with "spoke" hospitals that may have limited resources. By connecting the two, information and expertise can be passed between them in real-time.

Some of the expanded medical care offered by one of the hospitals involved in the scheme in Pakistan includes pre-operative planning and follow-up; cardiac assessment; ophthalmology; dermatology; radiology; treatment of infectious diseases; perinatal evaluations and medical triage for traumas and acute illnesses.

Telemedicine expert and surgeon, Dr Asif Zafar, of the Holy Family Hospital that is involved in the scheme says: "Pakistan is the sixth most populous country in the world - a nation of 173 million people. The goal of this project is to highlight technology's ability to overcome a significant healthcare imbalance. 75% of the population lives in rural areas but only 22% of the doctor's work there."

As well as using Wateen's nationwide Motorola WiMAX network the partnership combines an internet-access portal providing tools such as secure email, voice and video conferencing on a secure "telemedicine" network with medical peripheral devices including portable ultrasound, digital cameras, EKG, stethoscope and an X-ray machine.

Valuable market

Alcatel-Lucent's vice president of sales and support for emerging markets, Jan Zuurbier, says that the healthcare sector is growing in importance for vendors. He estimates that healthcare provides around 11%-12% of Alcatel-Lucent's Enterprise division's business, which he says is a 1 billion euro business (US$1.3 billion).

"It is one of the faster growing segments globally for Alcatel-Lucent," Zuurbier says. "Over the last year it has been growing at about 15-20%, and in North America even more, where I think we have been seeing growth rates of around 30% in our business for the healthcare industry, given a couple of very large projects we have there. For my region of the emerging markets the growth in healthcare is about 15%, which is also about the growth rate that we have witnessed for the healthcare segment throughout the Gulf area."

Nortel's account director for the UAE, Kuwait and Qatar, Steve Joyner says that healthcare is one of the top five verticals for the Canadian vendor, and it is a sector that he is confident will continue to be of benefit to vendors.

"Despite all of the economic downturn this is a vertical that can't afford to rationalise too much. I would expect that it at least maintains if not grows in the single digits," Joyner says.

"It can not afford to go backwards. Everything else in the world can decline appropriately, but there will be the same volume of ill people, if not more - that won't change. This particular vertical really can't afford to take its eye off the ball, but what it will do is look to become more efficient and this is where we hope that some of our solutions can save them money down the line elsewhere."

Pioneering technology

A $300 million joint-venture between Alcatel-Lucent and University of Pittsburgh has been established to deliver healthcare solutions developed by Alcatel-Lucent's innovation arm Bell Labs to the market. One of the products that has been developed is a ‘digital stethoscope'.

"What they have done is taken the stethoscope and through sensor and sound technology they can digitise whatever the doctor can hear, store it on a laptop, PDA or server," says Zuurbier.

"Then when the patient returns they don't have to judge by ear; they can judge based on the digitised format and the frequency spectrum, and immediately they can check against templates for a specific illness and see if the patient is improving or getting worse."

It is a sentiment echoed by Zuurbier. He says: "The IT spending in healthcare has been going up at about 15%-20% year-on-year. In the GCC the IT spending on healthcare will be around US$9-10 billion and that has been growing about 16% year-on-year. Even if you take a look at the next five years the healthcare sector will grow simply because of a couple of factors we are seeing."

Rising expectations from patients and citizens, coupled with a need for increased efficiency from healthcare managers have created an environment that is ripe for solutions provided by telecoms vendors.

"And then you have the demographics; the average age of people is just going up - in Europe you see that to a large extend but also in the Middle East and the Gulf area, the average age is going up. So these three factors make clear to us at Alcatel-Lucent that we have to invest in this segment because it is simply going to be a growing sector for us for the next decade," Zuurbier says.

Resiliency and redundancy and security are areas that we need to be absolutely spot on in healthcare.

Gains vs risks

Cutting edge technology is not only being used to connect remote locations, it is also being utilised by hospitals and clinics that operate in built-up areas where different departments are split across several different premises.

Nortel has installed some of its equipment to give physicians rapid access when and where they need it to diagnostic information from MRIs, CAT scans, ultrasounds and mammograms.

Some of the areas that savings can be made is through the eradication of errors. Aside from the alarming and potentially life threatening implications for patients, mistakes can also be costly for hospitals and clinics.

"It's so easy to make mistakes, particularly in a region like this that is multicultural where people speak different languages. It is possible to make mistakes and technology can help with that. They have a lot of duplication in some of their processes in the way they manage patient's records so any way that we can help them reduce or apply some efficiencies can help," Joyner says.

"If it takes two or three weeks to get diagnosed you can get progressively more ill, so the speed that you can get diagnosed is very, very important, so giving physicians broader access to databases and other physicians online through unified communications is a big point."

Joyner says that while efficiency gains can be made, there are also life-saving benefits for patients.

"The physician will have access to notes wherever he is. If he is at the patient's bed he'll have a PDA and he will be able to rapidly access all the information he needs about the patient's history. Then, if he's discharging them then he can update there and then on his PDA the latest course of action, or any reappointments or prescriptions so that when the patient checks out or is discharged their prescriptions are available. At the same time the doctor or nurse can inform the accounts department, if it's a private hospital, that the patient is about to leave so the bill can be prepared. All this can take place at the bedside, all in one go."

At the end of last year, Nortel unveiled a unified communications solution for Sharjah Teaching Hospital in the UAE to speed up diagnosis and teach the next generation of doctors and medical staff, through secure access to clinical notes, schedules and health information from anywhere on campus using Ethernet routing and a server for VoIP and unified messaging, as well as handsets for roaming communications between nursing staff and other health professionals.

Medical files are among the most personal of records, and this needs to be taken into account by vendors when devising solutions that enable a greater number of healthcare professionals to access them while on the move.

Zuurbier says: "What the health care provider needs to do is secure those business processes. They may be able to get away with the network being down for a couple of minutes - although you don't want it - but they cannot get away with having all the patients files on the street: that is clearly a management mistake. What you need is to secure the information flow for all the automated processes that you have."

"Resiliency and redundancy and security are areas that we need to be absolutely spot on in healthcare," Joyner adds. "It is paramount that patient information is secure. You can have the right products but if you don't know where the security risks and loopholes are they can be infected."

One of the issues familiar to anyone who has visited a hospital recently are the restrictions on using mobile telephones, through fear that they will interfere with the life-saving equipment. It is a concern that Joyner says vendors have to take into account, to make sure that the equipment they provide helps rather than hinders.

"The frequencies used are ones that don't interfere with any key equipment in the hospital, like heart monitors. The devices use very, very low power frequency as well," he says.

Remote access

The Pakistan Telemedicine Project has taken lessons learnt from IBM and Medweb's experience to establish a telemedicine scheme on the world's most remote inhabited island, Tristan da Cunha, which is 1,750 miles west of South Africa and 2,088 miles from South America.

With no airstrip the island is only accessible by a one week boat trip, which means that the 270 residents had to rely on the expertise of just one doctor - who didn't even have a telephone in his surgery - to cure all their ailments.

Project Tristan, established in 2007, connected the island via a satellite internet connection to a 24-hour emergency medical centre in the US, which enables digitised X-rays, ECG scans and lung-function tests to be sent to experts, who can be consulted via a video link.

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