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Sun 17 Aug 2008 04:00 AM

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Technology infects regional healthcare industry

Hospitals everywhere are going high-tech. ACN looks at some of the technology trends currently shaping the medical profession.

Hospitals everywhere are going high-tech. ACN looks at some of the technology trends currently shaping the medical profession.

Health is hot right now - especially in the Middle East. In addition to regional governments pumping billions into new hospitals and clinics, private medical providers are also pouring into locations such as Dubai Healthcare City and similar facilities in Saudi Arabia, amongst others.

In addition to the growing indigenous populations and resident workers, many visitors are now coming to the region for elective surgery - often cosmetic - as part of a vacation. These so-called ‘medical tourists', along with increasingly demanding residents, want the best in modern medicine - and IT is helping healthcare providers to deliver.

These 'medical tourists', along with increasingly demanding residents, want the best in modern medicine – and IT is helping healthcare providers to deliver.

Here ACN runs down some of the latest innovations to hit the hospitals, as well as some of the more interesting uses of the technology on offer.

Healthcare Information Management Systems

Not as glamorous or exciting as telemedicine or advanced imaging systems are, Healthcare Information Management Systems (HIMS) are nevertheless probably one of the most critical contributions IT can make to medicine.

Many healthcare systems around the world - even in the West - still rely on paper-based records, as well as physical images from X-ray scans and other procedures.

Pretty much the only remaining advantage to paper records is their inability to crash - but otherwise the potential electronic records hold for improving patient care is considerable.

HIMS systems, at their simplest, offer a way of recording, storing and retrieving patient information without the inconvenience of pulling a physical record.

This allows different areas and systems throughout a medical facility to act in a much more coordinated way - for example, it will be much harder to mis-prescribe drugs due to a missing record of patient allergies or medication conflicts.

Interlinked record systems also allow medical professionals other than a patient's main doctor to have full access to their records - potentially a vital advantage in the case of an emergency.

This, however, is a major point of controversy - security issues and concerns about who will have access to electronic records mean many healthcare providers have had strong objections about moving to comprehensive HIMS.

The UK's National Health Service is a case in point - massive public concern forced the organisation to backtrack on some of its plans for electronic records, and offering patients opt-outs and additional guarantees of security.

HIMS also offer substantial logistical and administrative functions, similar - or identical - to more general ERP systems, but geared specifically towards medical institutions.

Telemedicine

For most people, telemedicine is probably the first thing that comes to mind when thinking of high-tech healthcare - it's certainly the area that has most caught the public's imagination.Remote robotic surgery - something that seemed like science fiction 20 years ago, far-fetched five years ago, and merely quite risky in the recent past - is now more or less here, and in use in increasing numbers of (admittedly very expensive) hospitals around the world.

Fairly naturally, it's almost always the "robotic" element that gets most of the attention - but the real advances that have made remote surgery possible are the dramatic improvements in connectivity and bandwidth on data networks.

A lost connection could obviously be potentially fatal to the remote patient - but even slight latency on the link could also have extremely serious consequences, if the image seen by the surgeon lags behind the real situation in the theatre by even a miniscule amount of time.

Radio-frequency identification (RFID) has long been the problem child of modern IT, but no one ever suspected it could kill people – until now.

Such concerns - and, of course, the expense - serve to keep robotic surgery at the very high end of telemedicine. But the same principles are starting to filter down into much more general applications, such as remote consulting, where a patient may visit a booth, and be seen over video link by a doctor or nurse anywhere in the world - most likely a medical hub in a major town or city.

Vendors such as Polycom and Cisco are pushing these applications, up to and including offering complete self-contained "telemedicine booths" (which unfortunately look something like a public toilet).

Although still expensive, these applications are ideally suited to small communities in remote locations throughout regions such as the Middle East, where it may not be economically viable to set up a fully-staffed surgery. Real world applications of this are not yet commonplace, but as costs fall and network technology continues to improve, remote consultations may soon be a regular feature in the Middle East.

RFID

Radio-frequency identification (RFID) has long been the problem child of modern IT, but no one ever suspected it could kill people - until now. A recent report in the Journal of the American Medical Association has revealed that commonly-used RFID tags can produce potentially harmful electromagnetic interference (EMI) in medical equipment.

"In 123 EMI tests (three per medical device), RFID induced 34 EMI incidents: 22 were classified as hazardous, two as significant, and 10 as light," state the report's authors in an abstract. Worryingly - and contrary to what many might at first assume - passive RFID tags are more likely to create interference than their active cousins - the ones that actually generate radio waves.

This should be a major concern, as increasing numbers of hospitals are using the relatively cheap passive RFID tags to tag equipment, and even patients - a number of pilots have been deploying RFID technology in patient wristbands, to minimise risks of misidentification.

The report only came out at the end of June (although the research was conducted in 2006) so the medical community will need some time to digest its findings - and it should be noted that there have been no "in the wild" reports of RFID interfering with medical equipment. However, it may be that RFID's days as a viable technology in healthcare are severely numbered.

Imaging technology

Imaging is a critical part of medicine - being able to look beyond the skin and flesh and bone, and into problems deeper in the body.

Regional healthcare demand soaring

Demand for healthcare is expected to surge by 240% over the next 20 years in the GCC, with Saudi Arabia and the UAE expected to record the greatest demand. Growth is expected to be sparked by dramatic increases in cardiovascular disease and diabetes-related ailments, according to a recent survey from global consultancy firm McKinsey.

The survey said that by 2025 demand for hospital beds will more than double in the region, requiring almost 162,000 beds. Saudi Arabia, the UAE and Qatar are expected to register the greatest percentage increase in demand.

Spending on the treatment of cardiovascular disease, which now accounts for 12%of the total, will double and grow at almost twice the overall rate of healthcare spending during the period, the survey found.

Despite substantial investments by the GCC governments in medical education over the past 25 years, healthcare systems are still struggling as governments are not equipped to manage healthcare providers.

The problem with a great many imaging techniques is that they require the subject to be absolutely still - or just dead.

Systems like Magnetic Resonance Imaging (MRI) have always been plagued by movement issues that blur the images, making them much harder to decipher.

The march of technology and refinements of imaging systems means they can now perform "in vivo" imaging - examinations of living subjects - much more accurately.

Systems such as Kodak's In-Vivo Multispectral Imaging System can use several different scanning technologies to produce a composite image of a subject - and thus deliver important new details when looking at complex cases such as tumours, for example.

Aside from the advances in technology and physics that enable high-resolution, high speed imaging, it is again the improvements in processing power, storage and data transmission that make these imaging technologies viable - not to mention improvements in display technology.

Without these back-end systems, advanced imaging would not be practical, and would still be confined to extremely high-end applications - rather than the increasing numbers of hospitals worldwide and throughout the region.

Picture archiving system

Advanced imaging systems are all very well, but if you can't move and store the images - and retrieve them later - then there's little point in using it in the first place.

Document archiving systems are increasingly common across all enterprises, but healthcare-specific systems need to be able to deal with large numbers of extremely high-resolution - and therefore large - files. In addition, medical archiving systems must have extremely robust security and rights management, in order to make sure only authorised staff have access to patient records.

Many big-name vendors now produce Picture Archiving and Communication Systems (Pacs), including GE, Fuji, Philips and Siemens, and the range of options are extensive.

In addition to choosing an appropriate front end - now often including web-based options allowing remote retrieval, or just easier client control - the backend storage configuration is also critical.

Here the issues are very similar to many other storage array projects - but with a greater emphasis on data security and incorruptibility. As hard disk prices continue to fall, more and more organisations are opting for disk-based Raid solutions - although many systems also utilise off-line storage such as tapes or optical discs.

Data from these systems can be loaded onto disk at the start of a day, based on forthcoming appointments - although this does of course become complicated for emergency or short-notice consultations.

Saudi healthcare spending increases

The Saudi government will spend US$4.5 billion on building 350 new hospitals in the kingdom, health minister Hamad Al-Mani announced recently.

Al-Mani told an international knowledge forum in Al Madinah the hospitals would be built by 2012, according to the official Saudi Press Agency (SPA). He said the Health Ministry had extended 65% of its health services, while private hospitals had extended 20%, with the kingdom's total number of health centres reaching 12,000 in number.

Al-Mani told the forum that a planned health insurance scheme would also improve the efficiency of government hospitals. During the conference delegates called for more money to support research and health industries in Muslim nations, the SPA said.

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