Cloud favourite – e-care innovations

It is widely accepted that technology is a key driving force in sociological development. Throughout popular culture, visionsof future societies centre on the roleof technology in improving humanity's quality of life. As computing paradigms shift, we are able to change the way we manage our lives and institutions. One of the most exciting recent developments is the establishment and advent of cloud computing.

At last year's AWPC in China, technology leaders gathered to discuss the sociological, technological and economic trends that will shape the future of cloud computing and its applications.

KC Liu, founder and CEO of Taiwanese embedded-computing leader Advantech, identified that the central goal within cloud computing development is "a fully realised and connected planet".

The AWPC is a biennial initiative started by Advantech to better understand the role of technology in improving world services. The fundamental purpose of the event is to establish an innovation road map.

The latest meeting, held in Suzhou, China, saw Advantech joined by key partners from all over the world. ClinicAll, MaSante, Alphatron Medical and NDSsi joined from Europe. The Americas and Asia were represented by Microsoft, IBM, NEC and Medical Systems. Together, these companies are working towards the event's directive of enabling an intelligent planet.

Timely technology

In his keynote speech, Liu painted a vision of a world that is monitored, analysed and optimised: a world governed by the 'smart city'. This is a vision for all aspects of human life, including urban planning, hospitality and retail. The most exciting aspect of the discussion, however, centred on the possibilities for the healthcare sector. Best of all, the work being undertaken by those companies present will deliver the possibilities of the future today.

This work is timely: the problems addressed by these futuristic connected solutions are occurring currently in hospitals and communities globally.

David Lin, Advantech's director of healthcare, summarises the situation poignantly, describing the convergence of "a perfect storm, where a disruptive demographic meets a disruptive economy and disruptive technologies".

Ultimately, what this means is that, with current lifestyles clashing with significant cuts in healthcare funding, now is the time to take advantage of technology developments and optimise the healthcare sector.

The requirement for optimisation and greater connectivity is further compounded by the record levels of urbanisation now being observed. The World Bank has just released telling data that confirms that, for the first time in human history, the majority of the world's population now resides in urban areas.

This rise in population density is further increasing the strain on healthcare facilities and, in doing so, demonstrates the urgency for digital reform. Analysts predict that the percentage of the world's population living in urban areas will increase to 66% by 2025 - the time to act is now.

Within healthcare, the smart city concept envisions the collation and leveraging of big data, where hospitals enjoy extended mobile interaction with their patients.

The fundamental truth of this vision is that the benefits are felt by the patient and the caregiver, and the treatment process and results are fully optimised - truly digital healthcare.

For Advantech, there are three key areas that immediately lend themselves to digital optimisation: intelligent outpatient services, intelligent operating rooms and quality nursing care.

Intelligent outpatient services

As with the smart city concept as a whole, the central technology for intelligent outpatient services (IOS) is a unified cloud service. All key operations within the hospital would be linked remotely to the cloud - patient and treatment databases, nurses and doctors, receptionists, devices and pharmaceuticals. By ensuring that the best interests of the patients and caregivers remain fundamental to the IOS, the technology remains rooted in humanity.

The patient infotainment terminal is one such example of how one connected device can benefit the patient and caregiver. Alongside their software partner Imatis, Advantech can provide a bedside terminal with communication and entertainment capabilities for the patient while also allowing healthcare professionals real-time access to electronic health records (EHRs) wirelessly.

The clinical benefits of such a terminal are an increase in data transfer and accuracy, all the while improving the patient's experience, as feelings of isolation and boredom are tackled head on.

Furthermore, in markets where healthcare is privatised and competitive, such patient-centric devices will improve the service offered by the hospital without being a clinically unnecessary piece of hardware, like a traditional gaming console.

One facility already benefitting from such an installation is St Olav's University Hospital in Trondheim, Norway. As part of a technology overhaul, 300 systems were fitted, leading to positive results. The terminals are low in power-use and create minimal heat, which suits the efficiency targets of the facility, while improving patient experience and well-being.

Further to the administrative, clinical and patient-experience benefits, patient infotainment terminals create revenue-generation opportunities. In the same vein as an app download store, industry insiders believe bedside tablets will be loaded with games, television shows and movies requiring electronic payment.

Ultimately, while such a feature is not intrinsic to the development of such a device, it is easy to recognise the inevitability of their inclusion. Healthcare funding is stretched, and chiefs of medicine appreciate additional revenue opportunities.

Intelligent operating rooms

Globally, the numbers of surgical procedures that take place are increasing every year - in line with a growing population, and improvements in diagnostic imaging and patient education. According to hospital episode statistics,
in the UK alone, there were 4.6 million hospital admissions requiring some form of surgical intervention last year.

The workload placed on surgical staff, and the operative and interventional suites they work within, has never been greater. The construction of intelligent operating rooms (IORs) tackles one of the most life-critical areas of any hospital.

Alongside robotic surgical aides, computer hardware also delivers wireless input visualisation screens. Due to the consistent complexity of surgical procedures, it is imperative that any image is transmitted from its original source,
such as an endoscopic camera, via the processing equipment to the display as accurately and consistently as possible.

When constructing such a suite, hospitals aim to future-proof and invest in technology built for adaptability and modification. Advantech partner NDSsi offers displays that deliver clinically accurate HD images that aid the surgical team when performing a procedure, and can process analogue and digital signals that improve integration.

The importance of such displays cannot be overstated; continual innovation in the field of minimally invasive surgery has led to surgeons increasingly relying on visualisation solutions. The ability to recognise tissue abnormalities is governed by the quality of the image they are working from, meaning the correct hardware and display solutions are ultimately life-critical in this environment.

Another issue to consider when constructing an IOR is telemedicine and the possibility that consultation - and, one day, even the actual procedure itself - may occur remotely. The person ultimately controlling a robotic aid could be hundreds of miles away. As such, ensuring that the hardware to support wireless communications is as accurate, secure and quick as possible is essential. In this regard, the IOR has the potential to be the flagship of the smart city concept as a whole.

Quality nursing care

The rapidity with which patients' vital data can be monitored and responded to is one of the most obvious benefits for quality nursing care (QNC) with an integrated cloud-based solution. One aspect of QNC arguably less widely discussed is medication safety. The route from prescription to pharmacy and then pharmacy to bedside has traditionally been rife with opportunities for human error. Medication errors have been blamed for causing high numbers of patient fatalities and complications for many years.

By digitising the medication-dispensing process, the error rate has the potential to be drastically cut. The ideal scenario is the creation of what can be termed a 'closed loop', where the process becomes completely supervised and secure. By implementing cloud-based EHRs alongside a computerised medication cart and patient record band, the closed loop can, in principle, be achieved. A prime element of such a setup can be seen with the AMiS medication cart developed by Advantech and partner Alphatron.

The solution's design is geared toward the patient's safety as well as the user requirements. The fundamental benefits lie in the mobility and manoeuvrability of the cart itself - it can easily be moved between the patients' beds without impeding the caregivers - along with the fact the prescription is accurate.

As the initial prescription is remotely transferred via the cloud network to the pharmacy and placed in a drawer with an electronic locking system that can only be opened when the patient's tag is rescanned, the scope for error is minimised.

QNC is the most prolonged aspect of a patient's time in a hospital, and, therefore, the area with the most opportunity for complications and distress. By allowing better patient management and the reduction of unnecessary paperwork, the digitisation of the nursing environment is of the utmost importance. To achieve this, there is a requirement for a connected focus from all central hospital departments - from the pharmacy to the IT directors to the chiefs of medicine.

Cloud computing, despite only truly being realised in 2010, has unified the traditionally isolated innovations being presented to hospitals. Every level within a hospital has the potential to be optimised with considered integration of such cloud-based solutions, be it the intensive care unit, OR or the nursing station. The collection, analysis and leveraging of big data will redefine healthcare practices and the way hospitals are managed.

While the hospitals of the smart city have a tendency to appear idealistic, the technology to achieve these visions is more readily available than one might think: cloud computing is realised, wearable sensors have been developed, computing hardware has been accelerated and industry willingness has improved.

The positive signs were abundant at the AWPC, and it is natural to feel that the enthusiasm of all the companies involved to improve healthcare is the most positive thing of all.

The challenge hospitals now face is to develop the partnerships, as Advantech has demonstrated with the AWPC, to marry the vision with the reality.