Since the pandemic, the possibilities of digital technology have been explored to a greater extent. In the healthcare sector, too. Online appointments, video consultations and digital sick notes are just a few examples. But what about digitisation in the hospital sector? What smart concepts and solutions are already being used here to benefit medicine and people? What is currently being worked on? What might the hospital of the future look like?
In many industries, digitisation is seen as a job killer. And that's basically true. It ensures that activities previously performed by humans are carried out with the help of artificial intelligence and digital technology. In the medical sector, however, this could be extremely helpful when it comes to rectifying long-standing problems and ensuring that patient medical data is exchanged smoothly, that teams in hospitals are relieved of time-consuming routine tasks, and that patients receive the best possible support in their recovery.
The current reality is that hospital costs have been skyrocketing for years. Many medical services are costly for the healthcare system. Staff are stretched to the limit, and patients feel that they are receiving less care. All of this has not just been true since the corona pandemic, and so the need for digital transformation is growing in hospitals. The McKinsey & Company report "Digitalisation in German Hospitals" from 2018 quantifies the potential monetary effects in concrete terms. According to this, the commissioning of 26 selected digital technologies would lead to savings of around 16 billion euros in the hospital sector alone.
However, the topic of "smart hospitals" is complex. The Krankenhausgesellschaft Nordrhein-Westfalen e.V. (North Rhine-Westphalia Hospital Association) sees four levels: those of the employees, the patients, the strategic orientation and the processes. Considering these aspects in their entirety is a broad field. Therefore, in the following we want to concentrate on what appears to be relevant from a medical point of view and for the benefit of patients and staff.
Let's start with inpatient admission to a hospital. In a smart hospital, patients no longer have to ask their way to the ward with a paper file. There are already concrete ideas (Link in German) and scenarios for what the optimal patient journey could look like with the help of digital applications: convenient check-in from home via a platform, booking of the meal plan for the hospital stay, and so on. Even if individual components of such services are already in use, there is usually no central interface to intelligently link them together. Possible reasons for this: lack of structures, lack of budgets, inadequate IT landscapes.
Digital automation technology is already widely used in clinical laboratories. The spectrum ranges from simple pipetting robots to sequencing devices. The next step will be to use AI-based analysis techniques and to evaluate existing data material in an almost interdisciplinary manner.
But doctors and surgical teams are already benefiting from the use of digital equipment. For example, surgeons at Essen University Hospital are already working with immersive technology (Link in German). Here, the data from a computer tomography is converted into a 3-D animation. The doctor, who is equipped with special glasses, can project these directly onto the patient's body instead of having to look at the images over and over again on a wall and transfer them imaginarily to the person, as was previously the case. The advantages of so-called holomedicine are obvious: surgeries can be planned in a more targeted manner, performed even more safely, and facts can be presented more transparently to patients. Another example from the field of surgery is the use of the "DaVinci" surgical robot in minimally invasive operations at the Ruhrlandklinik. The machine never replaces the hands of the operating physicians, but supports them enormously.
By and large, the potential of digital solutions for emergency medicine in hospitals is still being explored, and in some places artificial intelligence solutions are in practical development. For example, AI-supported analysis systems for imaging procedures (Link in German). Already in use in some hospitals is software that takes over the complete control and optimization of emergency department processes: ERPath classifies emergency patients into levels of urgency, sorts them into a system that is easy to understand for practitioners, and provides information on the patient's health status. All subsequent treatment steps are recorded via the platform, electronic reports are generated, and service and billing data are provided.
Digitalisation is also already showing possible application scenarios in the inpatient area of hospitals. Service robots that automatically take over routine transports offer a perspective when it comes to permanently relieving staff on the wards. So-called "social robots" are intended to provide patients with emotional support in their recovery, encourage them to adhere to medical treatment plans or - especially in corona times - to stay in contact with their families. The latter has been tested in practice at the Clinic for Geriatric Medicine with the robot TEMI. With the help of wearables, patients' health data could soon be collected 24/7 and any values of concern could be reported promptly to the ward staff.
Once the technical prerequisites are in place, digital applications will help to make everyday processes in hospitals more transparent and simpler. However, this type of agile work requires mobile-networked devices for all employees, stable WLAN connections, and a digital patient file (ePA) deployed across the board. Only then can work areas be more concretely outlined, documentation reliably created via digital assistant, and tasks assigned in real time at the push of a button. Initiate a patient check-out, call a cleaning team, request a couch: In the future, all of this should be possible with a single click thanks to smart connectivity and good data. The call button at the bedside is also likely to become obsolete in the hospital of tomorrow and be replaced by tablets, which patients can use to prioritize and specify their requests more effectively.
With the Hospital Future Act coming into force on January 1, 2021, hospitals in Germany are now encouraged by law to invest in digital infrastructure and technology. Regular evaluations are to document progress. While the law has been praised in some quarters and is seen as an opportunity, its critics complain that the money is not being distributed according to need, but rather according to the watering-can principle.
But as is the case with subsidy programs: The available funds are not always used. Often, there is a lack of idea as to where, how and at what time investments should be made. As in many other areas, therefore, the clinics most likely to be able to make the transition will be those in which the need for change is recognized and met with firm declarations of intent. In addition to monetary factors, the mindset of all those involved will also play a decisive role in determining the cultural change in the hospital world.
Text: Alexa Brandt