Not too long ago concepts such as artificial intelligence, robotics and the Internet of Things (IoT) seemed like distant futuristic concepts, more fitting to a sci-fi movie than to a healthcare facility. Today, however, technology is bridging the healthcare gap and improving access to wellness for those who might otherwise be excluded.
The past 25 years have seen public health in South Africa make significant advancements and take strides to ensure quality healthcare as a basic human right for all. This extends from the preventative and primary health response to non-communicable diseases like diabetes and hypertension to more targeted responses for HIV, TB, and more recently Covid-19.
Technological advancements and their application in medicine and healthcare is further improving the lives and life expectancy of South Africans, and helping improve access to services and treatments that were unheard of just a few years ago. The future of healthcare will be driven by ever-evolving technologies to personalise and improve the patient experience, empower and enable clinical care staff, accelerate operational efficiencies, and drive greater security and compliance measures to protect patients and their data.
Brendan Cuthbertson is Head of Enterprise, Commercial and Regional Public Sector South Africa, at Cisco. He says that even in pre-Covid times, technology enabled better quality research, treatment and access to healthcare globally. “As a result, citizens around the world are increasingly empowered to focus on self-care, and people are now living longer than in previous generations.”
But as healthcare improved, the industry has been presented with new challenges. One example is the need to provide healthcare to aging populations with more complex, chronic care needs and limited mobility. “There is significant work ahead to bridge the gap between healthcare today and what we need it to be in the future to ensure more people around the world have access to the right help, support and facilities whenever they need it.”
Trends transforming health and healthcare
Remote monitoring for increased control
Consumer wearables such as smartwatches and fitness trackers are empowering people to be more in control of their health than ever before, and millions are making use of connected medical devices. “This trend is growing rapidly as consumers become more tech savvy,” Cuthbertson explains. “Greater connectivity among devices is accelerating the move toward remote monitoring, where patients are able to send data from their wearables and other remote monitoring devices directly to their doctors in real time, enabling a much more convenient, seamless and personalised patient experience.”
But, he adds, there is still a huge opportunity to further develop and expand capability of wearables beyond basic fitness tracking to support chronic disease management and use of other IoT devices to extend care delivery from hospitals into the home. “By bringing care from the waiting room to the living room, these solutions are transforming the way healthcare is delivered and will help expand access to the elderly, other vulnerable members of the community, and those living in rural areas,” explains Cuthbertson.
Improved clinic experience
It is not just patients who benefit from these technological advances. “Greater IoT device connectivity is enabling faster and more accurate data collection, analysis and location-based insights,” he says. “Advances in robotics are accelerating these efficiencies and freeing up nurses’ time by performing tasks like delivering medications and dealing with hazardous materials, and can also assist nurses with patient mobility and patient and equipment lifting.”
Assisted lifting, he adds, is not only more comfortable for the patient, but also better protects nurses, who are among the top at-risk occupations for lower back and muscular strains. “At Cisco, we continue to enable and advance wireless networks that help healthcare organisations adopt 5G and Wi-Fi6 and develop new capabilities that reduce latency, making remote robotic surgery from increasing distances more feasible too.”
Artificial intelligence (AI) is among the most talked-about technologies that will change the face of healthcare and health services, streamlining clinical, business and IT operations across the board. “Machines can think and act like humans, with much greater speed and precision,” Cuthbertson explains. “As an example, Gyant, a medical AI startup company, is using Cisco technology to develop an AI-based chatbot that uses machine learning and decision making to complete virtual triage, assess patient needs, determine the level of medical assistance required, and send a summary report to a call centre agent.”
Heightened security and compliance
The future is not just about bringing in new digital solutions, Cuthbertson says. “As we become increasingly connected, there will be greater need to use, secure, and govern the data that these new technologies produce more effectively, and ensure healthcare providers around the world are compliant with government regulations.” He says that with new advances in blockchain and biometrics to aid patient security, reduce fraud, and to aid better handling, storage, and sharing of patient data, it is important for healthcare organisations to invest in the right infrastructure. “This will ensure that they not only future-proof their operations, but also empower and enable the staff that will use these technologies to provide care.”
Smart hospitals are here!
As South Africa battled to contain the spread of Covid-19, local hospitals turned to telemedicine to limit foot traffic across isolation wards and improve patient access to medical staff.
To help reduce medical professionals’ exposure at the Chris Hani Baragwanath Hospital in Soweto, Cisco teamed up with RICATA, a telemedicine solution expert and Cisco Supplier, to develop and deploy 10 mobile medical trolleys at the hospital over an eight-week period.
The Department of Internal Medicine at Baragwanath staff explains: “The Cisco systems were used in the Persons Under Investigation (PUI) wards. One unit was located in an external office and the other units within the wards. With some senior staff members being unable to physically take part in these ward rounds, they conducted virtual ward rounds with more junior colleagues via these carts by reviewing patients, advising and co-ordinating the rounds from the remote device. This enabled more doctors with a wide scope of experience to be involved in these wards. What was also beneficial was that you could communicate verbally and visually on a secure mobile platform.
“These trolleys were used to cover up to two wards per day, each comprising 40 beds. There was also a unit available in the Covid Casualty for interaction with the Nasrec facility for advice and patient transfer. Time was saved, but more important was the more effective use of staff.”
Conrad Steyn, Cisco CTO and Head of Engineering for sub-Saharan Africa, says: “Remote connectivity has all but kept the world running through our current crisis. The medical trolleys enabled Baragwanath’s medical staff to quickly and easily connect and collaborate with one another across the different wards, speeding up consultations and ensuring that practitioners were able to adhere to social distancing measures.”
Since 2015, Cisco’s Country Digital Acceleration (CDA) programme has been developing trusted relationships across the world. Now active in 34 countries, CDA projects align with a country’s national development plan to bring digital solutions to unique societal challenges. By mixing network and technology expertise with partnerships based on trust and close collaboration, CDA is helping countries to stimulate economic growth and create an inclusive digital future that leaves no one behind.
The largest hospital in the southern hemisphere and third-largest in the world, with 3 400 beds spread across a 170-acre site, Baragwanath provides medical care to more than 2 000 patients every day. On average doctors walk about 20km per day as they consult with patients and respond to emergencies.
“The concept was to have a robust trolley capable of withstanding the pressures of a hospital environment; one that is highly secure and easy to use, with a short learning curve for users,” says Trishend Kambaran from RICATA.
The trolleys allow for two-way voice and video communication, as well as content sharing, including white-boarding capabilities in real time with multiple parties on a single call.
The “one button to push” approach for initiating a collaboration call has provided several efficiencies, reducing and, in some instances, even eliminating the need for medical staff to travel between wards, allowing more time for consultations and patient care.
Kambaran says this means that senior doctors can provide timely bedside support on complex Covid-19 cases, as the need to travel is reduced. In addition, the solution supports skills development, offering junior doctors and nurses the opportunity to engage with their senior counterparts more frequently.
“Critical care staff may also quickly and easily consult at the patient’s bedside in remote and isolated wards,” he adds.
Steyn says through this pilot at Baragwanath, Cisco has successfully demonstrated that telemedicine can help South Africa’s hospitals to better manage their resources and minimise risk to frontline medical staff during the pandemic.
“Following the initial deployment, we plan to expand the medical trolleys solution to a temporary hospital in Johannesburg, and then within more remote areas of South Africa.
“The lower skills levels and limited training opportunities for healthcare workers in isolated areas are critical issues for South Africa. Our solution will allow medical staff in more remote areas of the country to develop their skills through greater exposure to senior practitioners,” Steyn notes.
Cisco’s tech-lessons from the pandemic
The future of healthcare is convergent, tech- and data-driven and patient focused. This according to Brendan Cuthbertson, Head of Enterprise, Commercial and Regional Public Sector South Africa, at Cisco.
The Covid-19 pandemic that has changed the world has also brought a mix of challenges and opportunities, including rapid technological and bio-technological advancements, with widespread applications in healthcare and beyond: “Health services across the region have stood up new hospitals in days, converted in-person consultations to virtual ones, and moved back-office staff to the safety of their homes. At the same time, they’ve delivered ground-breaking research and development that will help us recover.”
Expanding access through technology
Many people have been able to access care that would not otherwise have been possible through telehealth and virtual consultations, and the Covid-19 crisis itself has greatly accelerated the acceptance of remote consultations — not only for patients, but also for healthcare professionals. “While this has clearly been forced due to efforts to minimise physical contact, it has worked well,” he says. “We know that, in many scenarios, patients respond to treatment better in their home environment than in hospitals.”
He says a virtual healthcare delivery model has also opened up the opportunity for greater involvement of family and other carers, which also improves care and recovery. “The critical contribution of families and friends in helping patients cope with illness cannot be overestimated, and it is vital that it is incorporated into our thinking.” Technology, in this sense, has assisted in bringing loved ones closer to the heart of patient care and facilitated their involvement in every step of the recovery process and healing journey.
Cuthbertson says data offers many opportunities, but acknowledges that robust regulation will be needed going forward. “Even with the enormous amount of data that has been collected during the pandemic, it’s striking how much there is still to learn about the Covid-19 virus.” He says patients will be more likely to share their clinical data for the greater good — provided that they can trust where and how that data is being used.
For this reason, it is important to involve patients in the design of the regulatory framework. “The scope and intent of the regulations also needs to be clearer to clinicians so that rules are properly applied and not feared.” After all, he says, regulations are not designed as a barrier to better patient care. “Trust is the key here, and building the right regulatory environment is really important to support that.”
Business continuity despite remoteness
A major change brought on by the Covid-19 pandemic across all industries and sectors has been a shift towards remote work, with office staff largely working from home where possible. “This is true in the healthcare sector too, where many back-office teams were quickly moved to safety, and we have seen that remote working can be successful and people can see the advantages of a hybrid model,” Cuthbertson explains. “As in many other sectors, we expect that in the future we will see a hybrid working environment, where offices are used for collaborative, in-person tasks but are mixed with much more frequent home working.”
What comes next?
Cuthbertson says there are two critical areas where concerted efforts will be needed if the benefits that digital transformation can bring to the health sector are to be realised.
The first is the improvement of digital skills — a challenge, he says, that is not unique to the health sector: “Across societies we need a higher level of digital literacy so that we can all have confidence in using technology. Ideally, we will get to a place where digital solutions are not forced on anyone, but taken up because people find them simpler, better and more effective. Creating a culture of learning and getting people comfortable and confident in using new technologies needs real focus.”
The second focus area will be in “extraordinary teaming” and partnerships. “We have seen great examples of this during the pandemic and we need to nurture those skills, with best practices shared across sectors and between organisations,” he says. “None of the many challenges the world faces right now will be solved in isolation, and partnership will be a core capability for any organisation.”
Rather than return to the old ways of doing things, it is important to retain the lessons from the pandemic going forward to ensure better, more equitable and accessible healthcare for all. “The biggest lesson the pandemic has taught us is just how important good health is and how important the healthcare sector is to society.”
The pandemic has proved again that a concerted health response is only as strong as its weakest link, and for this reason Cisco has committed to utilise technology and reimagine the future of health to ensure that no one is left behind.