Bozan

COVID was a catalyst for digital transformation in healthcare, possibly more than for any other industry. But even before the pandemic hit, Dubai-based Aster DM Healthcare was deploying emerging technology — for example, implementing a software-defined network for its Aster Hospitals UAE infrastructure to help manage IoT-connected healthcare devices.

Joseph George, GCC Regional Technology Head at Aster Hospitals and Clinics, is in a good position to talk about what’s next for digital healthcare in the UAE as well as elsewhere, since the entire Aster DM network now encompasses 17,594 employees, including 2860 doctors, extending throughout the Middle Eastern in addition to India.

CIO Middle East: To what degree are hospitals in the UAE in a process of digital transformation – using IT to fundamentally change the way they work?

It is a fact that healthcare is known for slow adoption of any sort of new technologies, but in the UAE, we should admit that the healthcare industry is embracing the technological advancements in a much better way. One of the main reasons is the regulatory involvement and governance. UAE healthcare started its digital transformation journey way back itself. The way Dubai rolled out e-prescriptions and digital revenue cycle operations are the best initial examples.

If we look into the healthcare facilities of the UAE, it is very obvious that the survival of the digital fittest is the mantra that prevails. The readiness of an organisation is the deciding factor for the smoothness of the digital transformation journey.

We are all familiar with the EMR (electronic medial records) adoption and maturity models designed by HIMSS (Healthcare Information and Management Systems Society). But honestly speaking, there exists no unique maturity model which measures the degree of digital transformation. In the same way there is no universally accepted definition for ‘digital’ either. From a discussion perspective, I feel the digital transformation journey can be assessed as different phases, instead of maturity stages.

When we used the old paper-based medical record system, which was the starting point, all facilities in UAE have already crossed that stage. The digital transformation of any healthcare entity has a deep dependency on the underlying hospital information system.  Many healthcare firms depend completely on their HIS (health information system) capabilities to drive the digital journey. For small to medium sized organisations, that is the right approach when extra CAPEX (capital expenditure) on digital is a burden.

CIO Middle East: Data Analytics is key in healthcare. How you see the role of business intelligence in healthcare?

When we look into the analytics scenario of healthcare, the accurate word to describe it is ‘clinical business intelligence’. It is a broader term, and as we mentioned above, healthcare is always slow in adopting technological advancements. The same goes for the adoption of data warehouse and business intelligence. One of the best examples of analytics adoption is in the telecom industry. The telecom sector prepares the data warehouse and business intelligence use cases even before they go live with their first customer. With regard to analytics in general, sadly, many organisations fail in their efforts to become data-driven.

Recently, we can see very good traction in the adoption of business intelligence in healthcare. We must say, the pandemic became a catalyst for that as well. The healthcare industry is well-known for rich data collection. Clinical business intelligence projects demand careful data modelling from the very beginning. The involvement of the stakeholders, particularly the clinical stakeholders, is heavily needed for the success of these projects.

A streamlined data flow through the data warehouse enables the organisation to forecast its business and operations with an unparalleled level of accuracy. Data integrity and consistency, achieved through the DW, provide a competitive advantage to the organisations by enabling them to make improved, informed and calculated decisions. Why is healthcare data unique from other industries’ data, and what makes healthcare data unique? There exists a lot of literature on this interesting subject. High context-dependency, the spread of data, variety and complexity, fast-changing regulatory requirements and definitions are a few factors contributing to this uniqueness.

CIO Middle East: IoMT (internet of medical things) and 5G are technologies that are penetrating the healthcare world. What trends do you think will change the healthcare system as we know it today?

These connected devices are ultimately enabling seamless care-flow management and improved care delivery, both in the case of remote care and in facility care. We see multiple types of IoMT devices nowadays, like on-body devices and in hospital devices. One major question on these IoMT devices is the security concerns, and it is interesting to note that many security vendors are now focussing specifically on this topic as well.

When it comes to 5G, I feel it is too early to comment or evaluate the aspects of 5G. But it is the future of care delivery beyond boundaries. The possibilities are enormous, and will definitely attribute in the areas of remote surgeries, telemedicine, real-time monitoring, huge medical file transfer, etc. Let us keep the right expectation; we are still in the early stage of 5G, and only pockets of 5G are visible now. In a couple of years, we can experience the real 5G spectrum.

CIO Middle East: How does the IT department work with doctors? AI in healthcare  — is a cultural change necessary in the sector?

I always like to say; there exist no IT projects (except IT infrastructure projects), but only business projects. EMR and other digital solutions used in care delivery are not at all IT projects, they should be clinical projects. We always say, the CMO (chief medical officer) is the owner of EMR projects and it works well. Implementation is not the measure of success in any project, success is measured on how we use it and get the best out of it.

Early involvement of clinicians is mandatory for the project success as they are the ones who are going to use it. The solutions shall not be a surprise to them, they must be involved in every stage of the project. We can see the role of CMIOs is getting a lot of attention nowadays. Clinicians are the major stakeholders of the EMR and other clinical solutions, we must listen to them – not only on pain points, but for ideas too. Trust me, a lot of innovative ideas and adoption options we received, are from our clinicians.

AI is becoming popular day by day and healthcare is one of the domains where AI produced wonderful results. AI on radiology is very much matured and stabilized by now. I really would like to use the word ‘collective intelligence’ rather than AI. Machines have a lot of capabilities which humans don’t. Similarly, there are still many things where we need human touch and intelligence. When we combine these two, that makes the difference, and ultimately, we get collective intelligence and better results. No one can say no to AI and technology advancements. As we commonly say, AI will replace those people who are not using AI, with those using AI, to produce collective or combined intelligence.

CIO Middle East: How do you see the changes in technology and business post-pandemic?

To answer the question, on how we managed the pandemic situation — the answer is by being agile. Repeated small things. Small things make a big difference. The first thing COVID taught was how to be agile. It was a term mostly used in the software industry till then, now ‘being agile’ is part of every aspect of a business.

I remember, a few years back, when we were looking into the optimized care delivery for LTC (long term heath) patients, the teleconsultation topic came on the table, but it was not accepted at all at that time. It was pushed down at the bottom of the list. But now, even patients are asking for it. I should say, the patients demanded it more than the hospital’s willingness to launch it.

Let us go back to April-May this year, that was the time when we all completely revamped the priorities and focussed on the so-called 100-meter sprint. We were not ready with teleconsultation at that time. But that was something needed ‘right now’ at that time. The primary question was how we are going to ensure care continuity. We quickly rolled out a platform — here comes the agile mode. We didn’t stop there, we extended the teleconsulting with Lab at Home and Medicine at Home too.

CIO Middle East: The UAE Ministry of Health (MoHAP) has established the country’s Unified Medical Record System to help the public and private facilities to collaborate on patient medical records and clinical details. What main advantages do you see in this initiative? How do you manage the flow of data?

These initiatives from the healthcare regulatory bodies show how seriously the nation is treating the health sector. A great salute to the visionary leaders on these initiatives.

Riayati, which is the national unified medical record platform, is the most innovative and digital transformation program from MOHAP aimed at transforming the entire nation’s healthcare landscape. Aster is always an early adopter of the initiatives.

When we talk about Riayati; Malaffi and Nabidh will come into the picture by default. Malaffi, the HIE initiative from Abu Dhabi, and Nabidh from DHA (Dubai Helath Authority), have already proven the power of HIE (health information exchange). As mentioned, we are already a part of these two initiatives: our Abu Dhabi facilities are already on Malaffi and our Dubai Hospitals are a part of Nabidh. As we speak, we are in the process of Riayati onboarding.

We have seen the benefits of HIE in many places around the globe. Patient centric care is one goal which we are all aiming for and that is not possible without data we can trust. These HIEs are the triple catalysts for a patient centric approach.