Cover story: Diagnosis goes digital

DIAGNOSIS GOES DIGITAL Digital technology now plays a key role in diagnosis and treatment of illnesses

Byju Aryad

Artificial Intelligence can increase throughput of patients, resulting in early diagnosis and reduction in treatment cost. Telemedicine, which facilitates remote diagnosis and treatment of patients using advanced telecommunication and information technology, and Artificial In telligence, which enables machines to detect abnormalities in various investigations, are going to be the game changers.

Technologies are gradually redefining modern medical treatment. It plays a a vital role in patient safety by identifying risks and reducing harm in the primary care setting. It helps cut down the risks of adverse drug events through electronic prescription which facilitates sharing of information about the prescribed medications for accuracy and efficacy.

Nowadays, researchers are turning to big data and the power of artificial intelligence to support complex clinical decision-making and identification and reporting of adverse events. Point-of-care diagnostic testing devices, such as

those for diabetes, HIV and malaria, now plays a big role in rapid analysis as a critical guide for treatment.

Modern technologies and innovations continue to make era-defining impact on the medical treatment and healthcare industry as a whole. The impact of mobility, connected gadgets, wearable healthcare devices and a host of other technologies has become so significant that any of the most advanced medical facilities equipped with latest gadgets and healthcare practices inspire positive awe when compared with those that have facilities available just a decade ago. Digital technology advancements in healthcare are helping people to lead safer, healthier and more productive lives. Increased utilization of digital health apps has particularly India has a huge rural heartland and, despite the advances that nation has made in the science and technology sector, the doctor-patient ratio is much below the recommended WHO standards, says Dr. Amel Antony, senior consultant and head, Lisie Institute of Radiology Research & Imaging Sciences, Lisie Group of Medical Institutions, Kochi. Lack of adequate infrastructure and poor remuneration are often cited as the major causes for reluctance of doctors to take up the rural health challenge.

However, digital technology can bridge the gap of inadequate personnel and infrastructure facilities to a great extent. Telemedicine, which facilitates remote diagnosis and treatment of patients using advanced telecommunication and information technology, and Artificial Intelligence, which enables machines to detect abnormalities in various investigations, are going to be the game changers here, he said.

been useful for controlling chronic diseases that have always had a big impact on the health of a population. The treatment, prevention, and management of acute diseases like diabetes, asthma, cardiac disorders, and pulmonary conditions have particularly benefited from the use of these health apps.

Mobile health apps have emerged as crucial tools in the day-to- day patient care and healthcare management across numerous facilities all over the globe. The promise of mobile apps in the healthcare ecosystem is not limited to better treatment. They are also useful in making healthcare more affordable and accessible.The Internet of Things (ioT) also plays a big role here. Healthcare IOT devices and apps have the potential to transAccording to Dr. Antony, digital technology facilitates online networking of primary health centres, allowing central monitoring of all functions including diagnostic and preventive measures. It also helps in close monitoring of the stock of essential medicines and other requirements for proper maintenance and replenishment. Pooling of skilled personnel would facilitate redeployment wherever there is shortage.

National health programmes are an ongoing effort at prevention, early diagnosis and monitored treatment of various disease conditions and digital technology would make it all possible. Similarly, in cases of outbreak of epidemics, timely diagnosis of the infectious agent, identifying and treating sources, isolating contacts and geographical mapping of the outbreak cane be in an efficient manner with digital technology.

With Telemedicine in place, online consultations with health specialists from remote locations are possible, thereby streamlining patient care and management. Timely referral to tertiary care centres is an added advantage. Networking of ambulance services works in tandem with the above facilities. Artificial Intelligence enabled machines like X-ray, Mammography and ECG can differentiate normals from abnormals, further speeding up diagnosis, he added.

“Data collected from patients in different geographical locations can be analyzed for variations in disease pattern and treatment responses. In combination with bioinformatics, big data would finally realize personalized medicine, resulting in optimum treatment and savings on precious resources.

Artificial Intelligence can alert the physician to the most effective treatments and also the most common contra indications. Common diseases with uncommon manifestations is another area where Artificial Intelligence can narrow down the possibilities to arrive at the most appropriate diagnosis,”Dr. Antony said.

One of the biggest concerns for healthcare providers all over the world is preserving and protecting the patient data and preventing all types of threats and vulnerabilities concerning data security. This is through mobile apps. Blockchain database can allow unhindered access to personalized patient records and databases while preventing tampering efforts.

particularly true in the context of connected healthcare gadgets that are increasingly posing security threats of all types.

When it comes to data security, there is no better and more equipped technology as the blockchain. Blockchain is a decentralized database that allows open access to information for all stakeholders within an organization, even while controlling access with secure encryption and prevention of data theft or tampering with a ‘write-once, never-delete, never-change’ protocol.

Thanks to blockchain, health apps can ensure far better user experience as they can do away with the socalled protective security protocols like registration and passcodes. Apart from this, blockchain-based processing in case of many healthcare facilities can save a lot of paperwork Mobile apps can aid in diagnosis of various conditions when symptoms and investigation are keyed in. Apps would also provide the most appropriate treatment and a schedule for follow up. The treating physician and the patient could be alerted regarding follow up visits. Information for the patient could be made available in the app and this could include details regarding disease condition, side effects of treatment, long term complications and warning signals. However, in order to ensure accuracy, the apps need to be endorsed/ certified by appropriate professional bodies, Dr. Antony said.

Digital healthcare market is growing exponentially, he noted. This is due to advances in computer technology, nanotechnology and the synergy and convergence of various related sciences. From robotic surgery to automated resuscitation machines and personalized medicine, the inventory keeps expanding. At the same time,technology-driven products are inherently prone for obsolescence, leading to a huge drain on precious resources. The dilemma of improving bed strength and preventive health versus investment in digital healthcare does not have any readymade

Technology can never replace doctors, Dr.Antony says. There are enough examples: robotic surgery requires a trained surgeon to handle the robot, just as autopilot doesn’t mean absence of a pilot. Technology is going to improve patient care and management, by taking care of efficiency and throughput. Doctors have to unlearn and relearn to harness the advances in technology and they will be less burdened by the routine, allowing more time for patient care and management.

Technology also would require redeployment of personnel and defining new roles. However, at the end of the India is leading in the adoption of digital health technology with 76% of healthcare professionals in the country already using digital health records (DHRs) in their practice, according to a 15-country Future Health Index (FHI) 2019 report by Royal Philips, a global leader in health technology. Interestingly, India meets the 15-country average when it comes to the usage of artificial intelligence (AI) within healthcare at 46%.

Rohit Sathe, President – Philips Healthcare, Indian sub-continent, said, "Philips’ Future Health Index 2019 report confirms that digital health technology is a pivotal pillar in delivering value-based care across the healthcare continuum in India. Tools including telehealth and adapnot concerned that AI will substitute the human aspects of their healthcare experience, as only one in five (19%) associate AI with less human interaction compared to one-in-three (31%) individuals living within the 15-country average.

The study found that when Indian healthcare professionals are supported by digital technology, their experience improves. For instance, a majority of Indian healthcare professionals who use DHRs in their practice report that the technology-driven system have a positive impact on quality of care (90%), healthcare professional satisfaction (89%), and patient outcomes (70%) when compared to the 15-country average of 69%, 64% and 59% respectively. 64% of Indian healthcare professionals agree that patients having access to their own health data (including test results, prescriptions, scans etc.) has positively impacted their patients’ experience.

day, it is going to be technology as a guide and able assistant and not a competing rival. Digital technology entails early diagnosis and non-invasive treatment, leading to reduced hospital stay and substantial savings. Telemedicine can facilitate diagnosis and medical management of cases in remote areas, which would in turn lead to savings in terms of personnel and better utilization of equipment. Artificial Intelligence can increase throughput of patients, resulting in early diagnosis and reduction in treatment cost.Personalized medicine means targeted treatment at lower doses, further bringing down the cost. Paperless hospitals and institutions would add on to the advantage, he added.

tive intelligence solutions can help lower the barriers between hospitals and patients, thereby improving access to care and enhancing overall patient satisfaction, particularity in tier II & III cities in India. We hope that the insights from this report will assist key stakeholders in designing and implementing robust and sustainable health systems in the country."

According to the findings, 80% of healthcare professionals in India have shared patient information with other professionals inside their health facility, which is equal to the number of healthcare professionals who share patient information electronically across the 15-country average. Individuals in India are also seemingly The report also found that about twothirds (67%) of Indians feel comfortable or neutral about seeking medical advice from their doctor through a health application on their phone, suggesting a high willingness and openness to further adopt telehealth and unlock its benefits.

Looking at the role and tasks of physicians in general, the era of the e-physicianshas arrived. These empowered physicians will be the ones who use digital technologies in their practice with ease. They are enabled by regulations and guidelines, empowered by technologies and have become experts in hunting down the most reliable and trustworthy digital health resources and innovations. They can also be described as ‘engaged’, when understanding the feelings and points of view of their patients, giving relevant feedback, and involving them throughout the whole healing process.