Digitalisation could make a significant contribution to a more efficient healthcare system, both during the current pandemic and, even more so, in future crises. Here, we outline potential routes to a better, more digital future. Part 1 looked at GP practices, outpatient care, hospitals and inpatient care. In part 2, we look at medical device manufacturers, laboratories, diagnostics and the pharmaceutical industry.
Medical device manufacturers
While the coronavirus pandemic has led to soaring demand for ventilators, many medical device manufacturers have been struggling with disruption to their supply chains. Strict quality requirements for medical devices mean it is very difficult to source replacement parts quickly, leaving many manufacturers with a serious problem.
The quick fix – using additive manufacturing to overcome supply shortages
Additive manufacturing could provide a short-term solution to problems caused by a lack of components. We have been working with parts printed on 3D printers for years. The quality of such parts has constantly improved and is today comparable to injection moulding. The big advantage is that there are lots of suppliers able to supply high quality products in Europe. Zühlke has already used additive manufacturing for prototype medical devices for clinical trials.
Where all parts are available, the production bottleneck often proves to be test and inspection systems. Before shipping, all medical products have to be verified on GxP compliant test systems. During the coronavirus crisis, we replicated well-documented test systems to enable us to increase medical device manufacturing output to meet increased demand.
The medium to long-term solution – integrate devices into existing IT infrastructure
Many newer diagnostic devices are equipped with technologies to enable data to be transferred to a smartphone or the internet. Despite an abundance of connectivity options, integration of such devices into existing IT infrastructure is not well advanced. Device manufacturers will in future need to pay more attention to device connectivity and interoperability. As well as future-proof connectivity standards, such as Bluetooth and LoRa, they will also need to think about using robust semantic standards, such as HL7.
Analysing the prevalence and infection rate of a viral infection is essential for choosing the right countermeasures. Laboratories play a key role in this process.
The quick fix – using GPS trackers to optimise capacity utilisation
To ensure that all stakeholders are kept informed of the status of samples, it would be useful to have automatic tracking of samples, including before they reach the laboratory. Established tracking solutions used in logistics are available, but are not yet being used for normal samples. Simple GPS trackers that could be included with consignments of samples would allow laboratories to optimise capacity utilisation and better coordinate transport capacities. Over the last few months, laboratories have been employing the simple, pragmatic solution of placing GPS dog trackers in consignments of samples.
The medium-term solution – standardised interfaces with laboratory systems
In a pandemic, ensuring that test results are passed on to key users rapidly and in an appropriate form is an essential countermeasure. In the absence of a unified digital standard, organisations like the Swiss Federal Office of Public Health (FOPH) have had to wade through a flood of paper documentation from laboratories. According to press reports, to determine the number of negative tests the FOPH has resorted to weighing the negative test reports. Using an up-to-date standard for connecting laboratory systems to national reporting systems (e.g. IHE/HL7) would doubtless have provided a more accurate and up-to-the-minute picture of the pandemic.
The long-term plan – increased automation
For many laboratories, managing the volume of samples produced at the height of the coronavirus pandemic has been a huge logistical challenge. Laboratories have to be able to guarantee complete traceability during sample analysis. Large numbers of manual processing steps represent a major source of error. Greater automation using robots and RFID readers could significantly increase throughput and quality.
The pharmaceutical sector
The pharmaceutical industry is a core part of the healthcare sector and is one area which has really steamed ahead with digitalisation in recent years. That’s especially true in the R&D field, where data-driven AI is already widely used.
The medium to long-term solution – getting closer to patients
In view of the long development times for pharmaceuticals, it’s hard to envisage ad hoc applications for digitalisation with the potential to help in the current crisis. It’s striking however, how much working from home has focused minds on the importance of digital projects and lent them new momentum, particularly in the healthcare sector. Clients have increasingly been telling us that coronavirus is the greatest catalyst for digital health they’ve ever experienced. Against this backdrop, digital transformation in the pharmaceutical sector is forging ahead faster than ever, with a big increase in investment in patient and consumer-focused digital solutions in particular. A combination of biosensors and artificial intelligence offers huge potential in this context, even to the point of detecting disease before symptoms are even apparent.
For the pharmaceutical sector, the possibilities offered by digital technologies are wide-ranging. Companies are already testing apps and devices that make it easier to participate in clinical trials. The pharmaceutical sector could play a formative role in using digital technologies to expand the scope of the doctor-patient relationship, as well as using artificial intelligence to support doctors in making a diagnosis.
It’s important to note, however, that this data requires a high level of protection. In Germany, for example, pharmaceutical companies are not currently permitted to directly collect data from end users. Interesting approaches to this problem are, however, already emerging. Examples include start-up Ocean Protocol (a Zühlke partner since March 2020) and ‘federated learning’ (Zühlke white paper in preparation). Both aim to enable data to be used to train algorithms exclusively, securely and without that data being readable for any other purpose. Both approaches could decisively advance digitalisation in the healthcare ecosystem – and allow the pharmaceutical industry to continue to play a key role in this process.
There’s no shortage of great ideas and helpful technologies. A number of voluntary initiatives (helpfulETH, Code vs Covid 19, Maker vs Virus, WirVsVirus, Hack the Crisis) show that the will to implement digital solutions is there. Many of the results produced by these initiatives have not been deployable in practice, however, as it has not been possible to comply with all applicable guidelines in such a short space of time. Ultimately user acceptance of digital solutions in the healthcare system will be key. In GP practices in particular, at present it feels like there is some resistance to digitalisation-driven changes.
We remain convinced, however, that technology and connectivity are the key to a more efficient healthcare system and could help mitigate the impact of viral pandemics.