The future of healthcare is bright if technology is used in the right way, according to the managing director of Siemens medical division. John Collinsreports.
The way healthcare is delivered will change dramatically in the next 30 years, with patients assuming more power and hospitals becoming just one part of an integrated treatment system, a conference in Dublin has been told.
Gunter Dombrowe, past-president of the British Institute of Radiology and managing director of Siemens medical division in Britain, says he believes the application of technology will have a fundamental impact on medicine in the next three decades.
Dombrowe cautions that while new technology does not always deliver expected improvements, he believes the focused application of technology to healthcare can simultaneously improve the quality of service and reduce the costs of providing it.
Dombrowe believes a number of over-arching trends will come to bear. Patients will be better informed, often better than their doctors, and will be considered "healthcare consumers" rather than patients.
Breakthroughs will be made which will mean that chronic conditions can be actively managed instead of "left alone to become an immense burden on the system" as he believes happens today.
Patients with the same conditions will not routinely be treated in much the same way - instead care will be tailored to each patient.
Dombrowe also believes that distinctions between inpatient, outpatient and home care will disappear in favour of a continuum of patient care.
"If we look at the hospital it is going to be just one part of a much wider, integrated network," says Dombrowe.
In his vision of a future "all-integrated digital delivery system", care will be delivered in the home, medical offices, surgical centres and hospitals, with a resilient information network providing the basis to co-ordinate it.
He points to handheld scanners currently on the market which could be used for patients to carry out triage and initial assessment of their condition at home.
Multi-functional devices are also emerging, such as a CT scanner that can carry out coronary angiograms, which may be able to provide a higher level of care at the community level.
"We see a far more diversified approach emerging already in some countries," explains Dombrowe.
"For instance, the big focus in Britain at the moment is standalone imaging centres and commissioning by the primary care sector.
"I think the primary care sector will increase the amount of work and the range of procedures that it does. The ownership of health will move away from the hospital to the primary care sector even more than it has already."
Dombrowe suggests that it is not surprising waiting lists have built up in Ireland and Britain given how GPs and hospitals currently interact. Typically patients visit a GP, are referred to a specialist for a treatment or procedure by letter, return to their doctor for the results and may then be referred for further treatment - all of which will usually take months.
"If you look at processes you could do all this on the same day, if you were properly organised," according to Dombrowe. "Those are the issues that we need to tackle."
With medical technology set to change so much in the future, Dombrowe provided pointers for how hospitals being built today should be designed to be ready for future changes. High capacity networks - both wired and wireless - should be built to facilitate the explosion in data that he believes is just around the corner.
Dombrowe suggests that everything in the hospital should be tracked with radio identification tags - from patients' identity bracelets to drugs that are being administered. The floor layout of hospitals will have to be flexible and capable of being reconfigured to accommodate new machinery and technologies which may require more space.
Instead of increasing the number of diagnostic rooms, larger ones should be built even though they will require more preparation areas to improve the flow of patients. Behind the scenes there will have to be increased power and cooling capacity to accommodate all of this, he believes.
The experience for the patient in Dombrowe's hospital of the future may be more like visiting a luxury hotel than a hospital.
In addition to larger rooms (in part to allow for a population that is taller and fatter), each room will have a computer with touch-screen that the patient can access from their bed.
If the patient wants to sleep, they simply push a button and the lights are switched off, the blinds will close, the telephone will redirect to voicemail and the nurse call system will display "do not disturb".
He acknowledges that questions will be asked as to how much it costs to build such high-tech systems, particularly given that health is already the biggest component of public spending in many western countries.
"You have to ensure that the budget is compatible with the vision. A lot of people talk about the vision and then they can't afford it so they build another rabbit hutch. But you also have to avoid the trap of just going for technology for technology's sake."
Currently information technology is largely used simply to retrieve information such as patient records, but Dombrowe believes the real benefit will come from using it to drive and optimise processes.
By applying technology to workflows in the hospital, issues such as waiting lists, bed blocking, lost records, late or wrong decisions and poor patient outcomes can be reduced or even eliminated.
He says the health sector could learn a lot from other industries and apply lessons about increasing productivity by reducing process times, eliminating waste and errors, and triggering actions based on information about past events.
He describes a scenario where a patient arrives in casualty suffering a stroke - the IT systems should then automatically book a slot for her on a scanner, notify the relevant radiologists, nurses and porters, and ensure the resources are in place for her treatment.
"In stroke treatment the saying is 'time is brain'," says Dombrowe.
"Reducing the treatment time by just 20 minutes could make the difference between complete restoration of health and chronic debilitation for the rest of her life."
He suggests that as a benchmark every €100 invested in building hospitals should be matched by a spending of €30-€40 on technology.
"You cannot just throw technology at a dysfunctional system - you will make it more dysfunctional because people will just play with the technology and not use it in a proper integrated manner," he says.
"By applying technology to workflows in the hospital, issues such as waiting lists, bed blocking, lost records, late or wrong decisions and poor patient outcomes can be reduced or even eliminated".
Gunter Dombrowe, managing director of Siemens medical division