By Jihane Madi

The use of digital technologies in healthcare

Healthcare systems are increasingly under pressure to deliver high-quality patient care and experiences. On the one hand, ageing populations face growing health concerns which demand costly medical care and place greater strain on human resources. On the other, there is a rise in chronic diseases such as diabetes, heart, stroke, and vascular diseases. The Middle East is no stranger to these trends. For example, the prevalence of cardiovascular diseases has increased to 13.7% and diabetes to 12.8%. This sharp rise is often attributed to lifestyle challenges, including sleeplessness, stress, a decline in physical activity, and poor diet, especially in the Middle East.

The use of digital technologies in healthcare is considered a necessary step in revamping patient care and experience. This transformation is no longer a theory to be tested but a part of our lives. From wearable sensors that monitor blood pressure and heart rate to robot assistants in hospitals, healthcare is embracing emerging technology. This trend is set to increase as omnichannel solutions, advanced data analytics, artificial intelligence (AI), blockchain, and super-apps become commonplace throughout the sector.

The GCC region has become a leader in digital technologies in healthcare, especially as its countries seek economic diversification away from oil and gas and towards a service-based economy. The UAE and KSA are leading the rollout of AI in the region and are implementing key strategies to improve their capabilities in this field. Telehealth services are becoming increasingly prevalent in both nations, especially as each government is developing a robust digital health infrastructure to support the growing sector. These services include mobile health, known as ‘mHealth,’ virtual visits and remote patient monitoring; the market in the UAE is estimated to reach “US$536.5 million by 2025 from US$121 million in 2019” and “likely to reach US$415.4 million over the forecast period from US$113.3 million in 2019” in KSA. Other trending technologies becoming used more often in the region include monitoring wearables and precision diagnostic tools – mainly developed as radiology solutions by using deep learning to interpret medical images and detect changes in the patient’s condition.

How digital health technologies are changing the patient experience

The healthcare sector has often focused on treating patients clinically and disregarded the experiences they go through. This situation is exacerbated by administrative tasks such as processing insurance claims, which become more complex, stressful, and time-consuming when patients need easy, convenient, and most importantly, timely access to care. The use of digital health technologies is already improving patient experience in many ways, including facilitated scheduling, appointment check-ins, remote visits and the cross-portal sharing of lab results.

Patient experience is also improving through some of the more advanced emerging digital technologies including AI and mHealth. Chatbots can be used for directing queries to the relevant area, answering simple questions such as location information or even for more complex tasks such as sharing information on lab results or prescriptions. Chatbot with AI offers powerful and efficient services such as diagnosing minor illnesses and connecting patients to online scheduling systems to easily book appointments with relevant doctors or be directed to the nearest care centre. Mobile applications and wearable sensors give patients instant access to their health data without the burden of scheduling appointments to visit their physicians. This not only simplifies processes but also empowers patients to become more autonomous, self-manage their lifestyle, and develop a greater awareness and understanding of their behaviours.

In addition, robotic surgeries have substantially improved patient experience. They allow for improved medical procedures through small incisions and minimally-invasive surgery, greater access to angled and deep areas of the body, 3D visualizations, and precise manoeuvres leading to fewer technical errors. All in all, these reflect positively on the patient who in return experiences significantly less pain, reduced risk of infection and blood loss, less scarring, a shorter recovery time and an earlier discharge from the hospital. However, accepting and trusting a robot to assist in their surgery remains a challenge for some patients.

Other concerns are raised regarding how digital technologies change patient experience and create gaps in the patient-physician relationship. Medicine is shifting from healing and curing to measuring and monitoring, and when communication is lost, the patient’s feelings are not heard. Also, new learning paths need to be adopted by physicians to properly train patients on how to interpret data. When considering mobile applications and wearable devices, tasks and responsibilities are being delegated from healthcare professionals to patients including monitoring signals and updating symptoms. These additional burdens could cause emotional stress and a sense of aloneness for patients. Furthermore, having access to data might not be enough for some patients to act on it, and this is where the intervention by a healthcare professional becomes crucial.

How digital technologies are improving healthcare

It is evident by now that digital technologies are improving the healthcare system in general. This section expands on the advantages of three of these technologies: blockchain, mobile applications and AI.

Blockchain:

Simply explained, blockchain is a record of chronological digital events that are “write-once-read-only,” meaning the data cannot be deleted or altered without approval from all authorized users. One company ‘Solve. Care’ markets a healthcare blockchain platform that connects patients to healthcare professionals and manages payments, benefits, and care packages. It is backed by several prominent insurance companies and has already received $30 million in funding. 

Traditional healthcare infrastructure has made it difficult to handle critical information when it is scattered across many systems and can be easily manipulated. Thus, the use of blockchain in healthcare offers several advantages:

• Single record system including all patient data (diseases, lab results, medications),
• Claims validation and decentralization of data leading to lower chances of fraud,
• Supply chain management through monitoring supply-demand cycles,
• Cost reduction by streamlining activities and preventing repeated and ill-managed tasks.

Mobile applications:

Mobile health provides healthcare support and intervention through mobile devices, including wearables, smartphones, and tablets. The market for mHealth is growing due to many factors including the affordability of smartphones, the rise in health disorders and the need for fast and convenient care.

“The mHealth market accounted for $46,048 million in 2019, and is expected to reach $230,419 million by 2027”. Without a doubt, the proliferation of mobile health applications comes with many advantages:

• Remote patient care from monitoring symptoms to offering prescriptions,
• Self-monitoring health parameters daily in a convenient manner,
• Custom remedies as doctors gain access to full patient data in their profiles created in apps,
• Cost reduction by minimizing visits to clinics.

Artificial Intelligence (AI):

AI is becoming more advanced and revolutionizing healthcare. There exist machine learning solutions that can understand, predict, and learn.

According to Gartner, by 2021, 75% of healthcare delivery organizations will have invested in AI technologies that improve operations and clinical results. The advantages of AI in healthcare are plenty and include:

• Early diagnosis of diseases based on previous and present health issues,
• Improved and efficient surgeries by AI-enabled robots,
• Faster and cheaper healthcare processes (such as examinations),
• Enhanced clinical trials due to the plethora of data from patients.

Concerns regarding the use of digital technologies in healthcare

Digital health technologies are rapidly invading and changing the field of medicine. Although there are abundant advantages for this shift, there are several regulatory and ethical concerns being raised.

The proliferation of varied digital health technologies is challenging the regulations adopted for medical devices. It is becoming more difficult to differentiate between what is and is not a medical device and therefore scope the proper regulations, and only a limited and specialized pool of professionals can assess compliance with medical device regulations.

Emerging technologies require innovative techniques, tools, and standards to assess their compliance and thus require even more specialized skills to be gained by professionals. Many digital technology developers are new to the field of medical devices and might be uninformed and unaware of the regulations as they are encountering them for the first time.

Finally, the once business-to-business medical device market is shifting to become business-to-consumer orientated. Hence, regulations must include additional requirements for testing and labelling to ensure safety and reliability.

At the intersection of regulatory and ethical issues, data privacy and security are major concerns, especially in the GCC region. Patients need to know how their data is processed and by whom. For example, the processing of data by third-party marketing agencies can lead to displaying unwanted and upsetting advertisements to patients. Also, discrimination can occur due to the processing of this data by employers and insurance companies.

Accessibility to these technologies is also a concern. mHealth, for example, is least accessible by people who need it the most: low-income groups, elderly people with less knowledge of smartphones, illiterate people living in rural areas and people whose local languages are not supported by these applications. Another ethical concern is improper empowerment of the technology users. Even when patients have access to the technology, they should undergo proper training to adequately assess the data they receive and make informed decisions. Otherwise, misinterpretation of data could cause substantial physical harm as patients make incorrect decisions, such as increasing their medication dosage.

The dignity and wellbeing of patients should be preserved if digital tools are to be used. For instance, delivering bad news through a screen can put the patient in a vulnerable situation and must thus be avoided.

In conclusion, the evolving problems in the healthcare field necessitated the introduction of digital technologies that are proving to be helpful on many levels. Nonetheless, as this shift occurs, patient experience, regulatory and ethical concerns should be well addressed with a comprehensive framework adopted to cater to the patient’s needs, right to privacy and ensure the process is enhanced by technology and not replaced by it.