Maintaining the pulse

Regional media estimates value the Middle East’s healthcare sector at as much as US$74 billion, with an annual growth rate of 16 per cent. Michelle Mills examines this vertical market and how wireless voice communications, portable handheld devices and online collaborations, help to improve the quality of healthcare services.

Francois Barrault, CEO of BT Global Services, says the current wave of ICT investments in healthcare means there is no better time to be involved.
HP Middle East’s Amin Kayal believes hospital networks need to be highly secured against hacking and data loss.

One of the most ubiquitous technologies in hospitals around the world today is wireless local area networking (WLAN), which has developed to become the backbone of communications services within the healthcare sector. WLAN offers broad wireless coverage of a specific location, and has the added advantage that line-of-sight access is not required between the sender and receiver of information.

A local area network transmits over the air typically in the 2.4GHz or 5GHz unlicensed frequency band, and a number of communications solutions providers have developed products addressing the specific needs of this technologically sensitive vertical.

WLAN provider Trapeze Networks, for instance, has developed a tool called RingMaster that checks for network latency that occurs when users roam from access point to access point. The product also conducts a site survey where the radio frequency signal in each room in a facility such as a hospital is tested to ensure broad coverage.

Riyadh-based Erfan & Bagedo New General Hospital uses a Nortel LAN for its data connectivity, and the hospital’s IT manager Magdy Abdul Mawgoud is in little doubt the network reduces costs by bringing information to the clinician, rather than having them search for it.

“In the medical sector, time is frequently critical,” says Mawgoud. “To be able to access patient data with total flexibility, regardless of location, is an important capability for us. It means we can make informed decisions at a moment’s notice.”

By the nature of their jobs, healthcare workers are highly mobile, though regular mobile telecommunications technology has not been widely used within medical facilities given concern over the interference of the signals with life-critical equipment. While there are debates whether mobiles actually interfere with health monitoring devices or not, the fears do remain.

Voice over IP (VoIP) deployments have successfully addressed the need for healthcare staff to remain contactable regardless of their location within healthcare facilities. Wireless IP phones have become widespread, while VoIP can also be integrated with nurse call systems that allow a patient’s bedside buzzer to automatically alert the phone of the nurse assigned to that patient.

Vocera is a WLAN solution that BT has implemented successfully in the UK and US and facilitates a voice-activated badge to transmit instant voice communications. Normally worn around the neck on a lanyard, the Vocera system supports both individual and group communication, allowing staff to stay in touch while going about their regular duties.

“BT demonstrated a very good understanding of healthcare and had practical experience of implementation of Vocera in a hospital environment,” says Peter Strombon, chief information officer of Meriter Health Systems in Wisconsin. “The hospital has seen significant time savings at the nurse’s station where it was not uncommon for nurses to have to leave in order to deal with communication issues.” After the initial Vocera pilot, the time away from the station for phone-call-related issues decreased by 45 per cent.

Another impact of IT and communications on the provision of healthcare services is in replacing paper charts with tablet PCs, PDAs, laptops and mobile PC cards, allowing patient data to be inputted and accessed electronically from anywhere in the hospital. This not only increases efficiency, it also reduces the potential for transcription errors. In the US alone, it is estimated that preventable healthcare-related errors cost the economy between US$17-19 billion each year.

WiMAX is another access technology that is set to offer further support for the development of communications applications in the healthcare environment. Last July, Welcare World Health Systems became the first private healthcare group in the UAE to deploy pre-WiMAX technology, linking Welcare hospitals and clinics across Dubai. The wireless link enabled the group to implement a centralised electronic medical record (EMR) database.

“The high data transfer speed of the pre-WiMAX link has enabled the hospital and clinics within the Welcare Group to operate more efficiently and deliver better patient service,” says David Ho, Welcare World director of IT.

EMRs are now often connected to a central database accessible from ambulances, within the hospital facility, as well as remotely from off-site locations. For example, HP’s Patient Monitoring application allows medical staff to receive alerts including cardiac status and vital signs, from patient-monitoring devices directly to their PDA.

Amin Kayal, communications, media and entertainment manager, HP Middle East, notes that information lifecycle management plays a key role in EMR, ensuring that the large volume of content generated for patients is accessible, searchable and retrievable even when a patient’s status changes.

“We have these solutions in the back-end that deal with that information and how to manage the lifecycle of that information,” says Kayal. “If someone is deceased, the file is closed but you still need to have that information in an archive so you can reach it, but there are no new entries as such.”

Medical data is also image-intensive, especially for areas including radiology, dentistry, neurology, radiotherapy and breast imaging. Mobile PCs in emergency rooms enable radiologists to display images, while cardiac surgeons can review digital images and zoom in for a closer analysis, while in the operating room.

The widespread adoption of Picture Archiving Communications Systems (PACS) in the UK has dramatically increased the delivery of diagnosis information by allowing instantaneous digital sharing and storage of x-rays, according to Francois Barrault, CEO of BT Global Services. “The average turnaround time for diagnosis reports used to be 6.24 days, post-PACS it’s only 2.93 days.”

Barrault believes healthcare is the last major information intensive sector to undergo ICT-enabled reform and as this process takes place around the world, there is no better time to be present in this space. The Middle East region is also proving to be fertile ground for communications investments in the healthcare sector.

Telemedicine

Telemedicine refers to the use of telecommunications and information technologies in the application of clinical care. From doctors consulting over a telephone to a videoconference between specialists in different countries, telemedicine’s application is wide and varied. It can be used for doctors in isolated situations – such as a war zone or disaster area – to gain a specialist’s diagnosis remotely, or for opinion sharing between two specialists on a unique or challenging patient case.

Areas in which telemedicine is increasingly being used is in teleradiology, telecardiology and in interactive remote training. Telemedicine software such as that offered by ThalesAlenia Space allows users to share medical images such as x-rays, cardiograms and other scanned images or photos, and to interact via voice, video, chat or interactive whiteboard. Online sessions can be recorded and played back offline.

Source: ThalesAlenia Space

“We have discussed with senior decision-makers in Qatar’s health community how we might be able to work with them to develop an effective and advanced healthcare information system for the country, and those discussions are continuing,” Barrault says. “We remain committed to working with the likes of the National Health Authority and ictQatar to help make their plans a success.”

Meanwhile, the UAE’s health ministry has outlined 35 key initiatives to be implemented between 2008 and 2010 in order to upgrade healthcare facilities across the emirates, including the construction of an electronic network to connect the country’s hospitals and healthcare centres, as well as the development of a medical archiving system and national healthcare database.

Infrastructure suppliers such as Alcatel-Lucent are also working with the likes of King Hamad Hospital in Bahrain and the health ministry in Saudi Arabia, which will see the technological transformation of regional hospitals in the coming years.

The GCC is likely to see most of this development and a huge disparity exists between countries in the GCC as compared to less developed countries in the region such as Syria, which are witnessing severe health spending cutbacks. An EU-funded modernisation programme worth €5 million (US$7.67m) aims to help Syrian hospitals improve their management though this is a small amount when compared to the overall capital investment required in such country’s healthcare systems.

Radio Frequency Identification (RFID) is another technology that has gained significant traction in the healthcare sector, allowing for the tracking of assets, patients and medical staff within the hospital environment. From knowing exactly where monitors, medical equipment, wheelchairs and pumps are, to securing patients, RFID offers a long and growing list of applications. RFID is also used effectively for inventory purposes for the plethora of moveable items within a hospital environment.

Telecommunications continues to have an important role to play in the healthcare sector though challenges in delivering these services cost effectively remain. A white paper by Alcatel-Lucent notes that information security and privacy; demands on bandwidth by images with large file sizes; and the provision of homecare and remote monitoring applications are all factors that require adaptation of regular communications offerings.

HP’s Kayal believes patient information travelling over telecommunications channels and securing infrastructure presents an important challenge that solutions providers continue to grapple with. Data transfers also require encryption in order to further improve security.

“The danger here is that it is not only a financial risk, there are lives at stake,” Kayal says. “If data is corrupted, there needs to be recourse to backup and disaster recovery sites to make sure that information is secured.”

IBM faces healthcare challenges

A key IBM executive with responsibility for the healthcare sector has pinpointed a number of major challenges facing the Middle East healthcare sector and predicted that major reforms in the sector will be triggered by the increasing impact of advanced technology in healthcare. Henrik Hoejlund, healthcare solutions leader for IBM’s northern region, said: “The Middle East faces a tremendous opportunity with world class clinicians, major pharmaceutical companies and a growing number of world class medical facilities. But technology remains a critical challenge in the future development of the sector.”

Hoejlund spoke at the Arab Health Information Technology in Healthcare Forum, held in Dubai earlier this year. “Today’s healthcare industry is under pressure to effectively manage a consistently higher quality of clinical care while minimising the associated administrative costs and meeting the need for tighter compliance, security and privacy,” Hoejlund commented.

At Arab Health 2008, IBM showcased solutions that are at the forefront of managing healthcare delivery in some of the world’s most challenging environments.

IBM addressed a number of key technologies for healthcare professionals at the event, including the enhancement of patient care by improving clinical workflow and business processes, medical archival and storage solutions to give clinicians fast, reliable access to medical imaging and electronic health record management. “Technology is transforming healthcare, giving clinicians access to resources at a truly globalised level,” said Hoejlund. “This is an opportunity for the Middle East but also a potential regional competitive challenge.”

Takreem El-Tohamy, general manager of IBM Middle East, Egypt and Pakistan believes the effective and timely deployment of technology in healthcare is critical for the development of the sector in this region. “Technology solutions in healthcare today use mobility, information management and the Internet to broaden the scope of the way that healthcare professionals plan, diagnose and work and impacts every aspect of healthcare and hospital estate management.”

With analysts predicting that the automation of healthcare will be a requirement rather than a differentiator, technology solutions offer the most effective way to hold and use clinical data, to interact with patients and to help develop patient communities, as well as taking a core role in processes such as clinician training, remote diagnostics and patient information.

Source: IBM