Technology applied to medicine has been changing the processes of diagnosis and treatment of diseases. In addition to the inclusion of electronic devices and digital applications, the use of alternative technologies in medicine is one of the transformations that seek to improve people’s quality of life.
Aiming to improve and prolong patients’ lives and contributing to the work of health professionals, diagnostic medicine associated with the advancement of technology has evolved considerably in recent years. Exams, procedures and results have become simpler, faster and safer, reducing the occurrence of invasive procedures and streamlining examinations and results.
“Disruptive innovation” can be understood as discontinuity, a break with the standards, models and technologies already established in the market.
The use of technology as an ally in the field of health care can be considered as a “disruptive innovation” for some reasons, such as:
- Providing a low-cost health care system is a complex challenge at global level;
- “Disruptive innovation” has transformed the automobile and computer industries, so that their products have become accessible to various financial classes of the population. Potentially, the same movement may occur in the health care system;
- Disruptive innovation can drive an entire industry in a whole new direction. Initially, a disruptive product may not be as well-accepted as existing products, but may be more economical and constantly improved;
- For this disruption to occur, new business models, technologies and value networks are needed. For health care systems, the first and essential step is attention to business models. This field demands more economic models of business, which deliver high quality in parallel;
- A technology-based medicine should replace the more intuitive / empirical medicine which, while based on the professional’s experience and ability to recognize patterns of symptoms, is subject to errors, forgetfulness, or lack of information;
- An integrated medicine can lower costs for those involved if suppliers can lower costs and maintain quality.
In 2016, there was a record with health costs, in the order of 11.05% (the highest value recorded since 2001). This increase was not accompanied by the Consumer Price Index (IPCA), which turned around 6.29%, as IBGE (Brazilian Institute of Geography and Statistics) points out. That is, the cost of health was not followed by the salaries of Brazilians.
Still in this context, there are indications that spending on health continues to rise. According to the Organization for Economic Co-operation and Development (OECD), in 2010, the cost of treating diseases reached 9% of gross domestic product (GDP) and in 2016, it exceeded 10%.
According to a prediction of the Ministry of Planning, in 2050, Brazil’s GDP will be R $ 50.6 trillion. In addition, expenses on health have the possibility of consuming about 20% of all Brazilian wealth, according to an OECD estimate. Thus, if no action is taken in relation to disease prevention, at least R$ 10 trillion of GDP in health can be consumed.
3) Examples of technologies that can be applied in the health area:
- a) Big data
In a simplified way, the Big Data concept can be understood as a set of information extracted from a large volume of data. Through the use of Big Data Analytics technology, it is possible to identify similarities within a group of individuals or in a locality – for example, the occurrence of a particular type of disease and its correlation with a genetic trait, age group and gender.
Thus, through the use of Big Data technology, it is possible to perform structured and unstructured data processing. Another important aspect is that this technology, besides analyzing the existing data, can answer questions that have not yet been idealized, in signaling new ways, possibilities and discover new patterns in the analyzed data.
With the use of this technology in the health area it is possible to think about the improvement of possible diagnoses of a patient and even the reduction of research costs thanks to the dissemination of knowledge.
A well-done analysis of administrative data may be the differential for improving the screening and admission process, employee distribution or bed allocation, for example.
- b) Blockchain
According to the Blockchain article: Freedom with Confidence:
“Blockchain is a technology that allows seamless data to be shared in a purely distributed system.
The term blockchain can also be used to name the data structure used in this technology, or the algorithm responsible for manipulating this data mechanism, or as a generic term, which refers to the fully distributed systems that use the blockchain.
It is called a purely distributed system that is composed of totally independent parts with no central element. An example of such a system would be a group of friends who exchange their favorite books with each other. A centralized system, in turn, would be exemplified by a sebum or a library that mediates the exchanges of works. However, the situation becomes more complex when there is the intention to make independent exchanges between unknown people or if the library loan book is damaged or adulterated.
By using blockchain, it is possible to conduct secure transactions between stakeholders in a low-trust environment without the need to expose yourself to the risk and costs of an intermediary. “
Therefore, it is a technology that can bring more security, reliability and transparency to the most distinct areas of a business. It consists of another technology to store the large amounts of data generated as sensitive patient data as test results, administrative data from health facilities that directly impact on costs, quality and value.
How can health, care, and administration costs be positively impacted by blockchain technology?
With the use of blockchain technology, one can centralize and optimize the data related to administrative expenses. In addition, it is possible to think of more effective ways to register and maintain personal data, avoiding duplication in situations such as: sensitive patient data, data related to studies and images of exams and laboratory results. Duplicity generates financial and time expenses of the professionals, which also reflects in more pass-through of expenses to the patient.
How can the quality of health, healthcare and administration be positively impacted by blockchain technology?
Blockchain technology can positively impact health quality, patient care, and health facility management through security and integrity, providing effective ways of sharing and accessing information, positively impacting cost savings with these operations.
In contrast, there are some points that need to be analyzed before the adoption of blockchain technology:
- Costs for system and hardware deployment: it is necessary that all the establishments have the hardwares and a robust interconnection network to add the blocks of information;
- Definition of Scope and Coverage: It can be difficult to measure these aspects at the beginning of a system deployment;
- Technical barriers: For example, it is necessary to have a robust data communication system in hospitals, clinics and laboratories;
- Management costs: related to the hardwares and robust network already mentioned, also consider the training of the professionals involved in the maintenance and input of data in the system;
- Issues related to the legislation and privacy and training of professionals who will handle such sensitive data.
- c) internet of Things (IoT)
One of the alternatives of using the “internet of things” technology is as a resource against the loss of inputs.
It can be applied, for example, in combating vaccine wastage. It is estimated that up to 50% of the total vaccine produced worldwide are lost per year, according to the United Nations. Among the causes cited are: power failures, inadequate refrigerators, deficiency and lack of continuous monitoring of temperatures and storage conditions and lack of training of health professionals.
Proper conservation and monitoring of temperatures, which are often second to governmental investment, are essential items within this context. With all the technology available and currently under development, it is possible to minimize or cure these causes.
Still within this comprehensive area of “Internet of Things”, there are the mobile devices, also known as “wearables”. These devices provide information to patients, such as data on sleep quality, amount of calories spent per day, number of steps, heart rate, temperature, and blood pressure.
Hypertensive patients, for example, may benefit from so-called smartwatches. The devices are connected directly to an application installed on a mobile phone or tablet and are capable of measuring blood pressure, oxygenation level, heart rate and other indicators. Thus, these rates can be followed in real time by doctors and health professionals.
It is also important to mention the devices that monitor quantities such as CO2, Nitrogen, Temperature, Humidity, Electricity, Oxygen and are increasingly present in hospital environments. A hospital with an ICU sector, for example, has a series of gases, equipment and materials collected, that is, items that need to be controlled to ensure the quality and safety of the patient and employees within the environment.
Other examples of IoT use in health care still under development:
- Neogia: combined technology using IoT and artificial intelligence to monitor occurrences of apnea – a rather perilous condition, consisting of periodic stops of breathing during sleep and, secondarily, generation of symptoms such as hypertension, cardiopathies, brain accidents, diabetes and drowsiness – through a smartwatch. Through its application, it will be possible to assemble a profile of the patient that suggests methods of improvement in the sleep pattern.
- Bloomlife: consists of a device capable of monitoring the belly during pregnancy and measure contractions by obtaining the electrical activity of the uterine muscles. This information is sent to the smartphone and, with some knowledge, it is possible to identify if it is the case of a “false alarm” (for example, contractions of Braxton Hicks) or the beginning of actual labor.
4) A look at the health professional
Through resources provided by the use of technology focused on management and efficiency such as the digitalization of processes or a system that manages the finances and administration of a clinic in general, health professionals gain time and energy, so that they can focus their professional development and the care of their patients.
Here are some possibilities:
- a) Electronic health record
With this type of system, you can centralize a patient’s information in one place. Combined with a cloud system, obtaining this data becomes much faster and possible from anywhere with Internet access, which can be crucial in emergencies.
This way of managing the information in the cloud can cause a strange beginning, however, it can be considered that, with this system, the accumulation of information in a physical machine is reduced, which is subject to resource constraints and possible risks.
In addition, the data is stored more safely and reliably, no longer subject to the risks of paper storage or lack of communication between people.
Another aspect to be considered is that, with this access to centralized data, the professional can quickly know if there is any procedure or medication highly contraindicated for his patient, as well as a procedure that has been previously indicated and not performed. Otherwise, this information would not reach the professional and, contextualized in an emergency situation, the information can be crucial in maintaining the patient’s life.
- b) Technology for surgical procedures
Anvisa recently approved software that collects and stores vital patient data in surgery, in real time. This software, called Centricity Anesthesia, allows the anesthetist to fully focus on the patient and ensure better care. For more detailed information, see this link.
Robotic surgery has also evolved rapidly, making surgical procedures more effective and reducing possible risks. According to the RetinaLink website, American hospitals already use Augmented Reality and 3D imaging technology to perform surgeries. Especially in delicate regions such as brain and eyes, this tool makes the work of physicians and patient experience less uncomfortable, preventing that only microscopes being used.
Another remarkable breakthrough can be seen through the use of 3D technologies. Right next to Venturus, we have the Renato Archer CTI (Information Technology Center), with the ProMED government program (PD & I Program of Applications of 3D Technologies in Medicine / Health), whose objective is to assist in the planning of complex surgeries. Through 3D technologies, it is possible to create replicas of injured regions, the “biomodels”, which can be used in surgical tests such as markings, cuts, molding and fixation of prostheses.
In conjunction with biomodels, 3D technology also enables the creation of customized surgical artifacts, such as prosthetic molds for the cranial region and tooling. However, in order to have all these features, it is necessary to develop and improve digital models.
There are two research groups associated with ProMED:
- InVesalius: free software development group for visualization of medical imaging. This group, in July 2017, had users in 143 countries;
- Bioengineering: a group that studies the mechanical simulation of biological systems so that the models of prostheses and orthoses incorporate a high degree of personalization, in order to allow the prostheses to adapt to the patient, not the other way around.
There are also the following research lines with strong application of technology:
- Modeling of three-dimensional structures for growth of tissues and organs, called biological scaffolds;
- Computational simulation of the processes involved in organ growth;
- 3D printing of new biomaterials.
5) A look at the patient
- a) Examination conducting
Another advance that can be verified refers to performing exams that in the past were based on more invasive, aggressive and painful procedures and that, currently, can be performed by magnetic resonance, computed tomography or PET-CT (Positron Emission Tomography).
Such advance also provided improved accuracy and time-to-return of the diagnoses, increasing the chance of success in the choice and outcome of treatments. For example, through specific tests, doctors can map the exact location and size of “small” tumors and cancer cells, making it easier to make the decision about the type and speed of treatment to be adopted.
- b) Telemedicine – Remote Assistance
Still in the initial phase, telemedicine is the fusion of technologies and applications that allow medical actions at a distance – be it patient care or other professionals in the area.
With the evolution of the media, it is natural that the contact between doctors and patients be done at a distance, being equally effective and beneficial. In addition, telemedicine can be used to enhance scientific studies or to issue reports and results. Telemedicine brings, along with technological advances, the possibility (and hope) of a more accessible and democratic health, since it can positively affect the lives of people living in remote areas or with fewer medical resources.
One of the purposes of technology is to generate experience for its users, regardless of their area of expertise.
On the one hand, the technology adopted and the software implanted should help teams and managers manage sensitive materials at high cost (for pocket and for life), such as medicines, the most varied types of exams, vaccines, clinical analyzes, bags of blood and food.
On the other hand, they must generate and deal with extremely sensitive and valuable data, ranging from the administrative and financial system of these environments to the most important and delicate of all, patient data, safely, effectively, reliably and primarily accountable.
Indeed, there are many new ideas and initiatives at the intersection between health and technology. It is a point of reflection: not only what is new, disruptive and different is necessary, but also a real update and improvement in existing products and services, through a gradual and constant process. And that won’t make the work be less exciting!