5 frontier technologies catalysing digital healthcare

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5 frontier technologies catalysing digital healthcare

Digital tools like AI, apps, and wearables are revolutionising healthcare by enhancing accessibility and personalisation. Image created by DALL·E 3.

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The healthcare space has seen significant innovation in recent years, but only a handful of these developments can truly be considered momentum-shifters.

In his keynote, “Five Frontier Technologies Shaping Healthcare in the Digital Era,” at the Healthcare Frontiers 2024 conference organised by Jicara Media, Dr William Kristanto, Consultant Cardiologist at Cardiac Care Partners, Mount Elizabeth Hospital, highlighted the breakthroughs that have had a lasting impact on the healthcare community — both for providers and patients.

Electronic medical records

Traditionally, doctors recorded patient information using handwritten notes, which were then organised into folders and tucked away in a filing room. Although this system worked for a long time, it had several downsides:

  • Different people contributing to a single patient’s medical history can cause confusion and misunderstandings during analysis, due to factors like handwriting differences.
  • Attachments can easily get lost, rendering a patient’s history incomplete.
  • Storage space can be a challenge, especially as an organisation expands.
  • Document retrieval can be difficult, particularly without an efficient filing system.
  • In the event of a fire or flood, documents may be destroyed.

For Kristanto, the shift to a digital medium was a much-needed solution: “All of these scenarios don’t apply with electronic medical records, because they’re there forever. This has really helped with the delivery of patient care, and now our EMR has evolved into something even more extensive and integrated. You now have records from hospitals, labs, community clinics, and various providers all dealing with the same patient, sharing information and data across the system.”

Despite the convenience, Kristanto observed a tendency to misuse the technology.

“Junior doctors nowadays are just conveniently cutting and pasting large sections of medical history. To the point that, when you read an electronic discharge summary, sometimes you don’t really know what they’re talking about — it’s just a verbose mess with no synthesis. So, while there are drawbacks to electronic medical records, overall, it’s been an improvement over the past,” he remarked.

Apps, software, and chatbots

When Kristanto was starting his career in medicine, the only way for patients to access a doctor was through a call centre, which was reportedly often a tedious process.

Dr William Kristanto, Consultant Cardiologist at Cardiac Care Partners, Mount Elizabeth Hospital. Image courtesy of Cardiac Care Partners, Mount Elizabeth Hospital.

“Sometimes, you’d wait for half an hour and never get through. There was a lot of frustration, delay, and a lack of accessibility and communication. With the rise of the fax machine and then email, patients could reach out to doctors to exchange information, but that has really been revolutionised with the advent of smartphones. Now you have apps, software, and even chatbots,” he noted.

Today, patients can interact with healthcare providers much more efficiently, with waiting times for appointments reduced to minutes, even seconds, instead of hours or days.

“You can go online and book an appointment yourself. But most importantly, this empowers patients, because now they take a vested interest in being responsible for their health,” he added.

Wearables

In the past, blood pressure could only be measured during a clinic visit or with a home BP apparatus. Today, the rise of smartwatches allows people to track vital signs, sleep patterns, and blood sugar levels.

While Kristanto is thankful for these devices, he remains cautious about interpreting the results they produce.

“You have your Apple smartwatches, for example, which some claim to be medical grade, but I still take their readings with a pinch of salt. At the very least, patients have something to share with their doctor, which leads to more frequent visits to learn more about their health,” he said.

He also shared his experience with a device he uses to monitor his glucose intake.

“This is a device you attach to the fatty part of your body. It syncs with your phone via Bluetooth, allowing you to monitor your blood glucose levels in real time. This helps guide behaviour and diabetes treatment. Before each meal, I take a photo of the food, which is uploaded to a server where AI analyses the calories and fat content. It helps me as a patient be more mindful of my calorie intake,” he explained.

3D printing

The advent of 3D printing has allowed healthcare organisations to turn concepts and designs into three-dimensional, tangible materials. This technology has been particularly effective for medical products, equipment, prostheses, anatomical models, tissue and biomaterials, and even drugs.

“Now, you can have personalised and customised 3D printing of the tools you need for a patient. For example, for a skull or pelvic bone fracture, you can use the technology to assist with surgical planning. With a CT scan, you can create a 3D anatomical reconstruction of the area you’re going to operate on, so you can practise and familiarise yourself beforehand,” Kristanto said.

In the near future, he predicted, there may even be personalised medicine.

“There’s a move towards printing pills so that patients can receive one personalised pill, making it easier for them to take their medication,” Kristanto revealed.

AI algorithms

Before AI, cardiovascular surgeons typically had to open a patient’s blood vessel to address the cause of a minor heart attack. Kristanto explained that they would insert a catheter, wire, balloon, and stent to restore blood flow.

“Without AI, we used to make certain judgements based on rigorous training. For example, the catheter, which is the middle tube, is about 2 mm in diameter, and the vessel is around 2.5 to 3 mm. We would estimate based on this, thinking, ‘For this patient, the vessel is about 3 mm, so I’ll use a 3 mm stent.’ That’s how we used to do things,” Kristanto recalled.

Today, younger doctors are using AI to assist in the decision-making process.

“They do the same angiogram and insert the wire, but now they run the data through a machine that does a pullback and analyses the vessel. In two seconds, it determines the exact diameter. For example, it might say the vessel’s reference diameter is 3.75 mm. So, you shouldn’t use a 2.0 or 3.0 stent because the diameter is closer to 3.47 to 3.75 mm. After the stent is placed, the machine shows that the vessel expands by 86%, and it provides a visual of what the stent looks like. It can even pinpoint areas of the stent that need more attention or areas of the plaque that may have been missed,” Kristanto explained.

However, human judgement remains crucial, and doctors ultimately decide whether to agree with the machine’s analysis or not. For Kristanto, if human judgement isn’t 100% accurate, then AI is even less so.

“I’ve always maintained that ECG was one of the earliest forms of AI. Even before I started medical school, we had computerised algorithms for ECG diagnosis. But doctors have never fully trusted them, because they’re not 100% accurate. For instance, I get many referrals for an ECG diagnosis of acute heart attack, yet the patient is sitting in front of me perfectly well,” he said.

When asked whether AI will replace doctors in the future, Kristanto was firm in his view: “Ultimately, there’s the issue of liability. Who’s going to be responsible when the computer is wrong? AI is never 100% accurate in medicine. They say it’s never perfect, so I believe AI won’t replace medical professionals, but medical professionals who use AI will replace those who don’t.”

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