Healthcare has evolved significantly since the dawn of man. Centuries have passed since the time when cocaine used to be prescribed to treat depression, elephant bile was used to treat bad breath and Romans prescribed an elixir containing human flesh, blood or bone aptly titled “corpse-medicine” to cure epilepsy in soldiers. Most of these practices have long been forgotten and have paved way for safer, precise and accurate medical technologies. The world of medicine has seen many cutting-edge technological innovations and advancements.
From surgery-performing nanobots to tremor tracking wristwatches, from robotic surgeons to depression-fighting smartphone apps, the latest trends are focusing towards providing at-home care for patients.this article will go in extensive details about the latest technological advancements in mobile healthcare, the need for state-of-the art hospitals, challenges and effectiveness of mobile healthcare.
Major Challenges Faced By Hospitals
There are a lot of challenges that current hospitals are facing. Sterilization is one of these issues. Sterilization requires a lot of time, money and effort to properly be applied in a healthcare environment.Many times hospitals cannot be fully cleaned. In such cases are a home to many strains of bacteria.
According to the Centers for Disease Control and Prevention (CDC) there are 1.7 million hospital infections, also known as Nosocomial infections, that directly or indirectly cause 99,000 deaths each year. These hospital infections can cause severe pneumonia, urinary tract infections and several blood infections. Many types of these hospital infections are tough to treat using standard techniques such as antibiotics. Moreover antibiotic resistance can complicate the treatment process.
Nosocomial Infections are infections that arise when the patient was admitted to the hospital, due to an unrelated diagnosis. These infections can occur up to 48 hours of hospital admission, up to 3 days after discharge or up to 30 days after an operation. An estimate of 9.2% of US patients acquire Nosocomial infection. These infections are caused by pathogens in the air that can easily spread in the body. These infections can affect any patient that has been hospitalized and patients with weak immune systems. Hence to combat such infections, which can become resistive to standard anti-biotic treatments, scientists are looking towards medical technology.
Another challenge faced by patients is the availability of beds and doctors within a healthcare facility. These ratios set the healthcare facility’s efficiency at delivering healthcare.
A study was conducted to determine whether hospitals with good organizational management, such as good facilities and good working staff, affects patient care and recovery time. Nurses were surveyed in general acute care hospitals (488 in 12 European countries; 617 in the United States); patients were surveyed in 210 European hospitals and 430 US hospitals. Patient satisfaction and willingness to recommend hospitals was compared with nurses’ outcomes such as hospital staffing, work environments, burnout, dissatisfaction, intention to leave job in the next year, patient safety, and quality of care.
The results showed that there were differences in nurse workloads across hospitals in Europe and the US and healthcare deficits were common in all countries. These shortcomings affected patient satisfaction and recovery times. The researchers concluded that improvement of hospital work environments might be a relatively low cost strategy to improve safety and quality in hospital care and to increase patient satisfaction.
Another major problem that hospitals face is medical errors. A study done by a team of researchers from Johns Hopkins Medicine says medical errors should rank as the third leading cause of deaths in US. The researchers elaborated medical error as an error in judgment, skill or care coordination, misdiagnosis, machine or system error, and a preventable adverse event such as an allergic reaction. But due to the limitations of the coding system factors such as diagnostic errors, lapse of judgment or communication gaps are overlooked and deaths in such circumstances are not recorded properly.
Home Based Healthcare: Making Healthcare Engaging
A growing number of evidences show that a more engaging patient experience leads to better health outcomes, lesser stay durations at hospitals and lower use of healthcare services. Patient engagement places focus on patient centered care and shared decision making. There is also evidence that family members play a vital role in making important decisions regarding a patient’s health and more active family members can change health outcomes for the better.For example, one study found that family members gave new information 46% of the time when present during rounds. Family members can help in coordinating patient care and be keen observants to make sure patients are getting satisfactory services in terms of quality, accuracy and safety.
Their responsibility is magnified ten-folds when the patient’s condition is unstable or is in an unconscious state, and the family members have to make decisions on their part.Hospitals put in place policies to facilitate patient engagement such as extended patient stays. One study reported that longer visiting hours in the intensive care unit were linked to a reduction in cardiovascular complications, possibly through patients’ reduced anxiety and better hormonal profiles.
A study published in the British Medical Journal, looked at a survey of hospitals in the USA regarding their patient and family engagement PFE practices during 2013–2014.Of the 3442 hospitals surveyed, 1457 (42.4%) responded.Among the most widely adopted organizational practices, 88% had written policies to identify which of the patients’ personal contacts they would like to have actively involved in their care, 86% had a policy for unrestricted visitor access in at least some units and 67% had formal policies for disclosing and apologizing for medical errors. Because increased PFE use is linked with overall improved patient health results, higher patient ratings of hospital quality and decreased use of health services, it is recommended that hospitals give priority to PFE practices and more hospitals start implementing these policies.
This study goes to prove that the current healthcare system lacks fundamental aspects of healthcare. Focus should be placed on delivering precision medicine, while building a healthy patient-caregiver relationship.
The Need For Home-Based Healthcare
Many patients are falling victim to chronic illnesses and co-morbid diseases. Due to the severe nature of the illnesses, patients are left physically weak and mentally damaged. This can lead to a series of complications, most of which cannot be solved in the current state of US hospitals due to their shortcomings discussed earlier.
Home based primary care (HBPC) has evolved from the roots of house calls and community outreach programs of the past. It now incorporates the latest advancements in the field of science and technology. from mobile health apps to patient vital monitoring systems to alarm systems, these advancements will provide an alternative way of managing and delivering care that may better assess and fulfill the needs, values, and preferences of chronically ill, weak, and disabled patients who have difficulty accessing traditional office-based primary care or newer models of healthcare that may require frequent visits to the doctor.
Technological Advancements In Home Based Primary Care
Scientists are becoming increasingly invested in the idea of delivering healthcare at home that they are going out of their way to equip homes with the latest technology to provide state-of-the art hospital level healthcare in homes.Scientists, information technology experts and healthcare researchers are joining forces to make huge leaps in this relatively new scope.
Mobile healthcare facilities allow efficient management of patient homes so they have access to same level of treatment found in medical centers, clinics and hospices. Many years of research has gone into this industry to improve healthcare and cut costs for homebound patients. this field has resulted in a lot of collaborations between scientists, technology experts and healthcare researchers.
One such collaboration is between a team of scientists and health experts from David Geffen School of Medicine at UCLA and UCLA Henry Samuell School of Engineering and Applied Science. The SMART Health Center aims to provide home-based health technology solutions.
Their project Smart Home Lab, a fake resident environment where scientists and researchers can simulate patient’s responses to a home treatment environment. This way more and more patients will be able to heal in their homes and avoid lengthy hospital stays. The “home” will contain several health sensors used to measure patient’s vitals and in doing so create a tailored treatment best suited to improve the patient’s condition.
Many inpatients are facing lengthy stays and facing many overheads due to this. Mobile healthcare if implemented properly can offer 24/7 surveillance and facilities through sensors, cameras and alarms. If a patient’s condition suddenly worsens, an alarm will go on informing the healthcare official to respond accordingly. Moreover, technical advice can be given remotely.
The scientists and health experts will gather data, and use the data to progress healthcare information systems that focus mainly on mobile healthcare. Currently, there is not much innovation in mobile healthcare solutions. The center is looking to change that. Iededt is dedicated to researching newer solutions and technology methods to better predict health risks, provide better treatment solutions and improve the overall quality of healthcare provided. Hence it is looking to capitalize on the growing trend of ‘precision medicine’ and ‘big data’.
Telemedicine is another major technological advancement in digital/mobile healthcare solutions. Telemedicine involves a healthcare professional interacting with patients remotely via the Internet. This technology is quite useful especially in remote areas, where patients do not have access to good healthcare facilities, and for disabled or elderly patients who cannot move freely, and seeing a doctor is a challenging task.
Telemedicine allows interacting with a real doctor using their computers or smartphones. The doctor can assess the patients’ physical conditions remotely and check their symptoms and diagnose accordingly.
Another major area of innovation is mobile health apps. Our smartphones have become more powerful than our computers of two years back. We can get all kinds of information from our smartphones. App developers have made apps that can book flights, reserve taxis and even order food.
App developers have put all their focus in developing health apps. This trend has grown exponentially over the years, so much so that Centre for Federal Trade Commission (FTC) recently issued guidelines for app developers to make apps more secure, reliable and relevant.
Health apps have seen such advancements that, developers are creating apps designed specifically catered to manage specific diseases such as cancer and diabetes. Diseases which are overlooked such as depression can be cured by an mobile app. Moreover, there are apps that are designed for healthcare providers to better manage their tasks such as making appointments etc.
Challenges Faced By HBPC
One of the most profound challenges faced by HBPC is that its impact remains a question to this day. while HBPC seems like a logical solution for patients with mobility issues, there remain a lot of unresolved issues such as feasibility, effectiveness, potential harms, unintended consequences, costs, and sustainability of this model of care.
Another issue is that many HBPC solutions are not standardized and their results could therefore greatly vary in individuals. Many researches do not provide detailed description of how these variations impact the results. Moreover, HBPC interventions have been used to cater to a variety of populations with different health risks, ranging from generally well elderly to severely disabled patients. Given these differences, there remain questions about which outcomes best match the different goals of different versions of HBPC and which outcomes are most important to different patients.
The most challenging part, however, is that home-care devices such as mobile apps do not provide precise results and have many variations that perform the same basic functions but differ in operability and ease of use. In many cases, these apps can only give an estimate about a patient’s condition and rarely give a precise assessment. They are not a replacement for proper healthcare as these apps make people reliant on them and can cause concern of reliability.
There is also the concern of creating distance between patient and healthcare provider since technologies such as telemedicine provide “over the air” medical advice. Firstly, not everything can be explained or assessed over the phone. What this means is that for example a patient is having chest pains, the doctor won’t be able to diagnose his condition just by looking at him, he’ll have to physically intervene, in this case to monitor his breathing via a stethoscope.
Secondly, as with all technologies, telemedicine has a risk of communication breakdown. Due to bad weather, servers crashing, “lines” being busy, or a million other reasons, the patient would not be able to get connected with a doctor. This problem is significantly more alarming when there is a medical emergency. Also a doctor has to be available 24/7 365 days a week for the same reason, otherwise what’s the point?
Then there is a need for security since technically speaking, all forms of information can be hacked. Hence patients who are mindful about their privacy will be turned off by the idea that someone might be “listening in” to their conversation.
Let’s just get one thing clear, hospitals aren’t going anywhere, there is however a definite need for innovation in healthcare and due to the issues faced by many hospitals, many healthcare experts, medical advisors, policy makers and technology experts are working to make home-based healthcare more accessible and universal.
HBPC is still in its infancy and is many years away from providing the perfect solution. Hence, hospitals need to overcome the challenges they are currently facing and incorporate some of the more effective technologies into its traditional suite of services to make for a more effective approach to healthcare.