The Impact of Digital Transformation on Healthcare

Arvind Sivaramakrishnan, CIO, Karkinos Healthcare

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Arvind Sivaramakrishnan, CIO, Karkinos Healthcare in a recent interaction with CIOTechOutlook, shared his views on how can digital healthcare solution providers respect and protect patient privacy while harnessing data's power for better outcomes, how telemedicine and remote care having gained traction, the future of patient engagement and relationships as telemedicine becomes increasingly mainstream and more.

Data is the new currency in healthcare, yet patient privacy remains a top concern. How can digital healthcare solutions respect and protect patient privacy while harnessing data's power for better outcomes?

The first notion of looking at a discussion on respecting privacy is invalid.  It is invalid because when a patient or a consumer is availing a service, it is a given that privacy will be maintained. Hence, it is not a discussion that privacy will be violated, and that is unethical practice. Therefore, when organizations are developing products and services, it is imperative that privacy and security of the consumer (the patient) is protected. It should not be seen as a business of data rather the data should be used in an anonymized format, protecting the patient identity. There can be lot of intelligence harnessed, and this intelligence can help in generating evidence based pathways and protocols which can act as an effective digital assistant to the providers, and thereby the quality of service will be better, which in turn will help in obtaining high degrees of clinical outcome. Lastly, using this data in an anonymized manner - as an insight as well as a cognitive intelligence to the provider, we can eliminate the dependency on geography for healthcare delivery, thereby increasing the much-needed capacity.

However, all of this exhibits that there can be no compromise or discussion on any violation or infringement on the privacy of the patient data. Data can be used in anonymized manner with explicit informed consent, and not implicit but explicit informed consent so that it helps everyone gain an understanding on what is going but at the same time there should not be any compromise whatsoever under any sort on the privacy or the security of the patient, since he trusts the provider on his health information.

With the increasing adoption of IoT in healthcare, what are some unintended consequences you foresee, and how might we mitigate them?

There are multiple aspects of it. Firstly, when you look at IoTs you can provide a degree of automation and continuous observability on various conditions. These conditions could be small or even as simple as vitals Monitoring to large conditions. The first aspect of it is to ensure that the calibration of the equipment is accurate and that there are no induced problems in the calibration, thereby providing the accuracy of the measurement. Moreover, as we are using internet-based technologies, digital technologies, we should also ensure that it is the quality of performance, and the applicability that is kept at a very high percentage. And particularly in healthcare, anything less than 100% is unacceptable, because at all points in time, we are dealing with a health condition, and anything less than perfect is not congenial for the health condition and for the state of health monitoring for any individual. Therefore, high degree of accuracy has to be maintained.

Owing to the usage of Internet of Things and internet based technologies, the concern on security is paramount as there are unintended consequences of security breaches. Security breaches are carried out due to oversight and bad actors who are trying to infringe on systems. Both these aspects are possible, and thereby it is important for organizations and providers of such solutions to ensure that there is continuous checks and balances as well as monitoring on the security of the devices it is kept updated with all the technologies which are directly & indirectly supporting it. This is because an indirect loop hole can also cause a breach that is unintended. This is from a technologist point of view. However, several factors may sound logical when we look at a breach, and such logical activities are harmful for the purpose of monitoring and supporting the health condition of a patient.

Hence, this should be viewed from the lens of a patient, where the patient's health is not being compromised. And thereby everything should be prioritized equally ensuring technology adherence, accuracy and efficiency. To achieve this we have to ensure that IoT devices, and have the ability to integrate with the mainstream health systems so that no equipment or device is an island by itself. Thereby compromising the longitudinal record and the need for this information, data, recorded health information, in context of the health appraisal, whereas it would could be a context of an encounter in an in-patient or an out-patient on an ER or an ICU, whichever be the case, it has to gel well into the context of Healthcare and not remain as an island of technology Excellence. This will not be useful since the overall purpose of deploying such technologies is to aid the health monitoring of a patient.

Telemedicine and remote care have gained traction. How do you envision the future of patient engagement and relationships as telemedicine becomes increasingly mainstream?

Remote healthcare as an enabler helps in building the capacity in healthcare. There are several conditions where we can ensure that we have the right advice from the clinically qualified personnel without the need for a physical visit. This also ensures that, we can have the healthcare and the clinical talent made available to patients without physical movement of people across geographies. This will help in eliminating geography as a barrier. Not just that, remote health and telehealth, can also ensure that high talent is available without the barrier of geography.

 Therefore, we are looking at it both ways. For the provider it should be with high talent to be available in any geography, and for the patient in any geography to access a provider from any geographical location. Hence, both are enabled, at high degrees of quality and clinical outcome, and not compromising any quality measures. They have to be used for conditions that are suitable for deploying the tele-health and remote health conditions. These are not used for purposes that are of a high emergent nature, however, they can be used for effective intensive care tele ICUs, in a provider to provider, institution to institution setup as well.

Therefore, concepts such as the tele ICU, the tele emergency, can be used in institution to institution, and provider to provider setups. If you are looking at remote health being an effective capacity enabler, which eliminates the limitations of geography, that eliminates the limitation of concentrated talent in a certain place, certain location and the lack of its availability in certain other places, it shows that you are completely eliminating the concept of urban, rural or semi urban connotations. Thus, tele health can be an effective enabler for all the current modes of healthcare.

Telehealth can be looked at as a force multiplier for the delivery of healthcare across conditions, across geographies, and for the best of best talent to be available to all. This is enabled with the power of digital technologies, similar to the entire reinforced cognitive algorithm embedded into these remote healthcare solutions and telehealth solutions that brings higher degree of clinical outcomes to be delivered. This leads to the quality outcomes and that is a great state we can all achieve and we all desire for as consumers. Therefore, this is how you look at telehealth and technology coming together to serve all who need healthcare, irrespective of their physical location or the availability of clinical healthcare talent.

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