The crisis as an opportunity for our health system? Part 2

• In the medium to long term, devices should be integrated into existing IT infrastructures.

• With a higher degree of automation through robots and reading systems using RFID tags, throughput and quality could be significantly increased.

Digitalisation can make our health care system much more effective - in the current but especially in future crisis situations. We outline possible paths to a more digital and better future.

In the first part we deal with family doctor's practices or outpatient care as well as hospitals or inpatient care. In this second part, we deal with medical technology manufacturers, laboratories or diagnostics and the pharmaceutical industry.

Medical technology manufacturers

While the corona crisis generated record demand for ventilators, many medical device manufacturers had to contend with interrupted supply chains. Due to the strict quality requirements in the medical sector, it is very difficult to find replacements at short notice, which posed serious problems for many manufacturers.

In the short term: Additive production to prevent supply problems

A short-term solution for missing components could be additive manufacturing. We have been working with parts from 3D printers for years. The quality here has improved continuously and is now comparable with injection moulded parts. The advantage is that there are already a large number of qualified suppliers in Europe. Zühlke was already able to use this technology in some prototypes of medical devices for clinical studies.
Once all the parts are available for production, the test and inspection systems often become the bottleneck in production. All medical products must be verified on GxP-compliant test systems before delivery. During the corona crisis, we were able to adjust the output of some medical technology production facilities to the increased demand by replicating well-documented test systems.

Medium to long-term: Integration of devices into existing IT infrastructures

Many modern diagnostic devices are already equipped with technologies that allow data to be transmitted to a smartphone or directly to the Internet. Despite the available connection technology, the integration of the devices into the existing IT infrastructure of the healthcare sector has not yet progressed very far. In the future, device manufacturers must pay more attention to the connectivity and interoperability of their devices. For this purpose, not only future-proof connection standards such as Bluetooth and LoRa should be considered, but also the corresponding semantic standards, such as HL7.

Diagnostics / Laboratories

The analysis of the spread and infection rate of a virus infection is important for the development of the right countermeasures. Laboratories play a decisive role here.

In the short term: Optimise capacity utilisation with GPS trackers

To ensure that all parties involved have a good overview of the status of the samples, automatic tracking outside the laboratories would be desirable. Here, there are already proven solutions in logistics, but they are not yet used for normal samples. Using simple GPS trackers that are sent with the samples, laboratories could optimise their workload and transport capacities could be better coordinated. A pragmatic solution in recent months has proved to be GPS dog collars, which were included with the deliveries.

Medium-term: Modern and standardised connection of laboratory systems

Timely dissemination of test results in an appropriate form to key agencies is essential to combat a pandemic. In Switzerland, for example, the Federal Office of Public Health (FOPH) has to deal with a veritable flood of paper documents from the laboratories, as there is not yet a uniform digital standard for this. According to press reports, there was also a pragmatic solution here in the form of scales to measure the stacks of paper with reports from negatively tested patients. However, with a modern and standardised (e.g.: IHE/HL7) connection of laboratory systems to national reporting systems, the picture of the crisis would certainly be more accurate and up-to-date.

In the long term: Increase the degree of automation

The management of samples on a scale similar to that at the height of the corona crisis presents many laboratories with major logistical challenges. It is crucial that complete traceability is provided during the evaluation of the samples. Many manual processing steps are a major source of error. With a higher degree of automation through robots and reading systems using RFID tags, throughput and quality could be significantly increased.

Pharmaceutical Industry

The pharmaceutical industry is one of the few areas in the healthcare industry that has already gained momentum in terms of digitization. This is particularly true in the R&D area, where AI is already widely used.

Medium to long-term: Closer to the patients

In view of the long periods of time in which development processes in the pharmaceutical industry take place, it is difficult to identify possible ad hoc measures here with which digitisation could help to overcome the current crisis. However, in order to be better prepared for pandemics in the future, pharmaceutical companies could move closer to patients and consumers. This is where the combination of biosensor technology and artificial intelligence offers a lot of potential - right up to the detection of diseases before the first noticeable symptoms appear.

For the pharmaceutical industry, digital technologies offer a wide range of possibilities here. It would be conceivable, for example, to develop apps and devices that facilitate participation in clinical studies. The pharmaceutical industry could also play a formative role in expanding the relationship between doctors and patients using digital technologies, just as it does in supporting doctors using artificial intelligence.

An important point here, however, is that the data in question is particularly worthy of protection. In Germany, for example, pharmaceutical companies are currently not even allowed to collect data directly from end consumers. However, interesting potential solutions are already emerging, such as the Startup Ocean Protocol or Federated Learning. The goal of both approaches is to provide data exclusively, securely and reliably for the training of algorithms, without the possibility to read them in any other form. Both approaches could decisively advance the digitalisation of the healthcare ecosystem - and give the pharmaceutical industry a central role in this process.

Conclusion

There is no lack of good ideas and the corresponding technologies. The number of voluntary initiatives (helpfulETH, Code vs Covid 19, Maker vs Virus, WirVsVirus, Hack the Crisis) have shown that the will to implement digital solutions is there. However, many of the results cannot be applied in practice, as not all existing directives could be implemented in such a short time. In the end, it will depend on how well the digital solutions are accepted by users in the health care system. Especially in the family doctor's area, one often feels an inhibition threshold against digital changes.

We are convinced that technology and networking are the key to a more efficient healthcare system and can reduce the impact of viral pandemics.