COVID has been a catalyst for digital transformation in healthcare, possibly more than any other industry. But even before the pandemic hit, Dubai-based Aster DM Healthcare was adopting new technologies — for example, implementing a software-defined network in the infrastructure of its Aster hospitals in the United Arab Emirates to help manage IoT-connected healthcare devices .
Joseph George, CIO at Aster DM Healthcare is in a good position to speak about the next steps for digital healthcare in the UAE and elsewhere as the total Aster DM network now comprises 17,594 employees including 2860 physicians, which stretch across the entire Middle East alongside India.
CIO Middle East: To what extent are hospitals in the UAE in a process of digital transformation – using IT to fundamentally change the way they work?
It is a fact that healthcare is known for being slow to embrace new technologies, but in UAE we should admit that the healthcare industry is much better at embracing technological advances. One of the main reasons is regulatory involvement and governance. The UAE healthcare started its journey of digital transformation a long time ago. The way Dubai has introduced e-prescriptions and digital revenue cycle operations are the best early examples.
If we look at the UAE healthcare facilities, it is very evident that survival of the digitally fittest is the prevailing mantra. The readiness of an organization is the decisive factor for the smooth running of the digital transformation.
We are all familiar with the EMR (Electronic Health Records) Adoption and Maturity Models designed by HIMSS (Healthcare Information and Management Systems Society). But to be honest, there is no single maturity model that measures the level of digital transformation. Likewise, there is no generally accepted definition for “digital”. From a discussion perspective, I think the digital transformation journey can be assessed as different stages rather than stages of maturity.
When we used the old paper-based medical record system, which was the starting point, all facilities in the UAE have already passed this stage. The digital transformation of any healthcare facility depends heavily on the underlying hospital information system. Many healthcare companies rely entirely on their HIS (Health Information System) capabilities to drive the digital journey. For small and medium-sized companies, this is the right approach when additional CAPEX (investments) for digitization are a burden.
CIO Middle East: Data analytics is key in healthcare. How do you see the role of business intelligence in healthcare?
If we look at the healthcare analytics scenario, the exact word to describe it is clinical business intelligence. It’s a broader term, and as mentioned above, healthcare has been slow to embrace technological advances. The same applies to the introduction of data warehouse and business intelligence. One of the best examples of analytics adoption is in the telecom industry. The telecom industry prepares the data warehouse and business intelligence use cases even before they go live with their first customer. Unfortunately, when it comes to analytics in general, many organizations fail in their efforts to become data-driven.
Recently, we’ve seen very good traction in the adoption of business intelligence in healthcare. We have to say that the pandemic became a catalyst for this as well. The healthcare industry is known for its rich data collection. Clinical business intelligence projects require careful data modeling from the start. Stakeholder involvement, particularly clinical stakeholders, is imperative for the success of these projects.
A streamlined flow of data through the data warehouse enables the company to forecast its business and operations with an unprecedented level of accuracy. Data integrity and consistency achieved through DW provide organizations with a competitive advantage by enabling them to make improved, informed and calculated decisions. Why is health data different from data in other industries and what makes health data unique? There is a lot of literature on this interesting topic. High context dependency, data proliferation, diversity and complexity, rapidly changing regulatory requirements and definitions are some factors that contribute to this uniqueness.
CIO Middle East: IoMT (Internet of Medical Things) and 5G are technologies that are penetrating the world of healthcare. Which trends do you think will change the healthcare system as we know it today?
Ultimately, these connected devices enable seamless care flow management and improved care performance, both in remote and in-facility care. Nowadays we see several types of IoMT devices, such as on-body devices and in hospital devices. A key issue with these IoMT devices is security concerns, and it is interesting to note that many security vendors are now also specifically focusing on this issue.
Regarding 5G, I think it is still too early to comment or evaluate the aspects of 5G. But it is the future of healthcare across borders. The possibilities are enormous and will definitely be in the areas of remote surgery, telemedicine, real-time monitoring, large medical file transfers, etc. Let’s keep the right expectation; We are still in the early stages of 5G and currently only 5G niches are visible. In a few years we can see the real 5G spectrum.
CIO Middle East: How does the IT department work with doctors? AI in healthcare – is a culture change necessary in the industry?
I always like to say; There are no IT projects (except IT infrastructure projects), only business projects. EMR and other digital solutions used in care are by no means IT projects, they should be clinical projects. We always say the CMO (Chief Medical Officer) is the owner of EMR projects and it works well. Execution is not the measure of success in any project, success is measured by how we use it and make the most of it.
Early involvement of clinicians is imperative for project success as they are the ones who will use it. The solutions must not surprise you, they must be involved in all phases of the project. We can see that the role of CMIOs is getting a lot of attention these days. Clinicians are the key players in EMR and other clinical solutions, we need to listen to them – not only for pain points but also for ideas. Trust me, many innovative ideas and acquisition options that we have received come from our doctors.
AI is becoming more popular every day and healthcare is one of the areas where AI has achieved wonderful results. The AI in radiology is now very mature and stabilized. I would really like to use the word “collective intelligence” instead of AI. Machines have many abilities that humans do not have. Likewise, there are still many things where we need human closeness and intelligence. When we combine these two, it makes the difference, and ultimately we get collective intelligence and better results. Nobody can say no to AI and technological advances. As we commonly say, AI will replace the people who don’t use AI with those who use AI to produce collective or combined intelligence.
CIO Middle East: How do you see the changes in technology and economy after the pandemic?
To answer the question of how we have managed the pandemic situation – the answer is by being agile. Repeated little things. Small things make a big difference. The first thing COVID taught was how to be agile. Until then it was a term mostly used in the software industry, now “agility” is part of every aspect of a business.
I remember that a few years ago, when we were dealing with the optimized care of LTC patients (Long Term Health), the topic of teleconsultation came up, but at the time it was not accepted at all. It was pushed to the bottom of the list. But now even patients are asking about it. I should say the patients were asking for it more than the hospital’s willingness to start it.
Going back to April-May this year, that was the time when we all completely shifted our priorities and focused on the so-called 100m dash. We weren’t ready for the teleconsultation at the time. But that was something that was needed “now” then. The primary question was how we will ensure continuity of supply. We quickly rolled out a platform – here comes the agile mode. We didn’t stop there, we’ve also expanded teleconsultation to include Lab at Home and Medicine at Home.
CIO Middle East: The United Arab Emirates Ministry of Health (MoHAP) established the country’s Unified Medical Record System to help public and private entities collaborate on patient records and clinical details. What are the main benefits you see in this initiative? How do you manage the flow of data?
These health authority initiatives show how seriously the nation takes the health sector. Kudos to the visionary leaders of these initiatives.
Riayati, the national platform for unified medical records, is MOHAP’s most innovative and digital transformation program, aiming to transform the healthcare landscape across the country. Aster is always an early adopter of the initiatives.
If we talk about Riayati; Malaffi and Nabidh will come into the picture by default. Malaffi, the HIE initiative from Abu Dhabi, and Nabidh from the DHA (Dubai Health Authority) have already proven the power of HIE (Health Information Exchange). As mentioned, we are already part of these two initiatives: our facilities in Abu Dhabi are already on Malaffi and our hospitals in Dubai are part of Nabidh. As we speak, we are in the process of onboarding Riayati.
We have seen the benefits of HIE in many places around the world. Patient-centric care is a goal we all strive for and is not possible without data we can trust. These HIEs are the triple catalysts for a patient-centric approach.