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Is Healthcare Ready for the Influx of Remote Monitoring Patient Data?

Technology

Sep 14, 2022 - 4 minute read

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Scott Watson Digital Health and Care Strategic Adviser

He is an evangelist of person-centred design, innovation, and the transformational opportunities of personal data stores. Scott deeply specialises in information system design, development, integration, interoperability, and architecture. 

See all Scott's posts

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We’re living through a period of transition in health and care services. No longer is all clinical activity required to occur within the bounds of a hospital or doctor’s office. Technical advancement and increasing service demands are outsourcing the care effort to people’s homes and their local communities. Home use of medical devices for clinical observations and diagnostics has significant potential to ease the burden on health and care services.

Patient experience is vastly improved as they are continually monitored for clinical deviations without the need of periodic appointments or visits. With this new capability comes new data sharing challenges. The tendrils of digital plumbing needed to ensure practitioners have real-time access to insight are going to explode in the coming years.

How Can We Guarantee the New World of Remote and Virtual Care Works Properly?

It is not unfair to state that health systems already significantly struggle to get information appropriately shared across health economies. The increasing number of remote device data sources and service connectivity is likely to further confound the problem. The current health data sharing patterns won’t scale and the bottle-neck of digital plumbing will significantly delay the transformational health outcomes promised by the remote monitoring.

Insufficient data standards adoption is the usual scapegoat for why a doctor can’t see a blood test result. Although the importance of internationally agreed data standards and industry compliance cannot be overstated, these standards only ensure that data can be semantically exchanged. What standard or best practice can we adopt for a regional information sharing topology that scales for millions of remote devices?

The most common health data sharing pattern is a hub and spoke model. This was adopted to replace point-to-point connections and decouple dependency between systems and processes. The central point acts as data arbitration, redistribution, and transformation for when standards aren’t adopted or available. The issue with hub and spoke is it won’t scale to millions of end points.

In the absence of an ubiquitous public health data fabric and associated standards to connect with, device manufacturers do the only thing they can — build their own platforms or ecosystems. Each device implementation requires bespoke engineering to connect to the legacy clinical systems. This is costly and slow. There’s simply not enough time and money to do that in the current economic climate. As more device manufacturers enter the market, the already complex health system will just grind to a data sharing halt. Patients and their health and care practitioners will see the promise of possibility once again elude them due to lack of digital foresight.

Insider’s Perspective

In my role as Enterprise Architect for the Greater Manchester Health and Social Care Partnership, I had two significant opportunities to broaden my understanding and approach to data sharing at scale.

First was the 30,000 foot view of a health economy covering 2.8 million people with all the complexity and challenges revealed. In the morning, a meeting with maternity, in the afternoon, mental health services. The diversity of exposure across most health and care domains was both daunting and exhilarating. I like solving problems — it is what gets me out of bed in the morning.

Secondly, I was exposed to the potential of Web 3.0 and the semantic web as a pattern for health data sharing. It wasn’t so much of a lightbulb moment, but more of a spark that set off a cascade of new ideas on different ways to approach the data sharing conundrum.

Today’s Landscape for Information Sharing in Healthcare

Currently, a regional topology for information sharing is based upon connecting each organisation providing services. We try to connect organisations together, pumping data around the system, hoping it gets to the right place at the right time. As the patient traverses services, the likelihood that the practitioner has the insight required to inform critical decisions decreases. Patients experience this daily with doctors informing them they don’t have their results, or worse, they make a clinical decision in the absence of critical insight unbeknown to them.

Regional, shared records mitigate the issue to a degree, but only provide the data for viewing in ‘yet another system’ and fail to implement seamless interoperability between organisations. The patient record is a data jigsaw scattered across the health economy with no single accurate representation of the full picture.

Leveraging the Collected Data for the Benefit of the Patients

The primary subject of a health and care system is the patient or individual. Instead of recording their critical data within organisations or regional silos, why not create a record that follows the patient around the system irrespective of the service, region or even country? Give all the data jigsaw pieces to the patient or their carer, creating a personal data store.

Having spoken with many patient groups across different health and clinical conditions, some common themes often emerge - patients having to repeat their stories on every encounter, the lack of shared decision making between the patient, their carers and health care professionals and general lack of coordination across services leading to delays of care.

Irrespective of the practitioner or service the patient attends, the data is available in a single place. If the service isn’t interoperable with the personal data store, at least the patient or carer can hold a smart phone with a unique QR code for the doctor to access information previously unattainable.

Instead of trying to plug remote devices into the already failing environment, push the data insights as new jigsaw pieces into the personal data store. This approach reduces complexity and completely eliminates the need to pump patient data around the health and care system.

The approach is not without its challenges. Fundamentally changing our approach to data sharing is going to hurt. But we have to acknowledge we are stuck in a sunk cost fallacy and change is needed to avoid more long-term pain. Maybe it’s time to be brave and do something different?

2988 HC Digital Transformation 476X381
Scott Watson Digital Health and Care Strategic Adviser

He is an evangelist of person-centred design, innovation, and the transformational opportunities of personal data stores. Scott deeply specialises in information system design, development, integration, interoperability, and architecture. 

See all Scott's posts

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