When chatting to industry insiders about healthcare innovation, several mention that many of the seemingly new and advanced technologies have actually been around for quite some time. This is particularly true in private healthcare. But when it comes to industrywide adoption, they all agree that getting new technologies into hospitals to better serve patients takes time. Of course, the pandemic accelerated the digitisation of healthcare, driving those who wouldn’t usually be dabbling in tech to reconsider how digital tools and solutions can revolutionise their business models.
According to Ruan Viljoen, CTO at the BroadReach Group, if you want to create a world where more people have access to good healthcare, you can either hire and/or train and deploy more people, or use more technology. This isn’t to say that technology will ever fully replace a doctor or nurse, but it can be used to augment and improve patient outcomes. One particular trend that Viljoen is excited about is personalised care. If practitioners can access more health data specific to a person, patients can be treated for their condition rather than receiving broadbased treatment.
He thinks this holds great promise to improve disease prevention and treatment and has the potential to transform how global healthcare systems are set up. “Typically, we have a very reactive mindset when it comes to healthcare. I’ve actually heard it being called ‘sick care’ because we wait for people to get sick and then we react. But with the right data and analytics, we can adopt a proactive mindset and prevent diseases so that we need fewer doctors because fewer people are getting sick,” he says.
Of robots and AI
Traditionally, a patient comes into a hospital with a concern and is seen by a doctor. Should they need some sort of imaging – say, an X-ray or ultrasound – they’ll be sent to the radiology department for a scan. Once the image is captured, it will join a queue of images for review by the radiologist/s on the staff. If there are already a number of scans in the queue and if there aren’t enough radiologists, the patient will have to wait a while before their results are sent back to the doctor, who then decides on an appropriate course of action.
“You feel like you’re inside the patient, which means that you can do a lot more intricate and delicate stuff.”Dr Farzana Cassim, Mediclinic Panorama Hospital
AI can be used to improve this process; the image is analysed immediately and made available on hospital systems for the doctor to review before a radiologist even gets a chance to look at it, says co-founder and CTO of Envisionit Deep AI, Andrei Migatchev. “AI can assess the image for typical signs of disease and for different conditions and identify and highlight various pathologies.” AI also helps with accuracy and urgency, he adds. “For example, if a patient moved when the X-ray was taken and the image is a bit blurry, you don’t want to only notice this after the patient has left. AI can pick up quality issues immediately and will alert the radiographer that another image needs to be taken.” Similarly, if a patient requires immediate attention, an AI solution will ensure that this image is prioritised and isn’t added to the back of the queue. “What this aims to do is augment and multiply available capabilities based on need. This is incredibly powerful when you consider that on the African continent, we have around 20 paediatric radiologists. This is for an entire continent of over half a billion kids. Some states in America and countries in Europe have that many in a single hospital.”
This isn’t the only emerging technology being used to boost doctors’ efficiency. Dr Farzana Cassim, a urogynaecologist at Mediclinic Panorama Hospital in Cape Town, is the first female surgeon in South Africa to be trained to perform robotic surgery. Robotic surgery was initially developed for use in warzones so that surgeons could safely operate on soldiers in the field, but they soon discovered that this wasn’t viable because of the extensive supporting infrastructure needed to be able to perform a successful surgery, she says. The medical fraternity realised that there was no use letting this fabulous machine, as she describes it, go to waste and made use of it elsewhere. Cassim says this technology is particular useful when performing laparoscopic surgery.
A laparoscopy is a surgical procedure that allows a surgeon to access the inside of the abdomen using only small incisions with the aid of a camera. Cassim says that with a traditional laparoscopy, the surgeon is able to see about four times magnification in 2D, but with robotic systems, you have magnification up to 10 times in 3D. “It’s completely immersive. You feel like you’re inside the patient, which means you can do a lot more intricate and delicate stuff,” she says. “This also enables greater precision. If, for example, you’re cutting out a cancer and you’re able to be more precise, you’re better equipped to remove everything, which increases survival outcomes.”
On the African continent, we have around 20 paediatric radiologists. This is for an entire continent of over half a billion kids.Andrei Migatchev, Envisionit Deep AI
Whereas a normal laparoscopy is performed using “straight sticks” – a long instrument with a tip that will either grasp or cut – robotic systems have “joints” so it feels like having your wrist or fingers inside the patient, which also increases precision, she says. These systems were designed with ergonomics in mind. “With a traditional laparoscopy, you’re often standing at odd angles, with your neck twisted because everyone’s trying to look at what is happening on the same one or two screens. But with a robotic system, the surgeon is seated and you’re resting your head and your arms. In theory, this means that a surgeon’s lifespan is a lot longer because their work is now a lot less strenuous.”
But, again, this isn’t to say that robotic surgeries will eventually replace regular surgery. “There will always be a place for the more traditional stuff. For starters, some surgeries just work better as open surgeries. To do these robotically would potentially add half an hour or even an hour to the surgery time, which is precious theatre time that we can’t afford to lose,” she says.
Given the potential, why is it taking so long for these innovations to find their way into clinics and hospitals around the country? Viljoen says funding is one of the greatest challenges. “If you look at machine learning and AI, for example, they require a big upfront investment with the promise of a return down the line. But if you use that same money to hire a doctor today, you provide immediate relief for an overburdened health system.”
He’s not exaggerating when he uses the term “overburdened”. “In Sub-Saharan Africa, the ratio of healthcare professionals to citizens stands at around 0.2 doctors per 1 000 people. So, when your consider where to put your investment dollars, am I going to hire another doctor who can see five more people or am I going to invest in a machine learning model, which may or may not bring relief five years down the line?”
* Article first published on brainstorm.itweb.co.za