The medical services sector is gradually but rather quickly adapting cloud computing technologies to its field. This happens because modern world medicine, adhering to the main goal - focusing on the patient - formulates a key requirement for improving the quality of medical services and improving clinical results (and, therefore, to improve the quality of life of a particular person and its extension): quick access to patient information regardless of the location of him and the physician. Today, only cloud technologies have tangible potential to meet this requirement.
For example, coping with the topical coronavirus The speed of information provided by China on cases of diseases and the results of studies, which has not least become possible thanks to modern information technologies, including cloud ones, helps. Compare: to confirm the epidemic (and therefore, to obtain and analyze data on the state of people's health, to study the virus for some time) caused by the SARS coronavirus to China in 2002 about eight months! This time, official information was received by the World Health Organization immediately - after seven days. “We are pleased to note that China is taking this outbreak seriously… including providing data and genetic sequencing results for the virus.” WHO Director General Tedros Adhanom Ghebreyesus at a meeting with Chinese President Xi Jinping. Let's see what potential "clouds" have in medicine and why.
Medical Data Issues
▍Volumes
The large volumes of data that medicine has always worked with are now simply becoming huge. This includes not only case histories, but also a collection of generalized clinical and research data in various fields of medicine, and new medical knowledge that is expanding exponentially: its doubling time was about 50 years ago in 1950; it accelerated to 7 years in 1980; 3,5 years was in 2010 and is projected to double in 2020 days in 73 (according to ).
Here are just some of the reasons for the global data growth:
- The development of science and, as a result, an increase in the volume and simplification of the methods for publishing new scientific materials.
- Patient mobility and new mobile data collection methods (mobile devices for diagnostics and monitoring as new sources of statistical data).
- An increase in life expectancy and, as a result, an increase in the number of "aging patients".
- An increase in the number of young patients who are attracted by the modern world promotion of a healthy lifestyle and preventive medicine (before, young people went to doctors only when they really got sick).
▍Availability
In the past, clinicians have resorted to multiple sources of information, from standard search engines where content can be unreliable, to printed journals and medical library books that take time to find and read. As for the case histories and test results of patients in public and private clinics and hospitals, we all know that until now, each such medical institution has its own physical card of the patient, where doctors manually enter information and paste sheets with research results. Paper archives have not been translated either. And that part of the information about the patient, which is entered in digital form, is stored on local servers within the medical enterprise. In this connection, access to this information is possible only locally (plus the high costs of implementing, supporting and maintaining such a “boxed” system).
How cloud computing is changing healthcare for the better
The exchange of information between medical professionals regarding the patient becomes more efficient. All information about the patient is entered into his , which is stored on a remote server in the cloud: medical history; the exact dates and nature of injuries, disease manifestations and vaccinations (and not the confusion from the patient's words that appears over the years - which is extremely important for diagnosis, treatment prognosis, predicting the risks of diseases for descendants); various images (radiological, CT, MRI, photographs, etc.); test results; cardiograms; information about medicines; video recordings of surgical interventions and any other clinical and administrative information. Access to this personal, protected data is obtained by authorized doctors in different clinics. This allows you to optimize the clinician's workflow, make more accurate and faster diagnoses, plan more correct and, importantly, timely treatment.
Electronic medical record
Instant exchange of information between different healthcare organizations becomes possible. This is the interaction of research laboratories, and pharmaceutical companies with various medical institutions (availability of drugs), and hospitals with polyclinics.
There is a point (personalized) preventive medicine. In particular, with the help of artificial intelligence technologies, which cannot be used in most medical institutions due to the resource intensity of their computing requirements, and in the cloud - .
Automation of the treatment process reduces the time spent on it. Electronic medical records and , electronic queue and remote receipt of test results, electronic social insurance system and medical archive, и - all this allows you to save medical workers from paper and other routines so that they can devote maximum working time directly to the patient's problem.
There is an opportunity to save a lot on infrastructure, up to the complete absence of investments in it. The infrastructure-as-a-service (IaaS) and software-as-a-service (SaaS) models offered by cloud service providers make it possible to replace expensive software purchases and huge investments in the infrastructure of a medical facility by renting these models and accessing them via the Internet. Plus, only those server resources that the organization actually uses are paid, and if necessary, it can increase the capacity or storage volumes. The use of cloud technologies, coupled with the technical support of a cloud service provider, allows medical enterprises to significantly save on IT staff costs, since there is no need to maintain their own data storage infrastructure.
Security is taken to a new level. Fault tolerance, data recovery, confidentiality have become possible thanks to various technologies (backup, end-to-end encryption, disaster recovery, etc.), which, with the traditional approach, require huge costs (including the cost of correcting errors by employees incompetent in this area of IT) or are completely impossible, and at are included in the package of services from the provider (where professionals deal with security issues, guaranteeing a certain, fairly high level of security).
It becomes possible to receive high-quality medical consultations without leaving home: telemedicine. Remote consultations based on electronic patient data stored in the cloud are already emerging. With the development of cloud computing in healthcare, teleconsultation is expected to become the future of the medical industry. The telemedicine market has grown significantly in recent years. As of 2015, the global telemedicine market was valued at $18 billion and is expected to be valued at more than $2021 billion by 41. A variety of factors have fueled the growth of the market, including the increase in the cost of traditional medical services, the funding of telemedicine, and the increase in the number of digital health users. Telemedicine is especially relevant for people with disabilities, plus it significantly reduces the burden on medical centers and clinics. At the same time, no one cancels a “live” doctor: for example, applications like the British cloud service , which works on the basis of AI (which is described below), is able to ask the patient about his complaints, analyze the results of the tests and make recommendations (including which specialist, when and with what questions it is worth visiting).
Volume of the global telemedicine market from 2015 to 2021 (in $ billion)
Urgent joint medical solutions become a reality. A big breakthrough in operative surgery has been real-time video conferencing using mobile applications. It is difficult to overestimate the possibility of a consultation of strong doctors in an emergency situation during an operation located in different parts of the world. It is just as difficult to imagine an uninterrupted consultation without the resources of cloud technologies.
Analytics become more accurate. The ability to combine electronic charts and archives with patient data with cloud analytical systems allows you to increase the number and improve the quality of studies. This is especially urgent in various medical and biological fields, in particular in the field of genetic research, which has always been difficult to carry out precisely because of the inability to collect a complete and accurate picture of the life history of the patient and his relatives.
New approaches to diagnostics are emerging. Emerging artificial intelligence technologies are able to diagnose diseases by collecting and systematizing not only disparate data from a patient's medical history, but also comparing this information with huge amounts of scientific work, drawing conclusions in a very short time. Yes, the system analyzed patient data and about 20 million scientific papers from various sources on oncology and made an accurate diagnosis for the patient in 10 minutes, offering possible treatment options, ranked by level of reliability and confirmed by clinical data. You can read about the system , и . Works similarly from google. read about how AI helps clinicians, in particular radiologists, who are faced with the problem of correctly reading x-ray images, leading to incorrect diagnoses and, consequently, delayed or absent treatment. A - AI rendering images for pulmonologists. This also includes patient monitoring: for example, the American system based on AI monitors the condition of patients recovering after complex treatment (or chronic patients), collects information, which is then transferred to the attending physician, gives some recommendations, reminds about taking medications and the need to perform the necessary procedure. The use of AI in this level of diagnosis and monitoring of diseases has become possible based on the power of cloud computing.
The Internet of Things is developing, smart medical gadgets are appearing. They are used not only by the users themselves (for themselves), but also by doctors, receiving information about the health status of their patients from mobile devices using cloud technologies.
Opportunities of medical online platforms
▍Foreign experience
One of the first U.S. medical enterprise clinical data platforms was a healthcare enterprise platform designed to extract and display patient information from many sources, including scanned documents (cardiograms, CT scans, etc.) and various medical imaging procedures, laboratory results, operations, as well as patient demographics and contact information. It was a development by Microsoft called Microsoft Amalga Unified Intelligence System. The platform was originally developed as Azyxxi by physicians and researchers at the Washington Hospital Center Emergency Department in 1996. As of February 2013, Microsoft Amalga was part of a range of health-related products that were put together in a joint venture with called Caradigm. In early 2016, Microsoft sold its stake in Caradigm to GE.
Amalga has been used to tie together many unrelated medical systems using a wide variety of data types to provide an immediate, up-to-date composite portrait of a patient's medical history. All components of Amalga have been integrated using software that allows you to create standard approaches and tools to interact with many software and hardware systems installed in hospitals. A physician using Amalga could, within seconds, have past and present hospital data, drug and allergy lists, lab tests, and an overview of relevant X-rays, CT scans, and other images organized in one customizable format to highlight the most important information. for this patient.
Microsoft Amalga Unified Intelligence System
Today, Caradigm USA LLC is a community health analytics company offering population health management, including data management, patient care coordination and management, wellness services, and patient engagement services worldwide. The company uses a clinical data platform , which is the next generation of Caradigm Intelligence Platform (formerly known as Microsoft Amalga Health Information System). The clinical data platform complements existing data assets, including clinical records and electronic health record systems. A complex environment for receiving and processing unstructured data and clinical documents, images and genomics data has been introduced into the system.
▍Russian experience
More and more cloud medical systems and online services appear on the Russian market. Some are platforms that take on all the administrative functions of private clinics, others automate work in medical laboratories, and others provide electronic information interaction of medical institutions with government agencies and insurance companies. Let's take a few examples.
– clinic automation platform: online appointment with doctors, automation of the registry and the doctor’s workplace, electronic cards, remote diagnostics, management reporting, cash and finance, inventory control.
- system , which allows patients to check the readiness of analyzes in two clicks and receive the results of laboratory tests at any time of the day and from anywhere in the world.
Electronic medicine is a company developing software for medical organizations, pharmacies, TFOMS, HMOs: Economic and statistical accounting of clinics, hospitals, integration of radiological and laboratory systems with federal services, electronic registry, drug accounting, laboratory, electronic medical records ().
— automation system for commercial medical facilities of any profile, with the exception of hospitals: general clinics; dental offices, for which there are specialized interfaces and separate workstations; emergency departments with fixing calls and registering various parameters and maintaining schedules.
is a company specializing in the development and installation of complex information systems for healthcare institutions. Offer technology platform to accelerate the development of medical applications.
— a cloud-based private clinic management program: online registration, IP telephony, client base, material accounting, financial control, appointment diaries, treatment planning, employee control.
Conclusion
Digital Health uses the latest information and communication technologies to develop and support faster, more efficient and cost-effective healthcare practices. This technological transformation of healthcare has become a worldwide trend. The main tasks here are: increasing the availability, comfort and quality of medical care for people around the world; timely, accurate diagnosis; deep medical analytics; getting rid of the routine of doctors. It is now possible to solve these problems with the help of high technologies only with the use of the allocation of serious computing power and technical support of IT specialists, which have become available to organizations of any scale and direction of medicine only thanks to .
We will be glad if the article was useful. If you have a positive experience using digital health, please share it in the comments. Share your negative experience too, because it is worth talking about what needs to be improved in this area.
Source: habr.com