Tomasz Judycki, deputy chairman of Atende Medica, gave an overview of the technologies that would be revolutionising healthcare in coming years. He mentioned the Internet of Things, telemonitoring via wearable devices, speech recognition for doctors, and the digital pen which, taking 50 photos a second, can enter handwritten data into computers. Mr Judycki passed the digital pen around the participants so they could try it for themselves. He also talked about more controversial technologies, such as expert systems, which doctors fear will supplant their own knowledge.
IT systems also offer solutions for hospital management. In the same way as monitoring devices can create smart homes, so sensors in hospital refrigerators and generators can save time on manual checking. Patients too can be monitored – blood pressure, temperature and pulse – and the data stored. And finally hospitals' administration can be fully integrated, he said.
Dr Andrzej Osuch, director of business transformation at Luxmed, Poland's largest private healthcare provider, talked about the implementation of an IT system that linked Luxmed's 180 hospitals, clinics and surgeries and 1,600 cooperating healthcare professionals. He put this 13-month project into the context of falling numbers of doctors (down to 78,000 from 100,000 over the past 20 years) and rising co-morbidity in patients (with 12% having six or more chronic conditions – and these patients being responsible for nearly half of all healthcare costs).
He said that data processing and patient engagement will become increasingly important, with patients demanding greater online access to their records. Data needs to be stored for five to 30 years (average length 20 years). Luxmed's aim was to totally do away with paper originals, and to ensure privacy through cryptography. The system is currently dealing with 2.1 million documents a month, a has peaked at 32 documents a second, dealing with 2,700 sessions at the same time.
Dr Osuch talked about e-prescriptions, e-referrals and telemedicine. The e-sick-note, however belongs to the realm of social security. He also outlined changes to the law as it affects telemedicine, as set out in the third reading of the current draft, now on its way to the Senate before becoming law. He mentioned an absurdity that had been picked up – a doctor providing remote medical services – sitting at a computer and looking at ECG results or ultrasound scans – no longer needs to be located in a room with washable white tiles on the wall.
Smarter implementation of IT solutions will offer greater coordination and interoperability, personalised medicine and remote diagnosis. By allowing doctors to focus on their patients, rather than on administration, they'll be able to achieve more in the same working hours. By 2020, the EU will face a shortage of one million healthcare professionals, and around 220,000 fewer doctors than required. Intelligent use of cutting-edge IT may be the answer, said Dr Osuch.
The biggest barriers to the implementation of these solutions are regulatory rather than technical in nature. Dr Ewa Butkiewicz and Sylwia Paszek from Wardyński & Partners law firm focused on the legal question marks hanging over the development of telemedicine in Poland. The biggest one relates to data protection issues. In Poland, written consent for the storage and processing of personal data is needed – simply clicking 'OK' is not enough. Providers of healthcare services need to be registered with Poland's data protection registrar, GIODO. When wearable devices such as smart watches begin to monitor patients' health parameters such as pulse or blood pressure, additional safeguards are needed.
The presentations were followed by a lively discussion into the matters raised. Expert systems, so feared by doctors, are not intended to replace doctors, only to stand in for them when they are physically not present. Mr Judycki mentioned a case of a hospital Warsaw where two patients died from strokes over the weekend because there was no specialist on hand to diagnose their symptoms. An expert system would have detected the risk.
Streamlining the 'patient journey' is crucial. Saving time where possible – two minutes per patient on a nurse's round, for example – will bring huge benefits to efficiency.
There was a general agreement that the Polish healthcare system needs to adapt to technology. The deficit of knowledge was underlined, as was the need to training and communication.