Medication delivery via drone? Sounds great. That's why the German Ministry of Transport is working on a drone strategy to make such futuristic transport methods possible. The fact that prescriptions still need to be carried to the pharmacy on foot by a person carrying a piece of paper does not appear contradictory to the politicians. Just as little as the fact that almost the entire hospital landscape can only be reached by a – to continue our metaphor – mail wagon.
Digitization in Hospitals
"Let’s first succeed switching from the mail wagon to the car before sending unmanned flying objects into the sky", appeals Dominik Pförringer, medical specialist for orthopedics & trauma and consultant at the University Hospital of the Technical University of Munich. That is why, Dominik Pförringer brought the visitors to this year's ETIM summit (Emerging Technologies in Medicine, February 22-23, 2019, Essen University Hospital) back down to earth with his lecture entitled "Digitization of hospitals – drones or data cables? Where does the deficit pinch?" "To make progress with digitization, we must first be realistic about assessing where we're standing. Then we can think about where our greatest problems lie".
Wireless Networking Before Drones
Looked at realistically, German hospitals are far from working digitally nationwide. Whether you are thinking about medical rounds, patient records, or image data, paper is still the most important tool for care staff and doctors in most hospitals – and not just at small hospitals, but also at university hospitals. According to Dominik Pförringer, this is partly due to inadequate wireless networking that makes it impossible, for example, to implement clever software solutions for a digital round on a tablet PC at the patient's bedside. And of course, digitization is also about money. The consultant estimates that each German university hospital would need an additional digital budget of around €100 million for the next five years to get on track digitally. In fact, only around €10 million is at their disposal. "Of course, this does not get us where we want to go digitally", Dominik Pförringer summed up the dilemma.
Deciding on the Appropriate Digitization Steps to Take
But how can hospitals still put digital horsepower on the road? First of all, hospitals need to analyze their processes in order to understand them. Only then they will be able to decide which processes to digitize, because not every kind of digitization makes sense. And if you digitize a bad process, you will end up with a bad digital process. This is what the expert advised his audience: "Look at areas of your hospital where savings from digitization are possible, where lightening your staff's workload will really save time or where the benefit for the patient is greatest. In short, find out how the €380 billion spent on healthcare can be better allocated for the good of the patient". In this context it could be useful to survey potential users. Comparable to a medical history interview by a doctor, we can use the survey results to clearly define, address and eventually soothe the greatest 'pains' endured by doctors and care staff.
Good Island Solutions are Better Than No Solution at All
The grand plan of moving towards a digitally, fully networked medical landscape is difficult to achieve this way. As a result, isolated solutions for certain sub-processes are implemented at best. Dominik Pförringer: "Of course, we all dream of a complete electronic solution that crosses over sectoral boundaries, but there isn't one YET. There’s no need to talk about the electronic health insurance card and there are also huge gaps when it comes to electronic patient records. And as long as that is the case, we are far better off with island solutions than with our previous analog working methods. We need realistic solutions that work and not theoretical ideals that don't happen". However, the orthopaedist also emphasized that the standardization, harmonization, and networking of medical data will be unavoidable in the long term in order to ensure high-quality care in the future.
Inadequate Communication as an Obstacle
From his day-to-day experience as a doctor, Dominik Pförringer knows where the “shoe” pinches the most at hospitals. And that is namely with the overwhelming flood of documentation and the non-standardized flow of information. The two go together: Not only that information first needs to be documented on paper and later transferred to a computer, this process is repeated time and again because medical information is not transmitted digitally and every treatment station requests this data again. "This media discontinuity and the resulting incoherent communication are the greatest stress factors – for staff and patients alike. And sometimes it is enough to use small solutions to produce small improvements and create more satisfaction. To identify these in the entire process, all the participants need to learn to talk to one another: administration with medics, medics with IT, and IT with procurement. This fully analog process is a prerequisite for ever meaningfully making medication drones fly", summarized Dominik Pförringer. He is looking forward to the tasks and the expected progress for the good of patients and physicians.
"Let’s first succeed switching from the mail wagon to the car before sending unmanned flying objects into the sky"
Medical specialist for orthopedics & trauma and consultant at the University Hospital of the Technical University of Munich