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Global Health Informatics: Cloud Technologies

The medical services sector is gradually, but fairly quickly adapting cloud computing technology to its scope. This is because modern world medicine, adhering to the main goal - patient orientation - formulates a key requirement for improving the quality of medical services and improving clinical results (and therefore, for improving the quality of life of a particular person and its extension): quick access to patient information regardless of the location of him and the medic. Today, only cloud technologies have tangible potential to meet this requirement.

For example, cope with the topical coronavirus 2019-nCoVhelps the speed of information provided by China on cases of disease and research results, which is not least made possible by modern information technologies, including cloud. 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) of SARS caused by SARS, China took about eight months in 2002 ! This time, official information was received by the World Health Organization instantly - after seven days. “We are pleased to note China’s serious attitude to this outbreak ... including the provision of data and the results of genetic sequencing of the virus,” saidWHO Director-General Tedros Adhan Gebreyesus at a meeting with Chinese President Xi Jinping. Let's see what potential the “clouds” have in medicine and why.


Medical Data Issues


▍Volumes


The large amounts of data that medicine has always worked with are now turning into huge ones. This includes not only medical history, but also the totality of generalized clinical and research data in various fields of medicine, and new medical knowledge that expands exponentially: the time of doubling was about 50 years ago in 1950; it accelerated to 7 years in 1980; 3.5 years was in 2010 and 2020 is projected to double within 73 days (according to a 2011 study by the Clinical and Climatological Association of America ). 

Here are just some of the reasons for global data growth:

  • The development of science and, as a consequence, an increase in volumes and simplification of the ways of publishing new scientific materials.
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Previously, clinicians resorted to the use of several sources of information - from standard search engines where the content may be unreliable, to print magazines and books in the medical library, which took time to search and read. As for the medical histories and results of analyzes of patients in public and private clinics and hospitals, we all know that so far every such medical institution has its own physical patient map, where doctors manually fill in the information and paste the test results. Paper archives have not been translated. And that part of the patient information that is recorded digitally is stored on local servers inside the medical facility. In this connection, access to this information is possible only locally (plus high implementation costs,support and maintenance of such a “boxed" system).

How cloud computing is changing healthcare for the better


The exchange of information between medical specialists regarding the patient is becoming more efficient. All data about the patient are entered in his electronic medical record., which is stored on a remote server in the cloud: medical history; the exact dates and nature of injuries, manifestations of diseases and vaccinations (and not the confusion according to the patient’s words that appears over the years, which is extremely important for diagnosis, treatment forecasts, and prediction of disease risks for posterity) various images (radiological, CT, MRI, photographs, etc.); test results; cardiograms; drug information; videos of surgical interventions and any other clinical and administrative information. Access to this personal, protected data is obtained by authorized doctors in various clinics. This allows you to optimize the workflow of the clinician, to make more accurate and faster diagnoses, to plan more correct and, importantly, timely treatment.


Electronic Medical

Record Instant information exchange between various healthcare organizations becomes possible. This is the interaction of research laboratories, and pharmaceutical companies with various medical institutions (availability of drugs), and hospitals with clinics. 

The point (personalized) preventive medicine appears. In particular, with the help of artificial intelligence technologies, which cannot be used in most medical institutions due to the resource intensiveness of their computing requirements, but in the cloud, it is possible . 

Automation of the healing process reduces the time spent on it. Electronic medical records and sick leave, an electronic queue and remote access to analysis results, an electronic social insurance system and a medical archive, electronic dentistry and a laboratory - all this saves medical workers from paper and other routines so that they can devote maximum work time directly to the patient’s problem. 

There is an opportunity to greatly save on infrastructure, up to a complete lack of investment in it. The infrastructure-as-a-service (IaaS) and software-as-a-service (SaaS) models offered by cloud service providers can replace expensive software purchases and huge investments in a healthcare facility’s infrastructure by renting these models and accessing them via the Internet. Plus, only those server resources are paid that the organization actually uses, and if necessary, can increase the capacity or volume of storage. The use of cloud technologies in conjunction with the technical support of the 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 goes to a new level. Fault tolerance, data recovery, confidentiality became 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 fixing errors of incompetent employees in this IT field) or are completely impossible, and when renting cloud facilities are included in the package of services from the provider (where security issues are dealt with by professionals to guarantee a certain, relatively high level of security ti). 

It is becoming possible to receive quality medical advice without leaving your home: telemedicine. Remote consultations based on the patient’s electronic data stored in the cloud are already appearing. With the introduction of cloud computing in healthcare, teleconsultations are 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; it is expected that by 2021 its value will be estimated at more than $ 41 billion. Many factors contributed to market growth, including an increase in the cost of traditional medical services, telemedicine funding, and an increase in the number of digital healthcare 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 canceled the “live” doctor: for example, applications like the British cloud serviceAn AI-based Ada (about which below) is able to ask the patient about his complaints, analyze the results of the tests and give recommendations (including which specialist, when and with what questions should be visited). 


The volume of the global telemedicine market from 2015 to 2021 (in $ billion)

Urgent joint medical solutions are becoming a reality. A major breakthrough in surgical surgery was real-time video conferencing using mobile applications. It is difficult to overestimate the possibility of a consultation of strong doctors in an emergency during surgery, located in different parts of the world. As it is difficult to imagine an uninterrupted consultation without the resources of cloud technologies. 

Analytics is getting more accurate. The ability to combine electronic maps and archives with patient data with cloud-based analytical systems can increase the number and quality of ongoing research. This is especially urgent in various biomedical industries, 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 diagnostic approaches are emerging. Developing artificial intelligence technologies are able to diagnose diseases by collecting and systematizing not only disparate data on the patient’s medical history, but also comparing this information with huge amounts of scientific work and drawing conclusions in a very short time. So, the systemIBM Watson Health analyzed patient data and about 20 million scientific papers from various sources of oncology and made an accurate diagnosis to the patient in 10 minutes, suggesting possible treatment options, ranked by level of reliability and confirmed by clinical data. You can read about the system here , here and here . Google's DeepMind Health works similarly . Here, 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, accordingly, untimely treatment or its absence. And this- AI, imaging images for pulmonologists. This also includes patient monitoring: for example, the American system based on the AI Sense.ly monitors the condition of patients (or chronic patients) recovering after complex treatment, collects information, which then passes it to the attending physician, gives some recommendations, reminds you of taking medications and the need perform the desired procedure. The use of AI in this level of diagnosis and monitoring of diseases has become possible based on the power of cloud computing.


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Internet of things is developing, smart medical gadgets are emerging. 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 technology. 

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One of the first US healthcare facility clinical data platforms was a healthcare facility platform designed to extract and display patient information from many sources, including scanned documents (cardiograms, CT scans, etc.) and various medical imaging procedures, laboratory tests, and reports on operations, as well as patient demographics and contact information. It was a Microsoft development called the Microsoft Amalga Unified Intelligence System. The platform was originally developed as Azyxxi by doctors and researchers in the emergency department of the Washington Hospital Center in 1996. As of February 2013, Microsoft Amalga was part of a series of health-related products that were jointly ventured withGE Healthcare called Caradigm. In early 2016, Microsoft sold its stake in Caradigm GE.

Amalga was used to link together many unrelated medical systems using a wide range of data types to provide an immediate, updated composite portrait of a patient’s medical history. All Amalga components were integrated using software that allows you to create standard approaches and tools for interacting with many software and hardware systems installed in hospitals. A doctor using Amalga could within a few seconds receive past and present data on the condition of hospitals, lists of drugs and allergies, laboratory tests and a review of the relevant X-ray, CT scans and other images organized in one custom format to highlight the most important information for this patient.


Microsoft Amalga Unified Intelligence System

Today, Caradigm USA LLC is engaged in public health analytics: it offers public health management, including data monitoring, coordination and management of patient care, wellness and patient attraction services around the world. The company uses the Inspirata Clinical Data Platform, which is the next generation of the Caradigm Intelligence Platform (formerly known as the Microsoft Amalga Health Information System). The clinical data platform complements existing data assets, including clinical archives 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 are appearing on the Russian market. Some are platforms that take on all the administrative functions of private clinics, others automate the work in medical laboratories, and others provide electronic information interaction between medical institutions and government agencies and insurance companies. Here are some examples. 

Medesk is a clinic automation platform: online appointment with doctors, automation of the doctor’s registry and workplace, electronic cards, remote diagnostics, management reporting, cash and finance, warehouse accounting.

CMD Express - Center for Molecular Diagnostics, allowing patients in two clicks to check the readiness of the tests and get the results of laboratory tests at any time of the day and from anywhere in the world.

Electronic medicine - a company that develops software for medical organizations, pharmacies, TFOMS, SMO: Economic and statistical accounting of clinics, hospitals, the integration of radiological and laboratory systems with federal services, electronic registration, drug accounting, laboratory, electronic medical records ( http: // electronic medicine.rf / solutions ).

Smart Medicine- Automation system for commercial healthcare 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 recording various parameters and maintaining schedules.

Cloud technology is a company specializing in the development and installation of integrated information systems for healthcare facilities. They offer an IBIS technology platform for accelerated development of medical applications. 

Clinic online - A private clinic management program based on cloud technologies: online registry, IP-telephony, customer base, material accounting, financial control, admission diaries, treatment planning, employee monitoring.

Conclusion


Digital healthcare uses the latest information and communications technology to develop and support faster, more effective and cost-effective medical practices. This technological transformation of healthcare has become a global trend. The main tasks here are: improving the availability, comfort and quality of medical care for people around the world; timely, accurate diagnosis; deep medical analytics; deliverance of doctors from routine. It is now possible to solve these problems with the help of high technologies only by using the allocation of serious computing power and technical support from IT specialists, which have become available to organizations of any scale and field of medicine only thanks to cloud services .

We will be glad if the article turned out to be useful. If you have a positive experience using digital healthcare, share it in the comments. Share negative experiences, too, because it’s worth talking about what needs to be improved in this area.

Source: https://habr.com/ru/post/undefined/

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