Technically, digitalization has already made many things possible in everyday clinical practice, says Dr. Christian Elsner in an interview. But the Chief Commercial Officer of Mainz University Hospital is convinced that another factor is crucial for success – people.
Dr Elsner, in which areas has digitalization already found its way into everyday clinical practice?
Dr. Christian Elsner: The range of applications is very broad. It ranges from little helpers, such as online appointment scheduling, to complex applications supported by artificial intelligence (AI). For example, we use AI for quality assurance in pathology images. This means that the AI provides the pathologist with information if it detects abnormalities when scanning the images. Overall, digitalization helps us to optimize our processes in a very practical way. One example that I am personally very excited about: we are currently testing the nursing history via app. Patients enter all the important data before their hospital stay begins. This means we know when they are coming, how long they are likely to stay and can already coordinate with potential rehabilitation facilities. Importantly, the data is stored FHIR-based, i.e. it is stored in an atomized form and not as a single document. This means they are absolutely secure and can also be easily processed as individual values. In any case, data protection and interoperability are very important in everything we do.
What other opportunities does the digitalization of healthcare open up?
Elsner: Today, we still have very cumbersome process chains and non-integrated data in many places. By securely storing and subsequently merging data with the help of platforms, healthcare processes can be dovetailed with foresight. And we can make them more efficient, patient-friendly and data-secure. In future, digitalization will mean that a lot of patient data will already be available when someone comes to the doctor. As a result, we will be able to provide more preventive and precise treatment. One example: there is currently a new patent that enables fitness trackers to calculate blood pressure from the pulse curve. As a doctor, I can of course diagnose and treat patients much more accurately on the basis of their blood pressure over the past two months than I can with the 24-hour measurements that are commonly used today. There is still a long way to go before this complete integration of data, but it is worth it. Reduced to one sentence, you could say: long fuse, big bang.
So are smartwatches, apps and similar products a gimmick or part of the medical future?
Elsner: I believe that mobile health is best used when it becomes part of our everyday lives. In other words, when we are not even consciously aware that we are being measured. In the USA, there is the term shy technology, which I think sums it up quite well. Technically, it is no longer a problem for manufacturers of smartwatches to incorporate the wearer’s data into health records. The prerequisite is, of course, that the data is only stored and used in the way I want it to be. Covid-19 and the associated changes to our everyday lives have a certain significance here: people are now familiar with webcams, video conferencing and other digital tools that they need for their daily work. They are developing a sense of what is necessary and what is not.
What is the biggest challenge in using digital health technologies?
Elsner: The biggest challenge is precisely to convince people – patients and doctors alike – to use these processes creatively. On the one hand, it’s about taking away their fears – not everyone is a digital native. And on the other hand, it is important to make it clear to them that any additional work in the meantime will pay off in the end: at the moment, for example, the fully digitized intensive care unit often still stands in contrast to fully analog documentation in other areas – this means double the work for those who have to find their way around both.
How do you intend to tackle these challenges in concrete terms?
Elsner: I think there are two things that work together here. Firstly, the necessary digital technology must be accessible to a wider audience – this will not be possible without private and public investment in future technologies. A lot has already happened here in recent years, if you look at the Hospital Future Act that came into force last year, for example, with which the federal and state governments want to promote digitalization in hospitals. The coronavirus pandemic has of course also focused attention on the equipment and condition of hospitals. And secondly, IT processes need to be adapted so that people can understand and use them. We have developed a special training series for our staff on campus and organize annual hackathons to solve specific problems. And on the patient side, the pandemic is acting as a catalyst for digital formats: Video consultations – previously the complete exception – are now a matter of course.