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Reimaging the Future of Hospitals, Cities and Communities in the Digital Age

A report from the ESC Digital Summit 2019
5 and 6 October 2019, Tallinn, Estonia

Chairperson: Wajid Hussain.

Speakers: Juuso Blomster, Martin Cowie.

Roundtable experts: Jeroen Bax, Daniel Ferreira, Ari Fischer, Donna Fitzsimons, Alexandra Goncalves, Magnus Jensen, Katrin Leadley, Paul McGreavy, Marco Tubaro, Panos Vardas, Axel Verstrael.



Cardiac diseases are the number one health burden in Europe, with some 49 million patients. These cause 3.9 million deaths and consume €210 billion of health expenditure every year. Resources are focused on complications of heart attacks, heart failure, and stroke, with little emphasis on prevention.

A paradigm shift is needed to avoid cardiovascular disease and the associated complications, mortality, and costs. Digital technology could save millions of lives through early detection using smartphones, wearables, and other devices. Electronic health records are becoming more comprehensive and should enable data transfer between providers and across borders. In future, genomic data combined with artificial intelligence might help predict risk and prevent disease.

One way to maximise use of information would be for patients and the public to have an international health account (like a bank account) or health passport. Holders would control their data and could grant access to health providers during treatment or to researchers for trial recruitment.

 

Discussion points

What will hospitals look like in future?

  • Hospitals should become smaller operation centres solely for critical care. Other healthcare can be delivered in outpatient settings.
  • The hospitals of the future are already being built as a collaborative effort between industry, healthcare providers, and patients. Centres are being tailored to the demographics and needs of each location.
  • Hospitals need streamlined and structured workflow so they can look at data and act on it.
  • Digital health is essential to the sustainability of hospitals. Hospitals need to consider the overall life cycle of disease, not just specific events, when evaluating the cost-effectiveness of existing versus novel interventions. This links with prevention efforts.
  • Digital technologies are being used to improve safety in hospitals. For example, the design of operating theatres and avoiding cross-contamination from electrical cables.
  • Hospitals in most advanced economies will achieve paperless level 6 or 7 in 20 years.

How should cities and communities be designed?

  • Cities of the future should be more than just where people live. They should encourage healthy choices, with parks and cycle lanes, and stairs more obvious in buildings.
  •  How do we help the city planners and others use technology for this goal?

How should use of data be maximised?

  • Data needs to be managed as well as monitored.
  • There is a danger of becoming swamped with data from different sources. Interpretation and prioritisation of that data becomes the challenge. Which elements lead to changes in behaviour and practice, ultimately improving outcomes?
  • A new niche for health professionals could be to help patients and the public interpret their data to understand risk factors, how to improve lifestyle, and stay healthy for longer.
  • There is limitless potential for data obtained from sensors. Could they be used in public places to detect the warning signs of sudden death?
  • A holistic view of the patient experience is needed which takes qualitative data into account.

What is the role of patients in the digital future?

  • Patients should carry their own data as a health passport, smartcard, or even implanted under the skin. It would enable people to become citizens of the world, not one hospital.
  • Clinicians, industry, and patients should agree what information to include on this health smartcard.
  • Can we learn from other industries – for example banking – on how to make data on a health smartcard readable worldwide?
  • When reimagining hospitals for the digital age, patients are one of most important stakeholder groups to consult.
  • Cardiac patients and their families should be involved in redesigning cardiac rehabilitation and support after acute events.
  • Digital tools can improve the long-term relationship between patients and clinicians. Patients will not feel abandoned after discharge. Clinicians can monitor and coach the patient to avoid complications and hospitalisation.
  • Patients of the future will be more educated about their condition. Digitals tools will empower them to self-manage and understand what is happening in their body.
  • Patients could compile a personalised care manual on their smartphone. Could this be translated into a QR code for scanning by friends, family, and colleagues so they know what to do in an emergency?

Conclusion

The best way to predict your future is to make it. Reimagining the future of hospitals, cities and communities in the digital age requires interaction between patients, citizens, clinicians, industry and others – where do we want to go and how can we get there? The ESC Digital Summit 2020 will move the conversation on to pathways of care that can make this vision a reality.

The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.