INNOVATIVE SOLUTIONSTo boost efficiency in health care

How does it work

Companion diagnostic isa medical test used as acompanion to a therapeutic drugto determine its applicability to aspecific person. It helps predict likelyresponse and consists on avariety of tests: diagnostic testsof proteins, metabolites, essentialelements, tracers, and othercategories of invitro diagnostics.

DIAGNOSTICS FOR PERSONALISED MEDICINE

Best Case 1

Benefit for the patients

Identify patients likely to be at increased risk forserious side effects as a result of treatment with aparticular therapeutic product.Monitor response to treatment with a particulartherapeutic product for the purpose of adjustingtreatment to achieve improved safety oreffectiveness.Ultimately, empower patients by improving healthliteracy and by fostering patient involvement indecision-making processes.

Benefit for the system

Companion diagnostics can limit ineffectivemedication use, preventing unnecessary ambulatoryconsultations and hospitalization. It can also make personalised healthcare moreaffordable across the EU. With knowledge of apatient’s genetic structure, tailored treatment cutdown on the unnecessary use of resources. Bypromptly determining how the person’s body willreact to that drug or treatment, the hospital loses lessmoney and fewer resources to the trial and errorinvolved in this process.

Challenges

Example of application

Oncology is the most common disease areas forcompanion diagnostics, covering 95% of the market. In the United States, lung and blood cancers are themost important application areas, whereas in Europe,breast cancer dominates the market. The overexpression of the so-called HER2 protein (amember of the human epidermal growth factorreceptor) has been strongly associated with breastcancer. HER2 is used as a biomarker or an indicatorof breast cancer. Companion diagnostic leveragesthis relationship to design therapies for patients anddelivered personalized care.

Challenges for equal access to companiondiagnostics in Europe relate to:

The variation of approaches for assessment andreimbursement across and within Member States.The general lack of link between assessments anddecision making.The lack of established clear processes forreimbursement, funding and uptake of diagnosticinnovation.

How does it work

Robot-Assisted Surgery wasdeveloped to foster minimally-invasive surgical procedures andto enhance the capabilities ofsurgeons performing opensurgery. Instead of directlymoving the instruments, thesurgeon uses a direct telemanipulator or computer control. With the support of AI, surgeonscan determine what is happeningduring a complex surgery byproviding real-time data aboutthe movements the surgeonmakes during the procedure.

ARTIFICIAL INTELLIGENCE IN ROBOTIC SURGERY

Best Case 2

Benefit for the patients

AI brings accuracy, better planning and betterassessment of the risks.AI robotics outcomes include shorterhospitalization.21% reduction in length of stay.Reduced pain and discomfort.

Benefit for the system

This technology can reduce avoidable discomfort andcosts. AI applications, by gaining experience in thefield, will continually lead to improvements inprecision, efficiency and outcomes. The benefits areconsiderable also for healthcare professionals andtheir workflow. AI can help surgeons in their decision-making process while assessing about potential risks,and likelihood of major morbidity and mortality inaddition, AI technology brings in more patientbusiness for elective procedures and makes thehospital more competitive when compared to otherfacilities.

Challenges

Example of application

AI-assisted surgery robot to suture small bloodvessels, some no larger than 0.03 millimeters. Assisting neurosurgeons treating epilepsy: Robotsplace electrodes into the brain and need 2–3 mmholes in the cranium, reducing the regular operativetime by half.Augmented reality systems will be used to overlayimportant information required during surgery that istypically displayed on multiple monitors stackedaround the surgeon.Improve the venipuncture procedure with robot-assisted and predictive models. A system based on ahigh-resolution motion rapidly detects the vein entryby detecting blood.

Considerable initial investment in training, devicesand infrastructures.

How does it work

Home tele-dialysis is used topurify the blood of a personwhose kidneys are not workingnormally, in their own home.There are two main homedialysis procedures:Peritoneal dialysis: A catheter isimplanted into the abdomen, intowhich a dialysis solution isinfused and drained out for aslong as is necessary to removewaste and excess fluid.Haemodialysis: Using a dialyzerthe blood travels through aplastic tube where it is cleanedand then returned to the body.Only a small amount of blood isout of the body at any one time.

HOME TELE-DIALYSISBest Case 3

Benefit for the patients

More free time and greater flexibility withtreatment schedules.Saves time and money in hospital travels.Access to the treatment is increased in rural areas. Deeper understanding of health conditions andcontrol over treatments.More autonomy and greater independence.More stable blood chemistry and body hydration.

Benefit for the system

The reduction of the expenses on hospital dialysisequipment and human resources in charge of monitorthe treatment, as well as, avoid long-termhospitalization, have better collection and displayof data and visibility to any missed treatments forhealthcare team. And ultimatelly, improve the qualityof life for patients who will be able to contribute to theeconomy.

Challenges

Example of application

A Tele-dialysis systems can be upgraded throughoutvirtual monitoring apps and tools, to make patientsfeel connected to healthcare professionals remotelywhile on dialysis at home. Ultimately, tele-dialysis canimprove compliance with the dialysis regime. Various mechanisms have been designed andimplemented in this sense, including digital logbooksfeedback tools and virtual dialysis assistance toenable cost-efficient remote dialysis care.Moreover, new apps have been developed to improvehealth behaviour via digital platforms. These apps canprovide virtual coaching, messaging nurses duringdialysis, camera surveillance and reminders formedications among others.

Dialysis patients lack knowledge about treatmentoptions, Patients who are familiar with home dialysismay not have accurate information. Many dialysis facilities are not certified to offerhome dialysis.

How does it work

The continuous glucosemonitoring system (CGMS)measures the content of sugar inblood. By using a sensor underthe tissue the glucose level datais transmitted to medicationadministration devices and / ormobile apps. In addition, peoplecan see their glucose levelanytime along some specialfeatures :

An alarm can sound when theglucose level inappropriate.Data can be downloaded to asmart device to see theglucose trends.Information ca be sendautomatically to a secondperson’s smartphone.

DIABETES CARE AND CONTINUOUS GLUCOSE MONITORING

Best Case 4

Benefit for the patients

Reduce incidence of problems in which a person’sblood sugar either becomes extremely high or low. Increase the quality of life.Cut down emergency visits to the doctor. Help to make more informed decisions throughoutthe day. Psychological relief due to the predictability ofglucose levels.

Benefit for the system

CGMS ultimately results in a lower hospitalization rateper patient.Over time, good management of glucose greatlyhelps people with diabetes stay healthy and outsidehospitals, which results in cutting healthcare settings’costs.

Challenges

Example of application

A CGM can be one part of the “artificial pancreas”systems, now beginning to reach people withdiabetes. An artificial pancreas replaces manualblood glucose testing and the use of insulin shots. Asingle system monitors blood glucose levels aroundthe clock and provides insulin or both insulin and asecond hormone, glucagon, automatically. The system can also be monitored remotely, forexample by parents or medical staff and it tests theglucose level every 5 minutes (day and night) througha CGM, and automatically gives the right amount ofbasal insulin, a long-acting insulin, through a separateinsulin pump.

The high ongoing cost of continuous glucosemonitoring devices is seen as the greatest barrierto their widespread use.The overwelmed amount of data patients receive.

How does it work

When admitting patients, theback-office workflow often hasto go from desk to desk, whichmeans longer wait times andmore hassles for patients. It ispossible to achievesubstantial improvements inhospital admission workflow byusing secure messaging. Secure texting can be used tomonitor bed availability andaccelerate lab turnaround. Themost recent secure messagingapps allow forwarding a consultwith several doctors in case oneparticular doctor is not available.

AUTOMATING THE ADMISSIONPROCESS IN HOSPITALS

Best Case 5

Benefit for the patients

Time saving.Improve patient's experience.Enhance effective operational procedures. More effective patient care. Reduce the need for manual searching for data.More effective diagnosis and treatment Improved patient outcomes.

Benefit for the system

Secure messaging for the admission process willultimately reduce the delays and manual searches,save money and provide a higher return on theinvestment.

Challenges

Example of application

The secure group messaging feature can be used toplace orders and send automated notifications tosection managers and nurses who oversee thepatient’s medical care. Section managers, administrators and nurses can getclarification of orders through secure messaging ifnecessary and obtain quick responses from doctorsor their deputies if they’re not available. Doctors can also obtain laboratoryresults and radiology photos as soon as they areinputted in the EMR to speed up diagnoses.

Many hospital information systems do notsupport the implementation of automatedworkflow.

FOR MORE INFORMATION

CONTACT USinfo@healthfirsteurope.org +32 (0)2 626 1999 www.healthfirsteurope.eu