Future clinical care

Medical technology is offering up new solutions for hospital, community and home care, but at the same time it’s raising questions about how we will deliver that care.

We put together a two-part session at the 2019 MedTech CoRE day to hear views from a range of experts on the opportunities, challenges and barriers to medtech.

“The biggest challenge will be managing the data,” according to keynote speaker Terry Reece, Country Head of Clinical Solutions ANZ for Elsevier, a global information analytics company. “By 2020, medical knowledge will be doubling in just 73 days, with data the fastest growing segment.

“For example, we’ve got data covering 150 million lives in the US, wireless AI-boosted stethoscopes in Australia and a breast cancer algorithm in China. We’re going to need AI and machine learning to handle existing data, to perform deep analytics, to provide decision support to the clinicians so that we deliver improved outcomes.”

We then asked a panel of stakeholders how they thought we’d deliver clinical care in the future. Our first panellist was Claudia Wyss, CE, Healthvision NZ, a company that delivers in-home personalised healthcare. Claudia trained as a doctor and previously redesigned healthcare systems in the US. She was joined by Sasha Kljakovic, Co-founder, Well Revolution who describes herself as “Mum, practising doctor and all-around nerd”; Jon Herries Group Manager Emerging Health Technologies, Ministry of Health who is leading the discussions at the Ministry around technology and health innovation and Gunnar Grah, Executive Manager Life Sciences and Healthcare, Badem-Württemberg International, BIKEM who provided a view of clinical challenges in Germany.

They all agreed medtech will play a key role in delivering care in the future, but this won’t be without challenges.

“It’ll be community-based with distributed patients and staff with more consumer self-management. We’ll shift increasingly complex hospital care such as dialysis or traumatic brain injury into the community to reduce cost. We'll be supported by technology including data, devices and systems,” says Claudia.

Sasha echoed the technology theme and talked about relationships being the focus. “It’s me and the health system working around you in your community”.

Gunnar is a behavioural biologist who studied ants. “And that is no use at all,” he said to great laughter. More seriously, he talked about the German experience which is similar to New Zealand’s. “Technology will take over certain work, but GPs are reluctant to do so. The problem is, we have a huge cohort of ageing doctors who are reluctant to use digital technology and not enough doctors coming through to replace them. Those GPs left, and this includes the older ones, will be forced into using this technology.”

Sasha also mentioned our ageing workforce, saying we need to focus on what the customer needs. “Right now. There’s a lot that can be done. Right now.”

Jon says there’s a difference between care and caring, saying, “We will still care for people, but robots will do the work.”

To deliver change, we need to change the needs of patients, providers, clinicians, regulators and funders, and then the money will come, according to Claudia. But she still sees barriers. “Clinicians are fatigued by change, by volatility. Everything new has to be done on top of the day job. We need to find solutions that make clinicians’ lives easier.”

Gunnar believes we need to include the big players, the associations, while Sasha reinforced the need for access to money and basic information to deliver a coordinated response.

“The main barriers are funding and collaboration. The CoRE is working to build the intellectual side, but we don’t know where to go for the money. There’s no clearing house, no quick info. That’s where the CoRE could help, such as identifying investors in the US,” says Claudia.

Sasha believes “We need to showcase our technology, bring people to New Zealand, show them that we’re a pipsqueak, but we’re good.”

MC Professor Merryn Tawhai then posed the question “How, as medtech, can we show clinicians we’re not replacing but improving their jobs?”

“They’re scared, they’re midlife, they have lots of debt, but they don’t realise just how quickly this will happen,” says Sasha.

Gunnar sees changes in the pecking order. “For example, a country GP is not seen as good as a radiologist, but AI will change that order.”

Claudia says we need a new approach if we want clinicians, nurses, caregivers or patients to participate in medtech product and service development. “We ask for their time and the company benefits from their participation. In other words, the company makes money, not the clinician.” She cited companies like Kinsey that pay for participation, saying we may need to do the same. Technology will drive huge changes in clinical care, from the way we train doctors, involve clinicians in trials to and gain support from current practitioners, to ensure that medtech does deliver on accessibility for all New Zealanders.

Read more about Claudia and Healthvision

Jon Herries, Group Manager, Emerging Health Technologies, Ministry of Health
Read more about the Ministry’s eHealth programme

Gunnar Grah, Executive Manager Life Sciences and Healthcare, Badem-Württemberg International, BIKEM
Read about our relationship with BIKEM

Sasha Kljakovic, Co-founder, Well Revolution. Describes herself as “Mum, practising doctor and all-around nerd”.
Find out more about Sasha and Well Revolution

By Prue Scott

The panel left to right: Gunnar Grah, Claudia Wyss, Jon Herries and Sasha Kljakovic