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My chosen specialty, Radiology, is at the forefront of the Digital Age, with more than 70 per cent of our work taking place in the digital space. Much like other industries that have undergone disruption, we are the proverbial canary in the coalmine, the first to be impacted significantly. At the same time, we also have the potential of having the first-mover advantage if we capitalise on the opportunities.
Herein lies what we term the ‘incumbent’s dilemma’: the same processes, assets and rules that made our field great in the first place may be the very same roadblocks preventing us from moving forward in this digital world.
An ongoing process
The adoption of electronic medical records (EMR) has been a gradual, ongoing process for the past 10 years. EMR has been a great boon for healthcare systems, linking doctors to medical records across public healthcare institutions, so that care is continuous and seamless. Patients can transit from hospital to community and across the continuum of care.
The digitisation of medical records may have unintended consequences — doctors spend more time on digital record entry, which can detract from time spent communicating with patients, but artificial intelligence (AI)- assisted scribe systems that can accurately take down physician notes using voice commands may help alleviate this issue.
Furthermore, EMR generates a huge amount of data, mostly unstructured. The ongoing challenge is to implement EMR systems that are contextual, searchable and structured, so that this data can be harnessed for population-based research, leading to new insights and discovery.
What it means for you
The changes we implement will increase convenience for patients and caregivers. Some are already in use, such as telemedicine for general practitioner consults, booking of appointments on the smartphone, and accessing medical records online. These initiatives save time and enhance convenience for patients.
Big data is poised to be the epidemiologist and public healthcare doctor’s silver bullet, allowing them to predict where the next cluster of flu or dengue fever will happen so mitigating actions can be taken.
The next wave of changes will directly impact clinical medicine and hopefully improve clinical outcomes. Initiatives include early warning systems for discharged patients at risk of readmission, inpatients at risk of acute kidney injury or a potentially fatal condition like sepsis, where one’s body responds to an infection and damages its own tissues, and those at risk of falls. These systems will positively impact lives, saving thousands, if not millions, worldwide.
Eventually, digitisation and AI will transform healthcare and introduce new models of care, some of which are currently being developed.
In the realm of imaging, opportunistic screening for cardiovascular risk may occur with routine images taken for other purposes, and screening for cancer and neurodegenerative conditions in our bodies can be partially automated and become common practice.
Therefore, we can expect to be told, at a young age, which food to consume or avoid; and at an old age, which symptoms to be aware of and what personalised medications to take. In this utopian picture of the future, we should also be prepared to live much longer, healthier lives.
Medicine has always been and will continue to be a ‘high-touch’ profession. Digital automation will help ease doctors from the burden of mundane manual entry of clinical records, and allow us to become more like the doctors of yesteryear — at patients’ bedside, where we are needed most.
What this means for my area of practice, and everyone working in today’s ‘industrial revolution 4.0’, is that we need to be acutely aware that the assets, services and processes, which once made our profession a success, may not ensue. Symptoms of this ‘incumbent’s reflex’ is the reticence to go on the offensive or to disrupt our current model of practice.
As we take our first steady steps towards the future, it is important to reflect upon the medical traditions gifted by generations of our founding doctors, and carry their wisdom with us.
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