The hospital of the future? «A city of health that combines one healthy lifestyle and innovative technology used in the key of preventive medicine », replies the professor Arnon Afek , associate general manager of Sheba General Hospital in Tel Aviv. Professor Afek agreed to answer questions from Corriere Salute, on the sidelines of the sixth edition of MedInIsrael, the main Israeli event on medical devices and digital health which takes place on 20 and 21 April. At the international congress and exhibition, organized by the foreign trade department of Israeli Ministry of Economy Israel’s leading industry companies, members of the medical health community and experts from around the world participate. Digital future of healthcare, global opportunities in the healthcare sector, home hospital and telemedicine, private sector investments, exploitation of artificial intelligence are some of the main topics covered.
Technology will improve the cure time
Prof. Afek, do you think there is an “ideal” hospital, a place where efficiency, sustainability and full respect for the patient can coexist?
“Absolutely yes. First, there is no alternative to the human contact “Compassionate” in medicine. The healing property of this particular attribute it will never be replaced by technology and should be kept in healthcare in the future. The technology will greatly improve patient safety and treatment accuracy, organizational efficiency and the goal of reducing costs. Implementing technological innovation will enable healthcare professionals, doctors and nurses to have more time to practice quality medicine with particular attention to clinical and communication skills “.
Hospitalization only for acute cases
In your opinion, what will be the main features of the hospital of the future?
«At Sheba Medical Center we imagine a city of health that combines one healthy lifestyle and innovative technology used for preventive medicine. Patient care will utilize telemedicine and smart wearable monitoring, enabling prediction of physical changes and medical emergencies. Care and hospitalization will be reserved for acute serious illnesses requiring intensive care or emergency surgery ‘.
“Conservative” health systems
In March 2012, the Royal College of Physicians – Britain’s largest medical institution – released a new report entitled “Future hospital: Caring for medical patients”. The hospital of the future is described as the hospital “without walls”, in which there is a rebalancing between the urgent activities – to be encouraged – and those planned; a hospital that operates throughout the week, not just for emergencies; a hospital where doctors work for part of their time on the territory. Agree?Ten years later, to what extent have these goals been achieved globally? And in Israel?
“Much progress has been made in the transformation of hospital acute care in recent years; however, health systems and doctors are “conservative” in the way of thinking and slow to change. We have deployed many resources to promote telehealth and raise awareness in the community and we are seeing an increase in the number of telemedicine visits and the use of remote monitoring, including glucose monitoring for diabetics, cardiac monitoring for heart patients, and physical examination using telemedicine platforms Tytocare for residents of long-term care facilities. Israel suffers from a chronic lack of resources in the intensive care hospitalization system and there is an urgent need to accelerate technological advances that shift resources towards more complicated cases ”.
Move care on the territory and at home
John Sharp, professor at Harvard and expert in doctor-patient relations, believes that in the future, hospitals will be reduced to emergency units and operating and post-surgical wards, while chronic diseases will be treated at home with the help of telemedicine. and wearable sensors. Is he right?
«Describes once and for all an ideal system in which hospitalization that it is in itself a risk factor for nosocomial infections, falls and delirium in the elderly it will be reserved only for acute serious diseases. The challenge of monitoring and caring for chronic patients at home it is both a logistical issue due to the shortage of doctors, specialists and nurses, and a technological challenge because some analyzes are only available in hospitals. It is expected that the trend to shift chronic care into the community will dramatically increase in the near future but the older population poses a special challenge to many of these trends ”.
Limited health needs and resources
Healthcare is constantly grappling with issues of sustainability of care. How can the need for health for all be combined with the ever-increasing costs of health?
“Israel should serve as an example for a highly efficient healthcare system. Our country spends only 7.4% of its GDP on healthcare, but we have an excellent healthcare system. This is done through low national health insurance that provides universal coverage to all citizens of Israel. Israeli health funds are efficient organizations competing with each other for customers by improving the quality of care and service and, as non-profit organizations, they maintain a efficient operation».
The results obtained
Let’s talk about technological innovation: what did you focus on at Sheba and what results did you achieve? What are the main results in terms of population health and cost savings?
«Sheba is the largest medical center in Israel and among the 10 best hospitals in the world thanks to one strong clinical academic component and one infrastructure that allow the growth of technological innovation. ARC is our innovation platform which allows collaboration in research and development between doctors and researchers of the Sheba, cutting-edge technology companies and top-level universities worldwide. We focus our research oninnovative assistance, i Pro (Patient reported outcome, which we can translate as the outcome measure of a cure or any service in the health sector reported directly by the patient, ed) and lo development of cutting-edge technologies that use artificial intelligence “.
Telemedicine and robotics
Can you give some examples of applications in the field of telemedicine? And what about robotics?
«Telemedicine: glucose monitoring Tytocare for residents of long-term care facilities. Robotics: operating room robot; Pharmacy; smart medical guards ».
The doctor of the future
What characteristics should the hospital doctor of the future have?
«Good communication skills, compassion and empathy (nothing has changed since the time of Hippocrates). Tech expert, able to use the available technological innovation. A good doctor should not take anything for granted and take everything “cum fiore salis”: this will guarantee one good quality of care, the identification of errors and innovation in all respects ».
How to overcome the digital divide
Epidemiology tells us that the world population is aging more and more and this part of the population absorbs the vast majority of health resources. How is it possible to guarantee the use of digital health care on the territory or at home, when perhaps these elderly people do not have the adequate knowledge tools to take advantage of it?
«By developing telemedicine tools adopted for use by older people as is the case in our rehabilitation hospital. Automatic “no touch” monitoring. Older people often feel isolated and lonely, this was the main challenge during the Covid-19 epidemic and ensure communication and physical contact they are a component of all therapy and monitoring plans ».
The value of life
At a time of constant progress in the biomedical field, biotechnology and new discoveries in genetic engineering, we must reflect on where life and, in particular, bioethics occupy. What value will life have in the future?What are the objectives to be achieved to ensure a high quality of care?
«I will answer with a quote Niels Bohr, the Danish physicist and Nobel laureate who said: ‘Making predictions is a very difficult thing, especially if they concern the future!’».
April 20, 2021 (change April 20, 2021 | 12:42)
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