ICT in Healthcare projects: Expertise without borders

International cooperation can support digital transformation in healthcare in many ways. However, healthcare is special when it comes to digital transformation.

A global industry in a locally regulated and locally managed service domain

While ICT is probably the most global industry on Earth, with global supply chains, global players and global standards, healthcare is still very „local” as a service – local processes, local protocols and local culture.

In many ways Healthcare applies global standards and best practices (people tend to have similar health challenges around the world). However, local regulatory and management practices can be very different, as well as protocols, administration or even financial background.

Global technology now has the power to penetrate local healthcare systems. Global IT providers co-operate with clinicians and academic experts, often using a collaborative approach with specialists to support this process. Therefore, technology and best practice is now available across various countries and industries.

The patient – acting as a customer, though more vulnerable

We should not forget about the consumer. The consumer is called „the patient” in this case.

Patients are more vulnerable than the average customer, as their situation is very special, and they are often not in a situation to properly assess their status, have options and make a fully informed decision. However, the patients now tend to have expectations, which come from customer experience in other service industries: personalisation, user experience, information at his/her fingertips, even gamification and empowerment. This is the journey that we are now embracing in healthcare.

Too busy to embrace innovation? Too busy to save time and resources?

Healthcare is SPECIAL. Any good healthcare specialist I know (in any country) is overloaded with work. AND they feel there are more innovations out there from innovators than they can possibly absorb – some examples might be new innovations in diagnostic imaging, robot-assisted surgery tools, using AI in patient data analysis and many more.

We exhibited this year at the Dementia and Nursing Care Show in Birmingham. I met several health specialists and experienced care managers. My overall experience was that many of them feel somewhat uncomfortable with technology. They feel they lack knowledge and experience, while learning these would require even more resources. However, technology is there to serve them – I remember when we implemented a solution for Fresenius Medical Care which saved more than 30 minutes on every single patient’s administration, not to mention increased patient safety as technology reduced the risk of human errors. It was about real impact for the patient and the staff.

Safety comes first

Healthcare is about patient safety. Not a single innovation can be implemented unless it is proved to be absolute safe. This may lead to slow decision making processes – in a very fast changing tech environment.

Technology also raises several NEW questions related to healthcare: shall we use robots to combat loneliness? Is it OK to give patients tools to self-manage their condition? Can we trust software to classify diagnostic images to support decision making of radiologists?

Startups and innovations in the spotlight

The good news is that current innovation trends encourage large tech companies and small innovators to contribute to our collective digital health future. This means more attention, acceptance and funding all around the world. Institutions and governments identified opportunities in digital transformation in healthcare: Germany has passed a law to acknowledge digital treatments: the E-Health Act was followed by the Digital Care Act. Prescription of digital tools such as health bands is now part of treatment options. This trend is also being seen in the UK.

Interoperability, cloud environments and 4G, 5G networks can support this process – enabling global solutions to be used in local healthcare. (Just a few examples: DICOM files can now travel a bit easier than before, services from the cloud give fast and seamless access to applications and data, while less physical travel is required to perform technical support tasks.)

We need this computing capacity to analyse the aggregated health data, by health imaging tools or IoT widgets or collected in patient records. The magic is in the relationships! Scientists can find new information and solutions just by connecting the dots and reveal relationships too complex for a human eye or the human brain.

Share your experience with us

I am more than interested in hearing some of your views.

Does anyone have direct experience with….

  • Digital transformation projects and challenges in Health?
  • Do you have any direct experience as a PATIENT who actually knew that it would have been possible to personalise their treatment if data is used more effectively?
  • Does anyone have experience with unused „data silos” or important data that is not used to provide better treatment? (Just think about smart wearables, as data is often NEVER shown to a doctor.)
  • Any IT specialists struggling with specific challenges of healthcare? (Regulatory/GDPR? Clinical testing? Specific patient groups with cognitive difficulties? Interoperability issues? Just to name a few we have already seen in NETIS.)
  • Anyone who thinks the solution does exist…but there is not enough time, money or knowledge to implement it? (It may be easier and cheaper than you think, and can bring very, very tangible results.)

These are all issues which are challenging, however, not impossible to solve.

International collaboration does matter – and can make a real difference

It might be the case that if you are a clinician, your International clinical peers can share with you successes in Australia/Germany/Estonia… If you are a health IT specialist, it may just happen that your perfect Machine Learning Expert sits only 2 hours’ travel and a phone call away. They may be currently working on a Horizon2020 project reflecting YOUR problem. Global talent pools can provide the best value for money –while YOUR expertise may be sought somewhere in Spain, US or Hungary – if you are connected to the right channels.

Thinking global (or at least at the European level) can also be useful when you have a short term project, if you need some rare skills or your budget is very limited. (If you face ALL these at the same time, you may be in trouble. Heading to Mars having only training shoes and a bicycle?)

Your startup can scale up with international talent, while you can outsource some non-core, repetitive but important tasks.

Let me illustrate this with our recent project for Medway Community Healthcare, which had a telecare solution for elderly households. They could maintain this with our team’s help and do necessary updates (including a complete redevelopment of a particular application) as all tasks could be safely done remotely, within a tight budget.

Forms of international collaboration: from outsourcing to team augmentation

Some of you may not be absolutely familiar with some forms of international collaborations but let’s quickly go through a few examples.

You OUTSOURCE if there is a particular task to be performed, especially in a market which is not your home market, when the activity is not your core activity but important. It can also be a cost saving exercise (some countries like Hungary may have excellent technical talent pools, and much lower cost of living, with a similar average living standards like in the UK) but again I’d say value for money is key. Outsourcing is focusing on deliverables, while the team is not managed directly, and communication between the entities can be formal and standardised.

Partnerships are perfect when the organisations have complimentary skills and services. You may need us if you are a mobile expert, but need a company with Microsoft expertise, and we may need you if you are a professional medical content provider.

If you have a startup, you could benefit from team augmentation – this gives more security than freelancers and more industry knowledge than agencies. It might be useful to know that in the case of team augmentation your extended team works ONLY on your project.

Avoid traps and mitigate risks

Be careful when you are offered a service which is Cheap, High Quality AND Fast – to avoid any disappointment. You may also find out that you and your partner use exactly the same term but you mean completely different things by it (you may test this by defining „server”). However, you can use standards and some main principles of Accessibility, Sustainability and Compatibility to mitigate such risks.

At the very end, where does NETIS fit in this puzzle? We have 10 years’ experience in healthcare ICT, product development and infrastructure support and integration.  We are committed to patient empowerment and patient education, data-driven healthcare as well as supporting the British economy and the United Kingdom. We trust our organisations can collaborate well together – and hope to meet our potential international partners in one-to-one meetings or smaller and larger events related to digital healthcare. Progress comes through trusted collaboration and we hope that our workshop in London was- the first step towards new relationships.

This is an edited version of my presentation delivered on 17 October, 2019, at the Hungarian Embassy in London, for a professional audience involved in digital healthcare. You may visit Prezi for the associated slides and images used in the presentation.

Author: Eva Lajko

Coming soon: Workshop in London

After fundamental changes in several sectors and industries, digital transformation now means rapid changes in healthcare.  Digital treatments, automated patient education, big data analysis or sensor-supported patient monitoring are all part of the change.

Except for a few cases, most of the changes seem to be technology-led, while it would be crucial to involve medical professionals, patients and health service provider organisations to fully benefit from what technology can offer.

We are tech companies, working closely with industry, health providers, researchers, doctors and other health specialists to develop solutions which provide real support and assistance both for patients and medical pros. We need an active discussion with users and specialists to have a real understanding about needs and elements where we can add value – from reducing time of patient education and prevention or offering fine-tuned, personalised diet suggestions for those with a serious chronic condition to reliable solutions to fight hospital superbugs or super-fast and super-reliable CT segmentation.

As an industry professional, you might already be aware what digital technologies can offer in healthcare and would be open for a discussion with tech professionals how blockchain, mobile technologies, image  and data analysis or digital patient assistance/digital treatments can improve the efficiency of medical diagnoses and treatment.

Come and join our workshop at the prestigious location of the Hungarian Embassy in central London on 17 October 2019 to discuss various aspects of digital health technologies to support UK and European healthcare and patient safety together.

Join the event

Due to seating and security limits, the event is invitation-only, however, if interested to attend, please contact us directly if an invitation can be issued.

How to use artificial intelligence to treat diabetes and dialysis patients

Millions of patients enter their doctors’ office every day around the world seeking information on how to better manage their diabetes. And while getting information on blood glucose trends can be helpful, patients are largely on their own the moment their appointment is over.

That’s where artificial intelligence (AI) enters the picture. Imagine getting real-time information on blood glucose levels without having to prick your finger. Imagine changing your diet because you can identify which foods are causing your blood to spike. Imagine having the ability to predict your blood sugar levels up to an hour in advance.

Continuous real-time information is the key to futuristic care for diabetes and dialysis patients, and it’s all thanks to artificial intelligence.

Diabetes meets AI

New technology, such as Abbott Freestyle Libre and Dexcom G6 (among various competitors), have slowly been making massive ripples in the way patients self-manage their diabetes. This new technology, known as Continuous Glucose Monitoring (CGM), is innovative because it’s FDA-approved and helps patients to make decisions on insulin dosage with the tap of a button.

CGM devices send wireless transmissions to your smartphone, delivering real-time information about glucose levels. This allows patients to continuously monitor their levels and take immediate action in the event of a severe spike. Medtronic, a competitor of Abbott Freestyle Libre and Dexcom G6, even offers technology that claims to predict low blood sugar 10 – 60 minutes before it happens.

“Predict” is the keyword here. By continuously monitoring blood sugar levels, Medtronic learns your highs and lows which enables it to predict when these moments may occur, alerting patients to take immediate action (such as taking an insulin shot).

Diabetes coaching in real time

Continuous monitoring is one way to manage diabetes; real-time coaching in the palm of your hand is another. Apps such as BlueStar diabetes acts as a diabetes coach that sits in your pocket. Patients can enter their blood glucose results (that they receive from their CGM) and immediately receive suggestions on what they should do next.

BlueStar solves a significant issue in diabetes care that doctors often fear the most – a patient’s ability to manage their own symptoms when they’re alone. This technology gives patients advice the moment they need it, allowing them to record what they eat, how it affects their blood sugar levels and removing much of the guesswork required by doctors.

Connecting the dots

The hope is that technology will begin to play a much more significant role in diabetes care which in turn can help patients to find a correlation between their behaviors (such as the foods they eat) and how it’s affecting their health.

Artificial intelligence has the potential to revolutionize the way we manage diabetes. Not only are patients given information in real-time, but they’re also given guidance on what they should do to manage their symptoms.

Freestyle Libre, Dexcom G6, Medtronic and BlueStar are all positive signs that artificial intelligence has the potential to transform diabetes care. As the technology improves and becomes more popular patients will be given more power over their ability to self-manage their condition, improving their quality of life and eliminating the need for guesswork the next time they visit their doctor.

Author: Laszlo Varga

Are you a startup or a specialist? Get the most out of remote IT pros

Are you in the group who can benefit from a remote IT/software department?

As promised, let’s have a closer look at those groups who can get maximum benefit from outsourced IT services of a small specialist team. Is your organization in one of these groups?

Industry specialists under the radar of big IT companies

Your core business is something different – you use IT (probably a lot) but do not want to invest into developing and maintaining it but want to focus on your key activities. You might even feel somewhat uncomfortable when it comes to technical issues – but could value impartial advice without tech jargon or “specialists” without knowing much about your industry.

You need a specialist IT partner if your business needs exceed the opportunities offered by standard, off-the-shelf software and technology products – or you have already burnt your fingers (and wasted some of your cash) on it.

Are you a service company having its core business in healthcare, Digital Health, Elderly/Chronic Care or modern forms of education? Do you manage lots of data, from numbers to videos? Need to convert a legacy function into a cloud application with data migration? Talk to us to see how much help we can provide.

Startups and innovators

Your team has a brilliant idea. You also have a clear picture about the users and their pains, needs and expectations. But currently you have no more resources than 3-4 enthusiastic people and some initial funding to reach your MVP (Minimum Viable Product). You know exactly (or more or less exactly) how it is going to work – but need a group of experienced tech people to make it a reality – including rigorous technical testing or an attractive front-end design.

Are you a startup from the digital health/medtech scene and need a web or mobile application to support your idea and deliver a brand new service to customers? Talk to us to see if fast development can help you to achieve your goals.

(Secret tip: we also know this and that about various grant schemes in Europe, including Horizon2020 or SME Instrument, and a few region-specific schemes. We are not afraid of documenting our work or support you in writing a good proposal. We are not grant application specialists, but know enough to overcome initial difficulties.)

Software developers in regions where IT talent is scarce and expensive

£660 a day, right? Or even over £800+VAT. But if you are not lucky, you do not get them even at this price – they work somewhere else and say “no” to you. You may not be able to afford them, while your project may not able to afford replacing seniors with juniors or inexperienced team members. You also may not be able to risk the challenges arising from cultural or regulatory issues – you need people who had been there and done that before, know those standards and understand the goals without drowning into endless meetings and e-mail threads to explain what, when, and how (and driving your own senior staff crazy).

You may also lack resources to recruit, relocate (maybe entire families) and meet additional cost of attracting the right talent – especially for a single, fixed time project. However, that project is important – and can boost your business if you can afford initial cost of experienced and skilled team members.

Are you a software company delivering solutions for the healthcare or social care sector? Do you develop sophisticated data warehouses for companies in the healthcare, transform or manufacturing sector? Is process management important for you and you have regulatory requirements to observe? Do you have an opportunity which could improve your business significantly if, say, you had 2 more senior .NET programmers or people with real experience in blockchain technologies or VR? Talk to us.

Do you have “issues” with testing, implementation and Quality Assurance during your software project? Can you see the point where automatic testing is worth the effort – which is going to be my next blog post on 4 July.

Author: Eva Lajko

An important IT project and short of resources? Pros and cons of freelancers, agencies and outsourcing

Digital transformation has reached almost every industry sector. Industry 4.0 (such as IT-assisted manufacturing and robotics), digital health, eGOV public services, smart buildings and smart environments, IT-assisted transport and logistics (from driverless underground trains to self-driving cars, automated warehouses and new generation of drones), virtual reality, new forms of gaming and entertainment, to name a few – all these use IT technologies of some kind. You need qualified engineers, specialists and developers to implement these IT technologies to get the maximum benefit from them. Finding the right ones starts becoming an issue – especially if your IT challenge needs a custom solution rather than an off-the-shelf IT product.

This new digital world forces companies and their CEOs to look at newly emerging IT needs even if they do not have a particular IT background. “Outsourcing IT” or “outsourcing development tasks” gained a new meaning in this environment.

Companies actively looking for developers may experience that recruitment, onboarding and related actions may be more time-consuming and risky than expected. Immediate or short-term project opportunities may be missed completely, while planning for longer term can also be difficult.

So, you have a very, very exciting development project or a pressing need to have a new application/module/portal etc. – but you do not have the resources/expertise internally to do it, or your resources become available only a few months later. What can you do? 

Employing
freelancers

Benefits

Upwork and similar sites provide unlimited source of global talent, where any reasonable opportunity may attract hundreds of applications. Some of them are definitely excellent at very, very attractive prices. Employing (good and affordable) freelancers is an awesome option to complete tasks which can be considered as low-risk (such as logo design, preparatory steps for a future development, content translation for an app and many more). You may also look for a freelancer when you need a specialist for a single task –having access to global talent can ensure you find a really experienced guy, maybe the most suitable (check references!) for your project.  

Risks

You may find a gem, but nobody guarantees this person is available for long-term or next time. They may retire, be busy in another project, be sick or may be taking exclusive, full-time employment in the near future. You may also find difficult to manage the performance of a person maybe sitting 2000 miles away from you, including personal problems – OK, if there is no delivery, there is no payment – but the work is not being done either which may ruin your entire project.

And once this person is gone from your radar, you may end up with a product (without documentation?) which is not future-proof. (Yes, there are companies doing well on redeveloping legacy software or doing reverse engineering – but this may be a complicated and costly exercise for the user, especially if the software is crucial for everyday operations).

Co-operate with large software houses in distant regions and countries

They might be, again, brilliant AND cheap. The good ones are utterly professional: always having capacity, tech and language skills, well-designed customer support. Their administration and project management supports smooth workflow and clear communication. You even might have a dedicated account manager and all the goodies a large company may provide – at, depending on location, very attractive rates. Standardized project may work extremely well as well as some repetitive business – this remote team may be the extended part of your organization.

Risks

First of all, your enquiry may be refused – especially if your project sounds unique and special or just SMALL for them. You may also be required to define very, very exactly what you want – and you may only trust real Agile methods if you want to change after the initial agreement on scope. Actual tech people may change during the project due to fluctuation or resource management. Even your Account Manager may change – everything should be very well-documented otherwise you may have to get back to Square 1 in the last phase of development. Cultural differences in communication do matter – the bigger the gap is between your working cultures the higher the likelihood of misunderstandings and misinterpretations is, which may turn your project into a nightmare.

Use temp agencies to “recruit interim staff members

This may work in some industries where fluctuation is high, work is standardized. Having qualified staff can be the most important aspect in the business – which is often mission-critical such as healthcare or transport. However, IT processes and tasks can be difficult to standardize. It may worth a try to get a temporary team member for a particular project – as paying higher fees may still be cheaper than struggling with endless recruitment. Your “temporary” colleague may be happy to work for you as a permanent member of your staff if both of you are satisfied.

Risks

Your interim may come from a different work culture – which can be good or not so good. It is almost sure that rates will be higher than your normal staff – consider this when you plan your budget. Non-standard requirements can be a challenge how the “temp” colleague fits in your team – prepare with detailed and clear job descriptions. Unless you are ready to consider traditional employment if you are happy with the interim, do not expect much loyalty or proactivity either.

Work with a small outsourced team near you

They might have specialist skills and qualifications you want without competing with you in your market. If you want those particular skills only for a particular project, fine – but you may also have them in a long-term partnership as your remote “software/IT department” if it fits your core business and you need more sophisticated IT than off-the-shelf applications with some consultancy. You may find small but professional companies with loyal team members (our programmers spend at least 5 years with us) – you do not have to worry about they keep changing all the time. They are legal entities, accountable for guaranteed SLA, delivery to agreed deadlines etc., without dealing with anyone’s personal problems which may be the case with sole freelancers or interim staff members.

Risks

Most risks can be hidden in details you may consider “minor” in the beginning. “Flexibility” cannot mean “unstructured”. Software development, yes, might be a kind of art, but methodical approach and attention to detail always pays off.  Having a brilliant tech team with terrible admin support might also be alarming – micromanaging ancillary tasks can be expensive and irritating for you as a customer (and I guarantee you no longer will feel like a customer, rather as an overloaded PM), no matter how brilliant the actual code is. It is also a benefit if your “remote team” has at least one member being familiar with the regulatory standards and other, non-technical requirements and standard practices of your environment to have a compliant product at the end of the day. Be also a bit suspicious if you receive a “yes” to virtually anything you suggest or ask – as it is said in my country, it does not make you a good musician if you cannot tell music notes from “fly leftovers” and play whatever you see on the sheet music in front of you.

Tips

Check references first – as part of “due diligence” which may also be done by a consultant working for you. Be cautious, if you are the only customer at the time or if the developers are immediately available – the good ones are usually busy, while professional companies prefer to plan ahead. There are, as usual, some exceptions: you may be lucky to send an enquiry when an important project is just about to finish, you may come from a priority market/industry which can put you into the VIP seat. You might be the so-deadly-important first reference to get a tremendous price (just keep in mind price is only one element you need to evaluate). 

If your potential outsource partner is based not far away, invest in a personal visit. It can tell a lot about their work style and working environment, while you also have the opportunity to chat with the team before hiring them. (If you visit us, you will see a neat, modern and organized environment with technology supporting remote working such as videoconferencing tools, very fast and reliable Internet connection and super secure server/cloud/communication environment).

Teams versus individuals – 2+3 may not be equivalent to 5…

Quality of teamwork is something what really matters but very, very hard to standardize or quantify. Leadership may not be linked to a formal management role, but more to technical expertise, coordination and communication skills. You may have a group of brilliant individuals but if they are not given enough time to formulate a team, it can ruin you project without knowing exactly what went wrong.

If you outsource, choose to “rent” a team, not a loose group of individuals. They already know each other, have worked together for years, have a mature communication and coordination style. This can boost your immediate efficiency, saving valuable weeks and resources in a period when it is most crucial. You know what you want – and a team having an architect, a developer, a tester and a Business Analyst will know howwithout the need to micromanage them, including in-depth technical discussions and guidance or endless clarifications on terminology and know-how. 

Not sure whether you are one of those who can get maximum benefit from nearshore development services from a small specialist team?  I am going to publish another post about this on next Thursday – you may find out that your organization is amongst them.

Author: Eva Lajko

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