Shrutin Ulman

For pregnant women in cities, a closely monitored pregnancy is often a given. Their regular visits to the doctor and prescribed ultrasounds make sure they get to see the child at various intervals during the gestation period. Any anomalies seen from such scans also get immediately addressed with the right interventions from healthcare specialists.

Unfortunately, this is not the case for pregnant women in rural India. In most of the cases, women do not get to see their child until birth. As per reports, many women do not get to see their child alive at all. Findings from HMIS, a web-based monitoring system, working under the aegis of Ministry of Health & Family Welfare (MoHFW), indicate that 70 per cent of districts (448 out of 640 districts) in India have reported Maternal Mortality Rate (MMR) above 70 deaths – a target set under Sustainable Development Goal. India in fact, accounts for 15 per cent of world maternal deaths, second only to Nigeria (19 per cent).

Philips partnered with Narayana Health, a hospital chain in India, to pilot, MOM (mobile obstetrics monitoring), a cloud-based software solution that is aimed at strengthening mother and newborn care delivery across the first 1,000 days of their life. The solution facilitates awareness, ensures collaboration across systems while maintaining care standardisation. The pilot covered 5,170 pregnant mothers and involved Mobile Obstetrics Monitoring solution (MOM) and Philips HD5 ultrasound machines. Each participant received at least one scan during their pregnancy. The ObGyn team at Narayana conducted remote review of the cases, retrieving data in real-time. The results were staggering with a 48 percent reduction in the number of anaemic cases from second to third trimester; 3x improvement in early detection of high-risk pregnancies; 2.5x increase in early referrals of high-risk cases to a higher centre of care. Preliminary estimates indicate that MOM solutions could improve 11Mn lives per annum. The easy-to-adopt digital MOM solution can transform the functioning of maternity wards across primary health facilities, especially in underserved communities.

MOM is an illustration of the vast potential of cloud technologies in transforming healthcare. At a predicted CAGR of 17.8 per cent, the worldwide healthcare cloud computing market is expected to grow from USD 39.4 billion in 2022 to USD 89.4 billion in 2027. COVID-19 saw a trigger in the adoption of Electronic Health Records, e-prescribing, telehealth, mHealth, as well as other healthcare IT solutions. Added to this is the uptake of big data analytics, wearable technology, and the Internet of Things. Further, the emergence of new payment models, and a stringent focus on cost-efficiency accelerated growth of the healthcare cloud computing market. However, obstacles including data security worries and complicated rules governing cloud data centres are anticipated to limit growth.

Empowering health systems with innovation 

Remote consultations via phone calls or video conferencing are here to stay because of their flexibility and speed. Medical services are more widely accessible across even the remotest of locations, reducing crowds in hospitals. It is not just the experience of patients that has become better, even the treatments have improved. This is so because doctors now have access to the full medical history of the patient on the cloud, which makes diagnosis and prevention highly effective and fast. This facilitates accuracy and transparency on the doctor’s part and helps the patient with increased control over their health.

Insights captured from raw data using machine learning capabilities, deployed at scale can help improve clinical outcomes and operational efficiency. The dependency on local hardware to store sensitive data is a thing of the past as automated software keeps the systems updated. All of this can be tracked in real time and shared among cross functional teams while collaborating on a single platform. Working in the cloud rather than investing in your own data centre infrastructure or local hardware significantly reduces IT costs. At the same time, another competitive advantage of the cloud is the speed of innovation that can be leveraged in building prototypes or new product features without having to do rapid experimentation or develop new algorithms.

Signing in with SaaS and Pay-AsYou-Go model

According to an article by Accenture, healthcare providers are embracing ‘Software as a Service’ (SaaS) model more after the pandemic challenged them to adapt and innovate like never before. Sixty-six percent of them expect to move their technology infrastructures to the cloud this year – a number that is set to rise to 96 per cent by 2024. Through SaaS, healthcare systems are beginning to unlock clinical and operational insights at scale while moving up innovation cycles for continuous value delivery. The pandemic created a new urgency for healthcare providers to expand their virtual care offerings and the way of connecting with patients beyond the walls of the hospital.

At the same time, they wanted the flexibility to scale up or down without large upfront capital expenditures. Effective crisis management also requires the rapid exchange of patient information across systems and care settings. Thanks to the flexibility of pay-asyou-go cloud-based services and solutions, healthcare providers were able to quickly scale up digital health technologies to meet new demands. In 2021, the software-asa-service segment was the largest segment of the healthcare cloud computing market.

Cloud adoption is becoming increasingly important in broadening the role of IT operations, ensuring data security, and improving the overall patient experience. Though adoption of the cloud in the industry is gradual and still underrated, many forward-thinking healthcare organisations are beginning to embrace the cloud. Channelling cloud computing power into the healthcare system can surely make substantial progress in quality and affordable healthcare for all, rather than a few privileged ones. After all, healthcare delivered as Software as a Service (SaaS) is both about technology transformation, and organisational transformation.

The model Philips adopts to support hospitals for cloud adoption

Philips is convinced that most hospitals and healthcare systems will move towards cloud adoption in improving efficiency, especially more so after the impact of the Covid-19 pandemic. Philips has been a leader in studying this landscape and has been pro-active in meeting with healthcare leaders globally and has published its findings in the Future Health Index report 2021.

Digital transformation can be a challenging task, and this can be very daunting for hospitals to organise their entire offering from the cloud. There can be challenges of data privacy, security, and re- organisation of services for a smooth transition, while at the same time optimising patient outcomes, reducing staff burnout, enhancing patient experience, and reducing cost of care.

Philips has a structured process which can help hospitals change and transform themselves. This process has been perfected after a series of pilots with clinical partners and helping hospitals offer better services to patients and pregnant women.

The structured process that Philips adopts is one of co-creation with clinical partners, training and transfer.

Philips Mobile obstetrics monitoring (MOM) is a cloud-based solution that is intended to digitise hospitals’ antenatal, intrapartum, and postnatal care pathways to help track and risk-stratify pregnant women. Philips helps hospitals and healthcare providers in adopting the MOM solution using the following steps:

Co-creation: Philips’ experts collaborate with clinicians in hospitals to map out the pregnancy journey to implement and manage the change with minimal obstruction in the daily work of the hospital staff. This could involve:

Charting new and optimised workflows to make sure that the waiting times at each antenatal visit are minimal and the doctors and other ancillary services have adequate time to make a correct diagnosis and optimise the care management based on the risk profile.

Making sure data collected during physical examination by the obstetrician/clinician, including the clinical laboratory, ultrasound examination and medicines administered are uploaded onto the solution.

Cloud economics reducing the on-premises infrastructure costs while moving to the cloud-based operations.

Early risk identification and management reducing the cost of care.

Risk Stratification: The risk profile of pregnant women is estimated using a scoring mechanism in MOM which is reviewed by healthcare providers who can re-assign the risk based on their own assessment.

Personalised treatment plans: The cloud-based solution provides the much-required mental comfort for women throughout their pregnancy. Women can enter their symptoms into the application and be alerted of any unfavourable indications that can then nudge them to contact the doctor. The doctors’ app enables them to scroll through the risk profiles of pregnant women and plan home visits or even plan the frequency of antenatal hospital visits based on their risk profiles.

Optimising pregnancy journey: In India, many women travel to their maternal house for delivery. The cloud-based service allows them to visit the obstetrician at the new location where they can be examined and managed in a seamless manner.

Re-imbursement: One of the vexing problems within hospitals is that insurance agencies have a long turn-around time between offering the service and reimbursement. Cloud adoption helps to reduce this turn-around time, by providing claims validation and services offered.

All the above steps are implemented while deploying the MOM solution, supporting the hospital all along the digital transformation trajectory.

Views expressed by Shrutin Ulman, Clinical Affairs & Research at Philips Innovation Campus

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