The rise of smart hospitals

New tech hopes to address shortage of medical professionals

MANILA, Philippines — The shortage of medical and healthcare professionals is a growing concern in a number of countries in Asia including the Philippines.

In a report, the Philippine Statistics Authority (PSA) said medical professionals top the list of jobs covered by occupational shortage. Occupational shortage is defined as having insufficient number of applicants to fill a job vacancy. 

This phenomenon has been observed worldwide for more than a decade now, according to the World Health Organization (WHO). Countries have been responding to this shortage by loosening immigration policies for health professionals or dangling higher pay for their own doctors and nurses to remain in the country and service the healthcare demand of their population. 

But in nearby, Taiwan, which is still gripped by tight immigration rules for health professionals, hospitals are turning more to automation and telemedicine to service thousands of patients daily and reduce human error. 

A two-year-old hospital in Yuanlin City in Taiwan is now at the forefront of the smart hospital movement in Taiwan. 

Yuanlin Christian Hospital is a 400-bed general hospital put up as the 11th hospital of the Changhua Christian Medical Foundation Group – run by the Presbyterian Church – to become a showcase facility for its foray into smart hospitals. It is situated in the northern side of southern Changhua Country where access to emergency medical resources are scarce. It takes about three hours to get there from Taipei City. 

The hospital offers medical care in 29 specialties including internal medicine, surgery, OB/GYN, and pediatrics and is equipped with a 24-hour emergency room, delivery rooms, newborn nursery, neonatal intensive care unit, intensive care unit, operating theatres, and an air ambulance helipad. 

Investment of up to $4 billion NTD was needed to build the  facility which boasts of green architecture controlled by a smart system, a cloud-based IT system, smart diagnosis and tubing system, and long-distance consultation systems for critical cases.

The hospital can service between 2,500 and 3,000 outpatient procedures daily with only around 400 employees already including key healthcare professionals. 

“We have to use automation because we have fewer nurses and (medical) technicians. Also, the population is becoming old. So we need more healthcare manpower but we cannot provide that. So we need automation to help nurses reduce human error,” hospital superintendent Kwo-Whei Lee told visiting journalists during the Smart Cities Tour hosted recently by the Taiwan External Trade Development Council (TAITRA). 

“We are short of nurses, especially,” Lee said. “The (immigration) regulation is very strong and the nurse unions are against foreign immigration of nurses. So this is a worldwide problem that is seen also in Europe.” 

Hospitals in Taiwan have been for quite some time now experiencing a shortage of doctors and nurses primarily because of emigration to countries offering higher salaries for medical professionals such as China and strict immigration rules for foreign nurses seeking work in Taiwan. 

Physicians working in big cities where there is technology and money are also reluctant to transfer to rural areas. 

“We have partners but they want to work in the big cities, they do not want to work in rural areas, in small islands. So we need telemedicine,”  Lee said. 

With these concerns in mind and more, the medical foundation has Yuanlin Hospital designed to minimize human intervention for menial and repetitive tasks such as the verification of national health insurance details, checking of vital signs, ordering hospital procedures and even transporting of medical waste and contaminated surgical equipment. 

These are all meant to reduce the need for more manpower, reduce human error, as well as the risk of infection from handling medical waste. 

To request a primary check up at the hospital, patients only have to insert their National Health Insurance ID Card at the self-service kiosk that automatically measures vital signs and uploads the information to the hospital information system (HIS). This cuts the long queues and waiting time in getting a consultation. 

The smart laboratory management system is linked to the HIS. Using the information provided by patients, this system can automatically select and label test tubes, preventing errors. 

Nina Kao, CEO of Changua Hospital Group’s Overseas medical Mission Center, said reducing errors greatly help in the enforcement of patient rights and lessens legal ramifications for the hospital. 

Should confinement be needed, patients are more or less assured of a pleasant stay despite having sparse manpower. 

Each patient bed is equipped with a touch-screen bedside entertainment system that provides entertainment options and displays information about the patient and their primary physician. It also enables real-time communication between patients and medical staff. The accompanying digital bedside cards contain information on vital signs such as respiration, heart rate, and blood oxygen which are automatically sent to the nursing station and to the primary nurse’s work mobile phone to enable them to monitor changes and make timely responses. 

 Great care is also taken into minimizing the infection rate in the hospital by eliminating surfaces where viruses and bacteria can thrive and carefully managing the disposal of medical waste. 

The 24 single rooms in the ICU section adopt cantilever overhanging systems to make sure that equipment does not touch the floor as well as switchable glass compartments that replace curtains to inhibit the growth of bacteria and viruses. 

The dentistry department uses light rail transportation to transfer the contaminated dental instruments to the cleaning and sterilizing room so as to reduce transportation by staff. This also ensures that the contaminated instruments and the clean instruments do not end up in the same route. 

Disposal of bulkier medical waste is done through the medical transport robot known in the hospital as ORBER which is able to carry 150 kilograms of contaminated surgical materials and supplies. ORBER helps reduce chances of work injury among staff and risk of cross infection when transportation is carried out by staff. 

Another feature of the hospital that sets its apart from other hospitals in Taiwan is its smart long-distance consultation system implemented through a consultation robot that can evaluate whether a patient with acute stroke needs to be injected with rt-PA, a protein that helps break down blood clots. 

Telemedicine

Taiwan’s healthcare sector is benefitting greatly from the smart technology movement that is taking the country by storm. Several manufacturers of smart healthcare technologies also have hospitals in Taiwan as their main clients. 

Taipei-based Advatech, for instance, supplies the smart beside system to Yuanlin Hospital. The firm has also developed the technology for conducting surgeries when the primary physician is away from the operating theatre and the patient is attended to by the junior physician. 

Hsinchu City-based Medimaging Integrated Solution Inc. (MIIs) is another Taiwanese firm making strides in telemedicine through the production of digital medical imaging diagnostic equipment. These cover diagnostic equipment for eyes, ears, nose, throat and skin that can be used by medical professionals in remote areas and in independent clinics. 

Images captured by these tools are uploaded to the cloud and can be viewed in the computers of specialists based remotely. In Taiwan, those who benefit from these tools are often patients in far-flung islands and provinces serviced by health professionals working with doctors in big hospitals in the cities. 

Using these tools, the specialist can confirm an initial diagnosis and refer patients to big hospitals for proper treatment. 

The use of these tools help address overcrowding in hospitals and reduce transportation time and costs for patients. 

“This is important because in some countries (like Taiwan), the number of doctors is small,” said Brian Chiu, Miss assistant vice president. 

MIIS products are now also used in clinics in the US and in China where it also has a manufacturing facility,. All of the tools, however, are designed in its headquarters in Hsinchu Science Park in Taiwan. 

Designed in Taiwan

The phrase “Made in Taiwan” used to be associated with cheap, mass produced products but now, this diminutive East Asian nation is becoming a hotbed of smart technology. This is seen in the ease at which people embrace the use of technology in daily living. 

The Taiwanese government has also laid down policies that support innovation and expansion of business in Southeast Asia including the Philippines. To date, several Taiwanese companies operating in the Philippines has expressed intention to expand operations and to put up news businesses. 

“Recognizing that low-cost hardware manufacturing is not a way to sustain an economy when other countries can undercut them in price and that it has tremendous, broad-spectrum engineering talent as a country, Taiwan is once again reinventing itself, focusing on intellectual property and innovation that are less capital-intensive,” said Raymond Chen, executive director of TAITRA’s strategic marketing department. 

Chen said the government intends to make Taiwan a world leader in smart technology, by improving the environment for open data, cybersecurity, testbeds, and human resources development.

“One of Taiwan’s goals is to become the Silicon Valley of Asia,” he said.  “Taiwan feels it can succeed because of its historical capabilities, geographic position in Southeast Asia. It’s relatively equidistant from Hong Kong, Korea, Japan, India, Indonesia, Thailand, and Vietnam. And also because of the global business partnerships it has forged and continues to explore.”