According to figures from the British Medical Association, October 2022 saw a record 7.21 million UK citizens waiting for healthcare treatment.
In addition, 410,983 patients waited over a year for treatment, which is approximately 265 times the number of people waiting an equivalent length of time pre-pandemic.
Similar statistics can be seen all over the world. For example, data from the Australian Institute of Health and Welfare shows that 2021-2022 saw the lowest number of elective surgeries at public hospitals for over a decade, since resources were redirected to deal with Covid-19 cases. The pandemic caused a backlog in the delivery of routine medical care, which healthcare providers are now struggling to overcome. And Sweden, which had mostly been able to maintain routine medical appointments such as cancer screenings and treatment, saw hospital visits decrease by 16 per cent between March and September 2020, according to research published in Cancer Epidemiology.
“The pandemic has had a profoundly negative impact on healthcare providers,” says Dr David Rhew, global chief medical officer and vice president of healthcare at Microsoft. “Clinician burnout is at an all-time high. Clinicians feel overworked, underappreciated and frustrated, and many are leaving the practice. While clinician burnout was present before the pandemic, it has significantly worsened in the past couple of years.”
Healthcare provider organisations are also suffering. “With staff shortages, higher operating expenses and decreased revenues, many healthcare provider organisations are facing financial challenges,” says Rhew. “And of course, the negative impact of the pandemic on patients, families and communities cannot be overstated.”
While much of the focus has been on the direct impact that Covid-19 has had on hospitalisations and death rates, Rhew fears that the next few years may see negative implications on the overall population’s health due to other chronic conditions such as cancer, cardiovascular disease and diabetes because screenings, preventative care and overall self-management have been deferred or neglected.
“To address these issues, healthcare provider organisations are placing greater emphasis on clinician well-being, operational efficiency, and patient access to care, and using technology to do so,” says Rhew.
For example, clinicians spend a significant amount of their time documenting in electronic health records (EHRs) during patients’ medical appointments. Industry-specific tools such as ambient clinical intelligence can automatically transcribe, codify, and organise the conversations that occur between a clinician and patient into clinical notes. The clinician can then review the notes, make edits, and seamlessly upload it to the EHR.
“This type of technology is potentially transformational,” says Rhew. “However, adoption of newer approaches in healthcare can be slow. Even evidence-based practices that have been well established can take 10-15 years before they are widely adopted. For this reason, it is important that we continue to explore and address local barriers to adoption, whether they be related to workflow, technology or culture.
“We also need to remember that change often requires a sense of urgency. With clinician burnout and the resulting staff shortages negatively impacting operations and finances for nearly every healthcare provider organisation across the world, technology-based approaches that can help alleviate these issues may soon become industry must-haves.”
Advances in times of crisis
Despite the challenges created by the pandemic, the urgent need to continue providing care did accelerate many positive advancements that were enabled by technology. “Data sharing facilitated global collaboration, which helped accelerate the development of life-saving vaccines,” says Rhew. “Fragile supply chains were stressed but later strengthened and optimised through technology. Large populations of people with pressing questions about Covid-19 received individualised guidance through artificial intelligence-based chatbot technology.”
However, the pandemic also shone a spotlight on existing health disparities. Older individuals, those with multiple medical conditions and those living in underserved communities experienced higher mortality rates. Moreover, the ability to access broadband and use the internet impacted people’s ability to find and receive Covid-19 vaccinations.
“As technology becomes an essential tool for delivering healthcare services to patients, we must continue to evaluate and address systemic and individual barriers to technology adoption, especially in the vulnerable and underserved communities,” says Rhew.
Every cloud has a silver lining
Microsoft Cloud for Healthcare could be a key solution for delivering better, more efficient and more equitable healthcare services.
“Some of the best experiences and outcomes are possible when we deeply understand an individual,” says Rhew. “To do this effectively in healthcare, we need to extract data from different – often siloed – systems of record, analyse the data to draw actionable insights, and act upon those insights in a coordinated manner.”
Microsoft offers platforms and technologies that comply with the Health Insurance Portability and Accountability Act (HIPAA). They can improve data ingestion through application programming interfaces, analyse data using AI and machine learning in Microsoft Azure, support data coordination with Microsoft Dynamics 365 and Modern Workplace solutions such as Teams, and provide data visualisation tools on Power Platform. Microsoft Cloud for Healthcare also enables Fast Healthcare Interoperability Resources (FHIR)-compliant data to flow seamlessly between Microsoft and third-party technologies and platforms.
These solutions have been put into practice to help healthcare providers get back on track. For example, after seeing significant reduction in the number of routine cancer screenings and vaccination appointments during the pandemic, Ohio medical centre Cleveland Clinic used Microsoft Cloud for Healthcare to identify eligible patients, engage them through a marketing-style campaign and schedule their appointments. “The results demonstrated dramatically improved rates of scheduled appointments and completed procedures,” says Rhew. “Given the importance of these screening exams and preventative care interventions, this technology-led intervention likely saved lives.”
The detail is in the data
Like all industries, healthcare trends change in reaction to factors affecting the wider world. “One of the first major healthcare trends was the move from paper to digital through the adoption of EHRs,” says Rhew. “Another was in technologies that patients could use while at home, such as mobile phone applications, wearables and virtual care solutions.”
However, today the focus has progressed to data, particularly regarding storage and computing in the cloud, interoperability, AI and ML, and data collaboration. Microsoft has doubled down on each of these areas to deliver new experiences to its partners and customers.
“Massive amounts of data can be generated from genomic sequences, EHR data and remote monitoring devices, which require upgraded storage and computing capabilities,” says Rhew. “Many healthcare organisations are now moving their data from on-premises data centres to the cloud, which also improves cost-efficiency as they only pay for what they use.
“Our high-performance computer capabilities and partnership with AI and computing company NVIDIA – which is focused on building a supercomputer and AI platform on Azure – will enable this transition.”
In the area of interoperability, Microsoft has built Microsoft Cloud for Healthcare with FHIR-enabled data at its core. “This allows data to flow between Microsoft platforms and facilitates interoperability with EHRs,” says Rhew. “The result is that interoperability opens up new and exciting clinical use cases in patient engagement, clinical and operational insights, clinician experiences and healthcare team collaboration.”
AI in healthcare is another key focus area for Microsoft, particularly highlighted by its $19.7 billion acquisition of Nuance. The firm is well-known for its voice AI capabilities, advanced imaging AI and image-sharing capabilities, and decades-long experience integrating healthcare data into clinical workflows in the EHR.
Microsoft continues to advance its AI and ML capabilities with solutions like Text Analytics for Health. “This powerful technology allows a computer – instead of a human – to rapidly search multiple data sets, read and extract data from text passages, and synthesise information in real time,” says Rhew. “One compelling use case involves clinical trials matching, helping patients to identify which clinical trials are most appropriate for their condition.”
Partnerships have also been key for Microsoft to facilitate effective data collaboration. It has joined forces with healthcare data consortium Truveta and biomedical research platform Terra to assist researchers, clinicians and industry partners in the development and validation of AI algorithms.
The power of partnership
Microsoft has partnered with many organisations to transform its ability to engage with patients; develop, validate and apply AI and ML in research and clinical settings; and transform the delivery of healthcare. However, there is one public-private partnership that Rhew believes is simple in concept but profound in impact.
“During the pandemic, we observed that many underserved communities consistently demonstrated low Covid-19 vaccination rates,” he says. “We later realised that it was not access to the vaccine that was the primary barrier, but rather the lack of trust with the people and organisations delivering the messages and the vaccine.”
To overcome this, Microsoft and a consortium of partners across the non-profit, healthcare and technology sectors began a joint effort to empower community-based organisations with the tools, information and resources to deliver Covid-19 vaccines and other health services such as diabetes and blood pressure screenings, adult and childhood immunisations, and enrolment in the US healthcare programme Medicaid.
The results were very impressive. This collaborative effort – later named the Health Equity Consortium – helped communities in four US states to increase Covid-19 vaccination rates and deliver essential health services to vulnerable, underserved and under-represented populations.
“Central to this model was the need to digitally connect community-based organisations, local healthcare providers and public health to enable a bidirectional flow of data between these three key stakeholders,” says Rhew. “This enabled more comprehensive and secure data capture from underserved communities, facilitated coordinated efforts around specific public health and community health initiatives, and expedited real-time reporting of conditions to public health.
“Microsoft helped to empower community-based organisations through public-private partnerships, technology and data in an effective model of care that is potentially reproducible throughout the world.”
We asked a selection of Microsoft partners about they are using Microsoft Cloud for Healthcare and how it can deliver more positive outcomes across the industry.
“At Gamma, we see the Microsoft Cloud revolutionising the way UK healthcare organisations operate. By enabling secure and compliant data sharing, healthcare professionals can access patient data more easily, leading to more accurate diagnoses, treatment and care coordination,” says Sam Winterbottom, public sector director at Gamma.
“With the Microsoft Cloud as the foundation for our infrastructure, we are able to break through these barriers and help our clients achieve superior clinical and financial results for themselves and the patients they serve,” says Dr Kent Locklear, chief medical officer at Lightbeam Health Solutions.
Read more from these partners in the Spring 2023 issue of Technology Record.