Finnish delegation trip to landmark German hospital reveals stark differences, similarities between healthcare systems

When 12 Finnish health IT directors and experts visited the state-of-the-art Charité University Hospital in November 2019, as part of the HEALTH Conference in Berlin, they didn’t expect to find so many similarities – and differences – with the way they did things back home.

The visit was set up to showcase the digitization of the hospital and its new speech recognition infrastructure and included presentations and discussions with representatives of Charité’s IT department. It was organized by the AKUSTI Forum, a co-operation network for the Finnish health and human services ICT, which supports activities to build, integrate and deploy the future health IT services for the social and healthcare sectors in Finland and which is coordinated by the Association of Finnish Local and Regional Authorities.

What are the similarities and differences?

“What struck me about the visit was how similar the famous Charité hospital is to the hospital I work at now,” said Leena Setala, MD, PhD, and chief strategy officer (CSO) at the Hospital District of Southwest Finland, who was part of the Finnish delegation (Charité has been ranked by Focus magazine as the best of over a thousand hospitals in Germany every year from 2012 to 2019). “Turku is also a long-established university hospital, but we have about 8,000 employees and are about half the size of Charité.

“The way we work, however, is very different. I think it is easier to operate within the Finnish healthcare system, as it is more coherent than and not as complicated as Germany’s healthcare system.

“The German people also see more risks in sharing their data than we do. We have a structure that makes it easy for us to see complete health data for a single person and we now also have legislation in place around the secondary use of healthcare data, which is expected to make things even easier.”

“Topics like the usability of data, modular or monolith IT solutions, preventive health care supported with data were among the topics in which we found similarities and similar agendas,” said Kalevi Virta, HIMSS Europe Nordic Community member, director eWELL Oy and also part of the Finnish delegation. “The basic need to build up effective and more productive digital services for the needs of citizens, patients and professionals from the same baseline, although the organizational differences in the operational environment may lead to different solutions.”

“Hosting this kind of event is always challenging, but at the same time very rewarding,” said Hanna Menna, senior adviser, Association of Finnish Local and Regional Authorities and coordinator for the AKUSTI Forum. “We got to speak about the issues which are on the table right now in Finland – for example the costs of healthcare ICT and the rapidly ageing population – with our counterparts in Berlin. The next steps will be to continue dialogue with our international counterparts and most likely we will soon start organizing the next similar such event.”

Hugely inspired by the use of speech recognition

Charité hospital, which has nearly 100 clinics and institutes across four campuses and more than 3,000 beds, has implemented and been using speech recognition for the past year and a half at all its Berlin sites. There are now more than 1,200 users using the Dragon Medical system from Nuance.

The hospital’s next focus will be on mobility: speech-based data collection on tablets (the hospital currently uses 1,100 iPads).

Though not a user of speech recognition herself, Leena Setala said she was hugely inspired by the use of speech recognition at Charité. “At present radiology is the biggest user of speech recognition in our hospital, but we’d like to introduce it to other medical specialities.

“During this visit we learned that more powerful algorithms and wider vocabulary are being developed for speech recognition and so I hope that this will improve the usability for speech recognition for our small country and this rather special language of ours!”

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AI-powered temperature screening solution being trialed in Singapore

Integrated Health Information Systems (IHiS), the national HIT agency in Singapore, has partnered with local healthcare AI startup Kronikare to pilot iThermo – an AI-powered temperature screening solution that screens and identifies those having or showing symptoms of fever. iThermo is currently being piloted at IHiS headquarters in Serangoon North and St. Andrews Community Hospital (SACH) from 10 and 11 February onwards respectively in “live” operational environments.

WHY IT MATTERS

With the growing threat of the COVID-19 (which was recently renamed by the WHO, formerly known as 2019-nCOV), Singapore has officially raised its ‘Disease Outbreak Response System Condition’ (DORSCON) alert level from yellow to orange on 7 February. The DORSCON orange status means that the COVID-19 disease spread in the country is severe but contained. As of 14 February, there are 67 confirmed cases of the disease. As part of the DORSCON orange status, temperature screening and monitoring become mandatory for most public spaces.

iThermo reduces the need for manual temperature screening and provides prompts where secondary checks can be carried out for feverish persons identified by the solution. With iThermo, less time is taken to conduct manual screening and it also reduces the exposure risks to viruses of frontline medical staff.

HOW IT WORKS

iThermo uses a smartphone fitted with thermal and 3D laser cameras. The AI application processes and analyzes the images from the smartphone camera (which captures facial features) and maps them to images from the thermal camera (which measures temperature) as well as the laser camera (which measures distance).

The Smart Health solution utilizing AI is able to recognize human facial features from thermal images to measure the forehead temperature, including individuals wearing spectacles, surgical masks, hats, and other headgear, even when they are walking. The solution can carry out this function for up to 5000 persons in a day.

The solution also incorporates distance analysis and compensation (as temperature measurements reduce with distance). It can measure temperatures accurately up to a distance of three meters from the camera (a feature not found in other similar range solutions).

Critically, the AI solution can also provide status reports and real-time updates via the dashboard with the rate of traffic and how many febrile persons were identified. The dashboard can be connected to multiple cameras at different locations, and enable remote monitoring of the status at different sites.

ON THE RECORD

“Healthcare institutions and many businesses find it challenging to perform large scale temperature screening at speed. AI can help. The iThermo solution uses mobile phones with thermal and laser cameras, and an AI app to seamlessly detect people who may have fever, as they walk by. The app will generate an alert if a febrile person is detected. This reduces scanning fatigue, manpower and time. IHiS and Kronikare co-created the iThermo solution in two weeks. It is being piloted now and the results are encouraging. We have received enquiries from healthcare institutions and other sectors including retail and banking,” said Bruce Liang, Chief Executive Officer, IHiS, in a statement.

Hossein Nejati, CTO and Co-founder, Kronikare, said: “KroniKare has been working closely with IHiS to introduce the use of AI in healthcare through automatic processing of multi-spectral images for diagnostic purposes. Together with IHiS, we were able to very quickly re-purpose our device using the same hardware, but different software, to perform real-time temperature screening. Our co-development with IHiS has helped us to be agile and enabled us to swiftly develop this solution, deploy a proof-of-concept and pilot in such a short time to respond to a critical period such as this.”

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What keeps health ITDMs from innovating?

A survey of IT professionals identified major barriers to innovation — including finding the time to introduce new technologies while occupied with supporting the current ones.

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