As the world slowly starts to return to normal, Steve Rogerson looks at the predictions for the future of technology in healthcare.

To say the last year and a half has been tough for health services globally would be the understatement of the decade. But the global pandemic has put into focus the needs for the medical world to move faster in its digital transformation, and I am not even going to discuss how I hate the phrase “digital transformation”.

The fact that technology advancements are uneven, not just between countries but within countries, was aptly illustrated this week by a feature on the BBC about how Indonesia was coping with Covid-19 when some of its hospitals do not even have an ICU.

In most places though, the pandemic has caused mixed feelings about using IoT and related technologies in healthcare. The advantages of remote-patient monitoring and video consultations over Zoom or Microsoft Teams have really come to the fore as medical staff try to reduce direct doctor-to-patient contact. On the other side, hospitals have been so overrun with Covid patients that they have had to postpone some technical updates because they cannot handle the disruption the changes will cause in the short term, no matter how beneficial they may be in the longer term.

Because of that I was quite intrigued by a report that crossed my desk this week from Juniper Research, which is predicting a doubling from $29bn to $59bn of the smart hospital market in just the next five years. I caught up with the report’s author Adam Wears to find out what the driving forces were behind this predicted growth.

But first, exactly what is a smart hospital? Wears said that for the purpose of this report, it was not just a hospital that had employed some hot technology such as a robot surgeon but one where the different systems within the hospital were connected. Key to this were the electronic health records (EHRs) that almost formed the glue with all other systems taking information from and adding to these records.

“EHRs are big but they are truly smart when they interact with other systems such as remote monitoring,” said Wears. “Are they talking with each other?”

The long-term goal, though, he said was to shift from reactive healthcare, where doctors fix you when you fall ill, to a proactive approach aimed at stopping you falling ill in the first place. In other words, looking at ways to manage people’s health as this can provide a higher standard of care and reduce the burden on an already stretched healthcare system.

And this is where your Apple Watch or Fitbit come into play. These consumer gadgets, despite not being approved medical devices, are already providing doctors with information about people’s ongoing health and lifestyle. Information from them is being incorporated by some doctors into patients’ medical records, and that practice is going to increase.

The US FDA and other regulatory bodies are already looking at this, with key concerns on whether they can meet standards and privacy concerns.

“Consumer devices are already employed in healthcare,” said Wears. “They were used during the pandemic by doctors, from consumer apps and Zoom to wearables like Fitbit.”

But he said a lot of cooperation was still needed between companies such as Apple and the regulators to make sure they hit the markers of stuff such as privacy.

“In some respects, Covid has hindered modernisation because ICUs are overrun,” he said, “but what we are seeing is health systems being more digitised with uptakes in remote monitoring so they can monitor patients at scale. One person can monitor a large number of patients in a hospital.”

Covid also had the effect of showing the world the massive regional variations in healthcare. According to the Juniper report, just two countries – the USA and China – will grow to account for more than sixty per cent of smart hospital spending by 2026, with Europe as a whole leading the rest.

“China is dominating the region,” said Wears. “It has a high level of infrastructure and significant government backing. It also has a high number of hospitals. The second in the region is South Korea, which is investing a lot into smart hospitals. Japan is doing nicely as well and they are looking more at proactive healthcare because it has a high proportion of people who are older.”

One thing the pandemic did change was consumer acceptance of teleconsultations. This was a hard sell before Covid hit as most people, with good reason, wanted to see their doctors in person not on a screen. But with circumstances forcing their hands, people started to see that the standard of care that could be offered by this method was OK, and they didn’t have to trek to the surgery when they were not feeling well.

“It reduced the workload for doctors and improved care,” said Wears.

All of which leaves us potentially in a better position than we were before Covid hit. Patients and doctors have started to see real benefits in remote care and now, as the pressure on hospitals starts to decrease, they can start more intense modernisation, building on technology they often had no choice but to adopt and yet are mostly glad they did so.