2018 – another year of progress in healthcare!

Written by Andy Smith, MTM publisher.

When looked at from an education, training, assessment and simulation point of view, 2018 was an interesting year in healthcare when some of the answers to the upcoming demographic challenges—including lack of staff, increasing long-term care demand and a different student profile—began to crystallize and perhaps really bite those in the industry.

The AR/VR scenecontinues to intrigue with new companies staffed by bright young engineers andbacked by VC money popping up at all events across the year. Their enthusiasmand positivity was wonderful to see and those of us with a few years ofhealthcare ‘action’ behind us certainly hope that survives after their early collisionswith healthcare professionals.

AI willundoubtedly help erase the errors made in increasingly (and necessarily) rusheddiagnoses and also will support and enhance the treatment decisions for complexconditions. The issue here is can we crunch the data quickly enough—a problemfor all data-rich industries that are dependent on computing power—as well asthe collection of the correct data? AI might also be used to enhance the ‘virtualexperience and judgement’ of students, perhaps allowing them to avoid theerrors and uncertainties of recent rookies. Could the dangerous month aftergraduation become a thing of the past?

Data mining,feeding from the workplace to training and education centers, helps them betterrepresent actuality and teach to the need, and should form a virtuous loop thatcould show all around improvement in outcomes from both a patient-safety and aneconomic perspective. However, we wonder how many teaching organizations willactually create that virtuous loop.

Students couldfind themselves assessed on entry to the next stage of their career/training witha purpose-built education and training course that is designed to take intoaccount their strengths and weaknesses. This ‘adaptive learning,’ orindividualized training is currently used by some institutions and can be appliedas long as the students have been properly assessed through the learningprocess and not just processed by their ability to pay.

Sixty-year-old’shave (mostly) stopped throwing their hands in the air when the subject of themillennial student is raised and have accepted that we simply have to managethings and move on. Their digital strengths and their likely dexterity withvarious machine interfaces, plus their confidence in technology may make themTHE robotic and minimally invasive surgeons of the future. Their interpersonalskills, the appalling language of many and their lack of leadership abilityhave been identified as real issues, but then nurses have grown used to dealingwith verbal abuse from patients and senior staff.

Simulation, fromthe computer-based and manikin perspectives, continues to improve in fidelity.Although industry itself probably saw few signs of real advance in that theirsis still a low-volume business. In other words, the demand is frequently foralmost bespoke solutions in low-volumes rather than standardized products andtechniques that can be manufactured and delivered in large quantities. Thatwill not change until healthcare itself changes and that seems to be as distantas ever. There are some not-for-profit organizations that have designatedserious solutions for their members and some have even mandated their use.

At the same time the simulationbuyer is becoming more discerning, mostly having been caught out first timearound, they are now aware of the fidelity cost issue, the need for amaintenance budget, the need for well-trained techs and the need for of all thedevices they buy to work together. Many still seem to base their buyingdecision on the ‘shiny new’ thing, rather than buying to fit the training need.

Which brings us to the myriad events everyone in healthcare attends at huge costs, each year. Ifthese events are to remain a recognized source of education, then we remain introuble as an industry. At best they may expose practitioners to the latestresearch, although 59 percent of that research is likely going to proveincorrect, the value is dubious. Scrap CMEs and replace them with a properlystructured and evaluated training, annually. Mandate this training and make itfree of charge and a part of the working day, i.e. pay the attendees as normalor provide insurance cost breaks.

An interesting commentfrom an extremely well-qualified physician seemed to capture the issue withhealthcare. During a briefing on a wonderful new initiative late this year, hepaused and commented, “At one time, and for many years, we accepted that 15percent of patients undergoing (procedure x) would suffer from an infection. Wesimply accepted it. Until we decided not to accept it any longer, then we fixedit and now the infection rate is under 1 percent.”

Increasing numbers of healthcare providers are saying ‘wecan fix it (healthcare) and we can fix it quickly, it can be done’. However,  it evidently won’t be done until enough cliniciansand other leaders decide it needs to be done and decide to do it. Adopting areal culture of safety is one verypotent answer. That means changing the approach to the healthcare enterprise whereeverything within the systems and all its processes must be scrutinized andimproved.