Digital health could revolutionise Karin Grech Hospital admissions

Francesca Muscat combines her experience as a physiotherapist with her interest in technology. She has adopted the digital health concept to create a paperless medical process that standardises the prediction of rehabilitation potential and aids doctors w

Public healthcare is a wonder of our age. Thanks to it, we can all rest easy knowing that if we fall ill or have an accident, professionals will be ready to look after us in spaces equipped for the job. Nevertheless, operating a national healthcare system is a mammoth task that requires the input of countless individuals. So, as we are all too aware, a bit of help from modern technology can go a long way.

Karin Grech Hospital (KGH) is a unique establishment in Malta’s network of public healthcare facilities. I have worked at the hospital as a physiotherapist for the past five years and can say that it’s a place where people are admitted for rehabilitation before going back into the community, so the idea is always that of a short stay.

However, admitting older adult patients to one of the seven wards dedicated to this isn’t always straightforward. Many domains affect whether a person will require short-term rehabilitation or long-term care.

This includes things like a person’s daily function, such as whether they can get dressed on their own or feed themselves; cognition, which is needed for tasks like buying groceries or remembering to switch off the oven and physical strength, like whether they can get out of bed alone. Then there is also the home environment and social support: is their home accessible to them in their situation, and are there relatives or friends who can help?

This information usually adds up to a couple of thick files’ worth of paper documents, some of which can sometimes be misplaced, leading to incomplete data. Either way, the consultant geriatricians must pore over these documents and use their expertise to determine whether a patient should be admitted for a short stay at KGH or whether they would fare better at a permanent care home.

But this is where my work could help: bridging two University of Malta faculties, namely those of Health Sciences and ICT. This can be done by employing the concept of digital health – the use of ICT to enhance the efficiency of healthcare – to help facilitate this process.

My aim is to standardise the process through which consultant geriatricians can decide whether KGH would be the best place to care for the patient. I am also working on a system that can predict the rehabilitation potential of a patient, helping clinicians in their work.

To make the use of this technology simple, I have created a tablet application that works on a predictive model; a system that uses statistics to forecast future outcomes. This has been created based on a systematic review of what assessors usually look at when admitting patients for rehabilitation, as well as on information received from a panel of rehabilitation experts, including clinicians and hospital managers.

The front-end of the app will have a series of questions that the geriatricians and the multidisciplinary team at Mater Dei Hospital (MDH) will fill in on behalf of the patient, either through one-on-one assessments or through the documents available. The app then gives a percentage score on how likely the patient is to benefit from being sent to KGH.

I am adamant that such a percentage is only meant to aid clinicians and not replace their expertise. Our goal is to ensure that patients receive the right care.

The final call is always the clinicians’; after all, human beings are more complex than statistics. It must also be said that we are not looking to deny anyone care. We aim to ensure that patients receive the right care for their conditions while freeing up spaces in respective hospitals.

Moreover, there is another benefit to such an app: through it, the information collected could be stored digitally. This would make it accessible to healthcare workers in any hospital or care home the patient is in and reduces the risks of any information or papers going missing.

Over my years working in the healthcare industry, I realised that one profession cannot be independent of another. So using more than one discipline – in this case, healthcare and technology – means that we’re more likely to find a solution to any shortcomings and improve our patients’ lives – which is why we’re here after all, isn’t it?

Indeed, although I am still in the first year of my PhD, my project shows how multidisciplinary ideas can benefit all industries.

Francesca Muscat is a PhD researcher at the University of Malta, under the supervision of Dr Stephen Lungaro Mifsud, Dean of the Faculty of Health Sciences and of Dr Conrad Attard, Deputy Dean at the Faculty of Information and Communication Technology at the University of Malta. Iggy Fenech penned the interview