EH 4_2015

EUROPEAN HOSPITAL  Vol 24 Issue 4/15 2 NEWS & MANAGEMENT Continued from page 1 The future of big data in medicine Are those data sets to be analysed actually Big Data? ‘Yes, we can now access these differ- ent “pots” of data stored in different silos and look for connections with the help of modern procedures, such as ‘Deep Machine Learning’ and neuronal networks, or respec- tively we can detect presumed links. This can lead to the discovery of connections that we hadn’t even imagined. It also means we are turning our backs on the natural scientific principle, i.e. the estab- lishing of a theory and proving it with experiments. Now we throw large amounts of data into a pot and leave it to high performance computers to look for patterns and connections, often with surprising results. For example, if the analysis shows that many people suffering a certain illness benefit from one par- ticular medication out of a number of comparable drugs, then a doctor can most probably help his patient by prescribing this medication – even though he may not understand exactly why.’ Could texts and images be cor- related in the context of Big Data Analyses? ‘This seems possible indeed; Ii is about attempting to bring images and texts together, i.e. mechanical recognition of semantics. Texts are now quite easy to understand, but how can I detect something in a video? You can describe the video with text, but we are looking for procedures that automatically rec- ognise what happens in a video at what point in time, to make retrieval of this information possible at a later stage.’ If this goes well, where will we be with Big Data in five years’ time? What will we be able to find out then which we can’t do now? ‘We will certainly know a lot more about the structural design of humans, i.e. gene analysis, protein analysis, molecular analysis, and also about processes in the body, what triggers what and how. This will result in improved opportuni- ties to diagnose individual consti- tutions and in more appropriate treatment of diseases, i.e. person- alised medicine. However, this will also require quite large financial investments. For the pharmaceuti- cal industry this means the devel- opment of individualised medica- tions, which will revolutionise the industry - bearing in mind that the strategy, so far, has been all about developing blockbuster drugs that help as many people as possible. Data protection ‘This is a key topic. Data obviously has to be protected, particularly where it is possible to draw conclu- sions as to personal information. However, neither the German data protection law, nor the proposed European data protection regula- tion, meet the level of data pro- tection required in the age of Big Data. Historically, the philosophical principle has been one of thriftiness with data. However, if we say that Big Data is the shape of the future this will be at odds with the princi- ple of data thriftiness. ‘Additionally, there is the issue that data collection is only allowed for a previously defined, specific purpose, which may be even more problematic because it contradicts the Big Data approach where we initially just have a look and see what we can find, and then make the best of it without prior knowl- edge of the purpose. ‘Therefore, we need at least the opportunity for special dispensation within the law to account for this, and the definition of a procedure on how to achieve special dispensation - otherwise Europe will turn into a digital colony.’ French fear for the f Reaching into the core of process rationalisation Excellent service but acce Facility Management An online survey of 1001 French adults, which aimed to reveal public opinion on healthcare access and other perceptions regarding pub- lic hospitals, has been carried out by IPOS for the French Hospital Federation (Fédération Hospitalière de France- FHF). Happily, analysis of results has shown that, regardless of political affiliation, age, gender or social status the vast majority (91%) of those polled consider that the pub- lic hospital system provides excel- lent healthcare. Scoring nearly as highly were the efficiency and performance of the public hospital system, which 84% of respondents think is a model worthy of introduction in other countries. They believe it to be adaptable, innovative and offering the latest in healthcare technology. However, despite a strong sense of pride in the system, almost all these supporters, 89%, are real- istic enough to be wary of the continuation of such a high qual- Report: Anja Behringer ‘Facilities management is the integra- tion of processes within an organ- isation to maintain and develop the agreed services that support and improve the effectiveness of its primary activities.’ According to the European DIN-Norm (DIN EN 15221), this defines facility manage- ment (FM). As a control tool, FM encompasses all supportive pro- cesses within a company, in this case referring to a hospital and its core business – caring for patients. As in a commercial company, it also includes service and mainte- nance of premises and all admin- istrative tasks and services. All services generated by the hospital alongside the key healthcare busi- ness are reflected in data, which are administered with transparency in a FM-system for all cost centres. From catering staff wages to cleaning products used by cleaners, from the occupancy to the IT infrastructure, all departments are covered by the system – provided that it has been professionally developed and is con- tinuously updated (see graphics). This results in clear findings as to opportunities for rationalisation and thus, in turn, in clear cost benefits. In theory, anyway; in practice, many problems can arise because FM is not usually implemented right from the point of building design and construction. Introducing FM to existing premises is unlike- ly to be successful all across the board, and hospitals are so com- plex that even ‘old hands’ at FM only attempt partial introductions. One of these experts is Professor Kunibert Lennerts of the Institute for Technology and Management in Construction in Karlsruhe. For a long time this facility manage- ment specialist was responsible for one of the most heterogeneous and comprehensive property portfolio in Germany – assets owned by Deutsche Bahn. European Hospital sought answers to three questions from the profes- sor, first asking how FM could save running costs in the hospitals. ‘The ideal scenario is for FM to be incorporated during design and construction,’ Lennerts advised. ‘This facilitates primary as well as secondary process-oriented plan- ning. However, this is extremely dif- ficult because architects tend to lack the knowledge and the individual processes are extremely varied, and hospital operators who are striving to build exemplary hospitals and provide the opportunity for the inte- gration of FM into the design and construction of a new building, right from the beginning, are very limited in numbers. ‘Therefore, the strategy revolves mostly around upgrading individu- al, particularly cost-intensive areas of the process with modern IT tools (see graphics). The so-called ‘Building Information Modelling (BIM) is a new tool that can also help with the design of virtual building models.’ Which hospital cost driver par- ticularly suits FM introduction? ‘Space Management is very effec- tive – as documented by some compelling figures from the Charité Hospital in Berlin. No other build- ings are utilised so continuously, intensively and differently as hospi- tals are, making under-occupancy or inappropriate occupation particular- ly costly. Some of the services that are closely linked with one another do have inherent savings potentials of around 10 to 30 percent – with- out causing any negative impact on the primary processes of healing and caring. ‘Energy consumption is obviously a good starting point, with BIM also helping to achieve cost optimisation.’ ‘The IFHE Europe, i.e. the European branch of the International ity service in the current economic situation with, in their opinion, an increasingly marked lack of trained personnel. This concern is slightly greater in the older age group (>35 years old) and also in respondents coming from lower socio-economic groups. Equal access to healthcare lies among areas for improvement in a public healthcare system that has consistently been judged as one of the world’s best. Geographical inequality is apparent from analy- sis of the results. While 64% of the French have a general practitioner less than 5 km from their home, nearly 70% of the respondents claim to have faced difficulty in finding a healthcare professional available within an acceptable period. A simi- lar number felt that there were not enough hospitals in France. This was more marked in rural than urban areas, where 21% of respond- ents had turned down a proposed healthcare option because it was ‘too far from home’. Overall only 33% of those questioned felt that healthcare was equally represented over the whole country. The cost of healthcare is also suggested as a barrier to its access. Amongst those polled, 95% have direct access to the social security system with a ‘Carte Vitale’ and 87% have additional private insurance (mutuelle). However, 46% think that Copyright:shutterstock/vetkit

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