The future of healthcare communications and tech products

Jeremy Paton is team engagement solutions lead at Avaya Australia and New Zealand, the local office of the California-based technology firm. After more than a century in the telephonic hardware industry, Avaya is transitioning into a software-led communications enabler. Healthcare is one industry Paton and his colleagues are focusing on in Australia.

He sat down with Nursing Review to discuss how technology is disrupting the way patients, doctors, nurses, paramedics and other parties interface, and what the industry will look like in the future.

NR: What is your process to learn about an industry and devise bespoke solutions?

JP: In the case of healthcare, for example, I'll go sit in a hospital, spend time with staff, see what their issues are and how we can help to communications-enable their problems. Then solve problems through automation of communications or being able to bring in a solution or an interface that's closer to what they need.

I sat in a hospital a couple of weeks ago and I was talking to the nurses and finding out what they do, how they work, that type of thing. A couple of strong use cases came up for us, which is a good way of explaining the way Avaya is working now. What I'd found was that 90 per cent of the calls that come into the nurses station just end up being transferred. The nurses have to walk back to the nurses station, they've got to answer the phone – taking them away from what they're doing normally – and then they've got to look up a number and they've got to know who on the ward to transfer it to. So it all takes a bit of time.

I said, "OK, well have you tried using some sort of soft-phone on a mobile device? Would that speed up the process?". (Editor's note: A soft-phone is an app or program on a hardware device, such as a smartphone or PC, that allows a user to make calls to other soft-phones and traditional telephones. Skype, Google Talk and FaceTime are prominent examples. – Patrick Avenell)

They had tried that and, they said, "You know, most soft-phones we need four or five button clicks to get them where they need to go."

So with Avaya now being much more software-led and with the software that we have, we've introduced much more customisability to create your own soft-phones. We said, "OK, well why don't we customise it so when you receive a call it just presents you with a simple button to transfer and the last couple of people who you transferred to?"

Then, in talking with hospital staff, we can start to get smarter around that concept. With things like analytics, we can know who's on the ward at the time, we can know where the doctors are who would usually receive transfers. It's a much more in-context experience than what the nurses happen to be doing at the time.

What other challenges did you identify when researching hospital settings?

One that came up was that in Australia many wards need to be locked 24/7, and people need to be visually identified before being allowed onto the ward. Children's wards and maternity wards, especially. We solved that problem a couple of years ago by putting in a video door-phone that comes through to a videophone back at the nurses' station. They've got to walk back to the video door-phone and answer it. Then, to open the door, they have to go over to the other phone on the desk and press a button because you can't program buttons around the video phone.

Why don't we, on that same interface, enable you to see that it's a call coming from a door-phone and present you with two buttons: an answer button and a reject button. Streamlining that whole process allows nurses to do what they should be doing, which is caring for their patients.

Is the software you speak of static or can it learn from use and adapt?

It can learn. Instead of having a fixed telephony environment, we have an environment that's completely customisable and programmable.

An example could be, if I got a ward's phone and we want to send them a message and order something that needs to be brought up to a ward – a wheelchair, for example – if I want to track where that wardsman is, that's a fairly unionised environment and they don't like you tracking exactly where they are. If we use a concept from our past in the context of the ward, like estimated wait times, what we could do is order that wheelchair and receive an estimate of that wait time and how long it's going to take to get to the ward, which is useful because then a nurse can go and do other things, returning when that wheelchair is going to be ready.

How do you foresee technology changing healthcare in the next 5–10 years?

Hospitals still have that concept of having a phone every 20 feet down the corridor. I think over the next couple of years, it's going to be about how we guarantee service on the mobile devices; how we guarantee end-to-end service from the emergency phone company. Some of the challenges we are going to solve are around the internet of things. Hospitals are ahead of the curve as far as connecting devices, but where I can come in and help is in creating the workflows of those devices and being able to design things with them. When an alarm goes off, I can alert someone, but we can take it that step further and bring in a dynamic team of people.

Imagine an ambulance that's inbound to a hospital, and within that ambulance we have vide. That's a good thing. A doctor can see the patient, can see the paramedic, and interact. Now imagine creating a dynamic team of devices and people, packaged up in the telemetry in that ambulance, the different monitors and things like that. If that were packaged up and presented as a view to the care team and to the hospital, we could do triage and handover while the patient is still in the ambulance, saving a lot of time.

Do you foresee a time when an AI Siri-style app could triage medical issues? Be it at an emergency ward or on Triple Zero?

The technology absolutely exists to do that. The problem is getting people's heads around that concept. People still get the experience of having to ask Siri something two or three times and misinterpretation. But the technology is getting there. We will get there sometime. I don't see that happening in the next 10 years, but we will get to that type of thing.

Where technology can help today, if we have real-time speech and the analytics behind that on a call, then we can evoke things like experts and bring them into the call dynamically. We can get that expert level of care brought in because all I need to say is a key phrase. For example, 'I need an expert in asthma patients,' and an asthma patient expert can be brought in, based around the analytics of a set of key phrases.

I'm going to go out on a limb here and say that you closely monitor how health agencies in other countries operate and what technology they use. Where does Australia place in that sphere compared with other Western nations?

We're fairly ahead of the curve. There are a couple of instances, Canada for example, on par with Australia. We've done some interesting things around the internet of things and connecting devices to dynamic networks. We're fairly up to date. We're not probably the most cutting edge; some European companies are a little bit more cutting edge than us.

Which ones are they?

Some of the Scandinavian countries tend to be pretty up to date.

What do they do differently?

It's more around the way that they're providing an end-to-end digital patient journey. Now we've got hospitals that have started to do that in Australia. What tends to be the gap in the digital patient journey and digital patient records is the communications enabler piece, which is why we are strongly focusing our efforts on healthcare to be able to help with the communication enabling aspect.

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