DIGITAL TRANSFORMATION IN HEALTHCARE: KEY TECHNOLOGIES AND APPLICATIONS

Abstract

Digitalization has become inevitable in healthcare as in other fields. It is predicted that healthcare services will become digital with the combination of genomics, artificial intelligence, the internet of things and robotic technologies. There is no doubt that this digital transformation will significantly change both the roles of healthcare professionals and the health status of patients over the next two decades. Although some of these technologies have started to be included in the health ecosystem, it has been anticipated that a certain period of time is required for genomics, artificial intelligence and, robotic technologies to be fully ready within the scope of digitalization in health. In addition, synergetic technologies should be developed to interpret and integrate data to be used in these approaches. It is expected that digital health technologies and related tools, whose sole goal is to improve human health, will be included in our lives more prominently and their positive effects on human health will be felt soon.

Keywords

• Artificial intelligence
• Digital Health
• Genomics
• Robotics
• Wearable devices.

SAĞLIK HİZMETLERİNDE DİJİTAL DÖNÜŞÜM: TEMEL TEKNOLOJİLER VE UYGULAMALAR

Öz

Dijitalleşme her alanda olduğu gibi sağlıkta da kaçınılmaz hale gelmiştir. Genomik, yapay zekâ, nesnelerin interneti ve robotik teknolojilerin birleşmesi ile sağlık hizmetlerinin dijitalleşeceği öngörülmektedir. Bu dijital dönüşümün, önümüzdeki yirmi yıl içinde hem sağlık profesyonellerinin rollerini hem de hastaların sağlık durumlarını önemli ölçüde değiştireceğinden şüphe yoktur. Bu teknolojilerin bir kısmı sağlık ekosistemlerinde yer almaya başlamış olsa da, sağlıkta dijitalleşme kapsamında genomik, yapay zekâ ve robotik teknolojilerinin tam olarak hazır hale gelebilmesi için belirli bir sürenin daha geçmesi gerektiği öngörülmektedir. Ayrıca bu yaklaşımlarda kullanılacak verileri yorumlamak ve bütünleştirmek için sinerjik teknolojiler de geliştirilmelidir. Tek amacı insan sağlığını daha iyi bir hale getirmek olan dijital sağlık teknolojilerinin ve ilgili araçların hayatımıza daha fazla girmesi, sonuç olarak da insan sağlığına olumlu etkilerinin yakın zamanda hissedilmesi beklenmektedir.

Anahtar Kelimeler

• Dijital sağlık
• Genomik
• Giyilebilir Cihazlar
• Robotik
• Yapay Zekâ.

Kaynakça

1. Topol, E., “Preparing the healthcare workforce to deliver the digital future”, The Topol Review. 1-48, 2019.
2. Coravos, A., Goldsack, J.C., Karlin, D.R., Nebeker, C., Perakslis, E., Zimmerman, N., Erb, M. K. "Digital medicine: a primer on measurement", Digital biomarkers. 3(2):31-71, 2019.
3. Genomics England, "The 100,000 Genomes Project", Genomics England. https://www.genomicsengland.co.uk/initiatives/100000-genomes-project. (Access year: 2023).
4. Siva, N., “UK gears up to decode 100 000 genomes from NHS patients”, The Lancet, 385(9963): 103-104, 2015. Department of Health and Social Care, "Matt Hancock announces ambition to map 5 million genomes", 2018. https://www.gov.uk/government/news/matthancock-announces-ambition-to-map-5-million-genomes. (Access year: 2023).
5. Laugesen, K., Mengel-From, J., Christensen, K., Olsen, J., Hougaard, D.M., Boding, L., et al., “A Review of Major Danish Biobanks: Advantages and Possibilities of Health Research in Denmark”, Clin Epidemiol., 21;15:213-239, 2023.
6. Köksal, M.O., Akgül, B., “The role of digital health technologies in disaster response”, The Lancet, 401(10388), 1566-1567, 2023.
7. Hyppönen, H., Lumme, S., Reponen, J., Vänskä, J., Kaipio, J., Heponiemi, T., Lääveri, T., “Health information exchange in Finland: Usage of different access types and predictors of paper use”, International Journal of Medical Informatics, 122, 1-6, 2019.
8. Hägglund, M., Scandurra, I., “Usability of the Swedish Accessible Electronic Health Record: Qualitative Survey Study”, JMIR Hum Factors, 9(2), 2022.

9. Ackerman, L., "Mobile Health and Fitness Applications and Information Privacy", San Diego, CA: Privacy Rights Clearing House. 2013.
10. Yao, W., Chu, C.H., Li, Z., "The adoption and implementation of RFID technologies in healthcare: a literature review", Journal of Medical Systems. 36(6): 3507-3525, 2012.
11. Köse, G. Kurutkan, M.N., "Sağlık hizmetlerinde nesnelerin interneti uygulamalarının bibliyometrik analizi", Avrupa Bilim ve Teknoloji Dergisi, 27: 412-432, 2021.
12. Tian, S., Yang, W., Grange, J.M., Wang, P., Huang, W., Ye, Z., “Smart healthcare: making medical care more intelligent,” Global Health Journal. 3(3): 62–65, 2019.
13. Myers, J., Frieden, T.R., Bherwani, K.M., Henning, K.J., “Ethics in public health research: privacy and public health at risk: public health confidentiality in the digital age”, Am J Public Health, 98(5):793-801, 2008.
14. Karabekmez, M.E., “Data Ethics in Digital Health and Genomics”, New Bioeth, 27(4):320-333, 2021.
15. Nature Medicine, "GWAS to the people: Editorial", Nature Medicine. 24, 2018.
16. Uddin, F., Rudin, C.M., Sen, T., “CRISPR gene therapy: applications, limitations, and implications for the future”. Frontiers in Oncology. 10, 2020.
17. Miesbach, W., Meijer, K., Coppens, M., Kampmann, P., Klamroth, R., Schutgens, R., Lebeek, F.W., “Gene therapy with adeno-associated virus vector 5– human factor IX in adults with hemophilia B”, blood, 131(9):1022-1031, 2018.
18. Aiuti, A., Roncarolo, M.G., Naldini, L., “Gene therapy for ADA‐SCID, the first marketing approval of an ex vivo gene therapy in Europe: paving the road for the next generation of advanced therapy medicinal products”, EMBO molecular medicine. 9(6): 737-740, 2017.
19. Porter, D.L., Levine, B.L., Kalos, M., Bagg, A., June, C.H., "Chimeric antigen receptor–modified T cells in chronic lymphoid leukemia", N engl j Med, 365: 725-733, 2011.
20. https://www.nice.org.uk/guidance/TA567, (Access year: 2023).
21. Marshall, M., Shah, R., Stokes-Lampard, H., "Online consulting in general practice: making the move from disruptive innovation to mainstream service", Bmj, 360, 2018.
22. Farr, M., Banks, J., Edwards, H. B., Northstone, K., Bernard, E., Salisbury, C., Horwood, J., "Implementing online consultations in primary care: a mixedmethod evaluation extending normalisation process theory through service coproduction", BMJ open. 8(3): e019966, 2018.
23. NHS England, General Practice Forward View, NHS England www.england.nhs.uk/gp/gpfv/. (Access year: 2023).
24. Korkmaz, S., Hoşman, İ., "Sağlık sektöründe tele-tıp uygulamaları: tele-tıp uygulama boyutlarını içeren bir araştırma". Uluslararası Sağlık Yönetimi ve Stratejileri Araştırma Dergisi. 4:251-263, 2018.
25. Pourman, A., Ghassemi, M., Sumon, K., Amini, S.B., Hood, C., Sikka, N., "Lack of telemedicine training in academic medicine: are we preparing the next generation?" Telemed e-Health. 27(1):62-7, 2021.
26. Lesher, A.P., Shah, S.R. "Telemedicine in the perioperative experience", Semin Pediatr Surg.27(2):102-6, 2018.
27. World Health Organization. "Medical devices: managing the mismatch: an outcome of the priority medical devices project". Geneva. 2010.
28. Wilson, L.S., Maeder, A.J. "Recent directions in telemedicine: review of trends in research and practice", Healthcare Informatics Res. 21(4):213, 2015.
29. Swiatek, P.R., Weiner, J.A., Johnson, D.J., Louie, P.K., McCarthy, M.H., Harada, G.K., "COVID-19 and the rise of virtual medicine in spine surgery: a worldwide study", Eur Spine J. 30(8):2133-42, 2021.
30. Villa, A., Sankar, V., Shazib, M.A., Ramos, D., Veluppillai, P., Wu, A., Shiboski, C., "Patient and providers’ satisfaction with tele (oral) medicine during the COVID-19 pandemic", Oral Dis. 10.1111, 2020.
31. Pazar, B., Taştan, S., İyigun, E., "Roles of nurses in tele-health services", Bakirkoy Tip Dergisi (Medical J Bakirkoy). 5(1):201, 2015.
32. Sana, F., Isselbacher, E.M., Singh, J.P., Heist, E.K., Pathik, B., Armoundas, A.A., "Wearable devices for ambulatory cardiac monitoring: JACC state-of-the-art review", J Am Col Cardiol.75(13):1582-92, 2020.
33. Demirci, Ş.,"Sağlık hizmetlerinde sanal gerçeklik teknolojileri", İnönü Üniversitesi Sağlık Hizmetleri Meslek Yüksekokulu Dergisi. 6(1): 35-46, 2018.
34. Lewy, H., "Wearable technologies – future challenges for implementation in healthcare services", Healthcare Technology Letters. 2(1): 2-5, 2015.
35. Garg, S.K., Liljenquist, D., Bode, B., Christiansen, M.P., Bailey, T.S., Brazg, R.L., Denham, D.S., Chang, A.R., Akturk, H.K., Dehennis, A., Tweden, K.S., Kaufman, F.R., “Evaluation of Accuracy and Safety of the Next-Generation Up to 180-Day Long-Term Implantable Eversense Continuous Glucose Monitoring System: The PROMISE Study”, Diabetes Technol Ther, 24(2):84-92, 2022.
36. De Miguel, K., Brunete, A., Hernando, M., Gambao, E., "Home camerabased fall detection system for the elderly", Sensors. 17(12): 2864, 2017.
37. Majumder, S., Mondal, T., Deen, M.J., “Wearable Sensors for Remote Health Monitoring”, Sensors (Basel). 17(1):130, 2017.
38. Aktan, M. E., Akdoğan, E., "Design and development of a mobile application for a robotic rehabilitation process: Diagnoconn", In 2017 IEEE 11th International Conference on Application of Information and Communication Technologies (AICT), 1-5: IEEE., 2017.
39. İleri, Y.Y., “Sağlık hizmetlerinde nesnelerin interneti (NİT): avantajlar ve zorluklar,” The Journal of Academic Social Science. 6(67):159-171, 2018.
40. Xiang, G.Y., Zeng, Z., Shen, Y.J., “Present situation and development trend of China’s intelligent medical construction,” Chinese General Prac. 19(24): 2998– 3000, 2016.
41. Perera, C.C., Liu, H., Jayawardena, S., “The emerging Internet of Things marketplace from an industrial perspective: a survey”, IEEE Transactions on Emerging Topics in Computing. 3(4):585–598, 2015.
42. Tütüncü, D., Esen, M.F., “The use of Internet of Things in the management of epidemics: The case of COVID-19,” Sağlık Akademisyenleri Dergisi. 8(2):169- 177, 2021.
43. Xu, D.L., He, W., Li, S., “Internet of Things in industries: A survey”, IEEE Transactions on industrial informatics. 10(4): 2233-2243, 2014.
44. Segato, F., Masella, C., “Telemedicine Services: How to Make Them Last Overtime”, in Health Policy and Technology. 6: 268-278, 2017.
45. Yang, T.M., Gentile, C., Shen, F., Cheng, C.M., “Combining point-of-care diagnostic sand internet of medical things (IoMT) to combat the COVID-19 pandemic”, Diagnostics. 10(4): 224, 2020.
46. Fox, G., Connolly, R., “Mobile health technology adoption across generations: narrowing the digital divide”, Information Systems Journal. 28:995– 1019, 2018.
47. Nakamoto, S., "Bitcoin: A peer-to-peer electronic cash system", Decentralized Business Review. 21260, 2008.
48. Aktan, M.E., Akdoğan, E., "Development of an intelligent controller for robot-aided assessment and treatment guidance in physical medicine and rehabilitation", Turkish Journal of Electrical Engineering & Computer Sciences. 29(1): 403-420, 2021.
49. Lee, E.E., Torous, J., De Choudhury, M., Depp, C.A., Graham, S.A., Kim, H.C., & Jeste, D. V. "Artificial Intelligence for Mental Healthcare: Clinical Applications, Barriers, Facilitators, and Artificial Wisdom", Biological Psychiatry: Cognitive Neuroscience and Neuroimaging. 2021.
50. Aktan, M.E., Turhan Z., Dolu İ. "Attitudes and Perspectives towards the Preferences of Artificial Intelligence in Psychotherapy", Computers in Human Behavior, 164:1-18, 2022.
51. Gyles, C., "Robots in medicine", The Canadian Veterinary Journal. 60(8):819, 2019.
52. Akdoğan, E., Aktan, M.E., Koru, A.T., Arslan, M.S., Atlıhan, M., Kuran, B. "Hybrid impedance control of a robot manipulator for wrist and forearm rehabilitation: Performance analysis and clinical results", Mechatronics, 49: 77-91, 2018.
53. https://interestingengineering.com/15-medical-robots-that-are-changing-theworld, (Access year: 2023).
54. https://aabme.asme.org/posts/robot-assisted-surgery, (Accessed: 05.06.2023).
55. Dash, S., Shakyawar, S.K., Sharma, M., Kaushik, S., “Big data in healthcare: management, analysis and future prospects”, J Big Data, 6(54), 2019.
56. Zhu, L., Zheng, W.J., “Informatics, Data Science, and Artificial Intelligence”, JAMA, 320(11):1103–1104, 2018.