Liquid hospitals and the interconnected patient

The "liquid hospital" was just one futuristic concept unveiled at this year's World Health Care Congress in Amsterdam.

The institution in question is Hospital Sant Joan de Deu, a large paediatric hospital in Spain linked to a network of medical charity centres in the developing world. Its new name was created in a stream of consciousness: H for hospital, with Web 2.0, led to H2.0, then H2O - hence liquid hospital.

Jorge Juan Fernandez, e-health director, said the key to the "liquid hospital" concept was to integrate a wide range of technology channels into patient care including smartphones, the web, telemedicine, social networks, traditional phones, tablet computers, email and medical devices.

Patient web portals had been created tailored to specific conditions through which patients or their parents can access a limited version of their electronic health record including test results and reports (but not doctors' notes, as well as health information and online consultation tools.

For some this was combined with telemonitoring at home, with glucometer readings for diabetics for example output to nurses. The plan was to use this to move from four to three outpatient appointments a year for these patients, a clear cost saving, Fernandez said.

Other technologies used included use of social media to send health information to families; webcasting for nurse training; and smartphone apps for uses between professionals; between professionals and patients; and even from patient to patient, Fernandez said. The focus is on developing apps that do not need to integrate with the hospitals' own back-end systems, he said, as this tended to cause long delays.

Key themes of the project include to encourage open conversation with patients; listen to what they say; and to be transparent and publish all feedback, Fernandez said.

Delegates seemed impressed at the range of projects underway at the liquid hospital, though one said afterwards the approach seemed a bit scattergun: "they will have to show that the use of all these systems are improving patient care."

The developments were not the most futuristic to be discussed in Amsterdam, however. Bill Boyles, Director of the Global Business Forum on Health, said artificial intelligence techniques are already mining medical research and live data to make new discoveries even before any specific research had been done, or any human had even posited a theory.

A system like this in use by the US hospital and care group Kaiser Permanante, for example, detected a link between women with uterine cancer and the babies they delivered having high levels of asthma, he said, "something that was not even hypothesised."

Ubiquitous internet will also drive a move towards "completely interconnected patients and doctors", said Boyles, whereby lab tests are sent to doctors and patients at the same time. There will also be an explosion of home self-monitoring and testing, on devices which patients will buy for themselves: "Within two or three years, 20 major tests will be available for patients to test themselves, and this will feed into the system - biomonitoring in the cloud."

There was a catch however: some of these systems may prove costly and may not become available to all citizens equally. "Even though this system will eventually come about, it will only apply to a percentage of the patient population," Boyles said. For the NHS, therefore, the future may still be some way off.