Hello once again! 

One of the buzz words often quoted and sought for in the current noise of industrial transformation is ‘Eco-Systems’. Generally, it means a complex network or interconnected system. Reflecting back the first memory I have of a connected system is the conveyor belt assembly line in car manufacturing, with machines doing all the repetitive tasks with far greater efficiency and consistency than a manual model. There is a huge scope to reduce variation, improve performance and productivity by mapping the same model onto healthcare. 

Having set up, a consultancy in advising on health ecosystems[1], I often get asked, what does a SMART health ecosystem look like? By SMART, generally the inference is, something that reduces wastage, is value for money, has user-friendly operations, gives good stakeholder experience, is sustainable and scalable.

One could argue these are the LEAN objectives in project management. The thing that really is my area of interest is how we embed relevant disruptive technologies within a SMART model of health ecosystem. Being a clinician with a “digital antenna” to forecast what solution matches which need, I feel there is an advantage in being able to develop a working map of the system. There are two ways of developing such a map. The starting point can be one of the following two options in my experience. The first option starts from a population health need and the second is around the prevalent health need or disease entity.

There are many subsequent steps involved in developing the model further, however, the key factor that ensures its success to have an educational arm embedded within it. Some very good examples of SMART solutions have been quoted in a recent publication by the European Rural Development organization under “Digital and Social Development in Rural Services”[2].

Being a gynecologist, I have picked the one which includes an uro-gynecological issue, especially for elderly patients. It’s named as IMPROVE and is an e-health project about “involving the community to co-produce public services” that enhances services for the elderly through smart homecare in Västernorrland, Sweden. The project, supported under the EU’s Interreg programme, used an open innovation or ‘living lab’ approach to tailor a sustainable public service solution for homecare in peripheral and sparsely populated areas. IMPROVE began by selecting a network of ‘local champions’ to identify four priority areas for e-health services: keyless homecare; cameras for night-time monitoring; sensors for incontinence management; and remote patient care planning.

The IMPROVE project addressed the problem of incontinence, which is not uncommon among its elderly clients by the use of a sensory device that detects urination patterns and allows individual plans to be drawn up. The project’s system tracks patterns over a 72-hour assessment period and its accurate data, superior to manual recordings, enables caregivers to make more informed decisions for their individual patients. Patient care was further improved through the use of technologies, which could be SMART apps with VIRTUAL NURSES that allow carers to engage with their clients remotely. 

Such care results in time and travel savings – benefitting both the patient and the care provider. They have plans to roll out of remote care on a larger scale, including at the local hospital. I can see this solution being part of a major rural health ecosystem in many places. Within the urban setting, there are places mimicking rural setup. 

I think I have given enough to think about until the next time,

Clicking off,


[1]NSK Health Ecosystems Ltd. [email protected]


Author Bio

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Naila is a senior clinician affiliated with the NHS for almost 26 years. Her career has evolved not only in her specialty (Gynaecology) but also in medical education, patient safety and informatics in healthcare. She has held several senior leadership posts such as Associate Dean London Deanery, Associate Director for Medical Education and Lead for OBGYN undergraduate course at Imperial College. She is a champion for embracing technology in the delivery of high standards of healthcare and is a frequent speaker on disruptive technologies and their place in futuristic healthcare. Recently she was interviewed by HIMMS TV at the UK eHealth week, where she delivered two talks which were very well received.