Interview with Professor Vinesh Raja, Warwick Manufacturing Group

Published July 2010

eHealth is swiftly becoming a catch-all term for advances in health care practices that make use of electronic processes and communications. Professor Vinesh Raja is evangelistic about the multitude of benefits this could facilitate for the treatment of patients in the NHS. eHealth could not only make treatment more effective, provided in the home as opposed to in hospitals, but more importantly, enable patients to take more responsibility for their own recovery. Behaviour change can be a significant barrier challenging doctors' ability to effectively treat a patient. Giving the individuals the knowledge and tools to monitor their own condition can be an influential factor in them making the necessary lifestyle changes.

Giving the individuals the knowledge and tools to monitor their own condition can be an influential factor in them making the necessary lifestyle changes.

“Informatics is the foundation of efficiencies within the health care system or any business: without information you cannot make sound judgements. Patients records are so important. If you go to your optician they have no way of knowing that you have diabetes unless they ask the question and you tell them. This potential breakdown in communication can cause havoc. We need an integrated system. I am not talking one database here but a distributed system.” Prof Raja is painfully aware of the acute anxiety that is induced by talk of digitalising medical records: “Every time we talk about electronic data privacy issues crop up. Of course there is risk - we need a better authentication system. We need to learn lessons from credit card companies because the benefits could outweigh the risks. People are so frightened no one wants to try.”

Similar knee-jerk reactions are induced by talk of treating patients at home but when hospital beds are in hot demand there is a need to look for potential solutions. Technically it is possible for certain patients to be monitored remotely. Thinking needs to be done on how to make this experience equitable to face-to-face contact with nursing staff: “When patients are in hospital and a measurement is taken the patient can see that the results have been considered by medical staff. With out this reassurance that the results have been acknowledged, they feel anxious. We need to think about closing the loop in our systems. When the measurements have been received at the hospital there could be a message sent or a telephone call made to say: ‘Thanks Mrs Raja! Good work.’”

Whether or not this is the ideal situation, the question remains whether the NHS can afford to ignore such cost-efficient solutions. The NHS does not have endless resources and doctor’s time is an expensive commodity. There are technological challenges that still need to be overcome but in Prof Raja’s opinion there is no excuse not to drive these changes through: “We need to convince people why this is a good idea. Often introducing electronic processes has resulted in people being forced into it. This is bad consultation. When you have a good idea the biggest challenge is convincing others, but patients are warm to the idea of being treated at home - especially when visiting hospital for a brief consultation can take up a whole morning.”

When you have a good idea the biggest challenge is convincing others, but patients are warm to the idea of being treated at home...

Prof Raja’s team, The Informatics and Virtual Reality group, are also working on another problem modern times has created. Surgeons used to go through 33,000 hours of training; the EU working hours directive has meant that this training time now stands at 6,000. “How can we produce the same quality of surgeon on that amount of training?,“ Prof Raja asks. His team are developing a virtual surgery tool for young surgeons to practice on. The two key innovations required to make this tool functional are allowing the surgeons to see the interface in 3-D without wearing glasses and to give them the feel of the organ’s in the body: “If they are doing a surgery where the kidney is involved they need to be able to feel the kidney. A computer programmer doesn’t understand the properties of human anatomy however. How do we find out?” - the answer is to road test the programme with clinicians - “Each individual’s ability to sense is slightly differed so some are more satisfied than others. There is a lot of tos and fros. It can be very difficult.” They are also developing a virtual breast that offers the same functionality. This tool can then be configured differently for use as a training tool for doctors as well as giving individuals valuable practice in assessing themselves for breast cancer.

Collaborating with medical practitioners is the key to the successful development of both products. In the case of the virtual surgery tool they will use expert surgeons to provide a signature for operations that can then be used to assess how trainees are shaping up. They do this by measuring the distance that the tools are moved during the operation: “Trainee surgeons move the tools around more inside the bodies which increases the risk of doing damage. Their signature covers a longer distance. This information means that we can offer target training specific to the individual’s needs.” Prof Raja cannot guarantee that 6,000 hours on the virtual tool compares with 33,000 hours of real-life experience but given the restrictions in hours, these technologies could prove fundamental in maintaining the calibre of surgeons in the health system.

Before joining WMG as a Professorial Fellow, Professor Raja spent 12 years in industry, in the machine tool trade and then as an IT consultant to Rover Group. He is also in charge of the Object Technology Centre, the Computer Integrated Manufacturing Centre, the Reverse Engineering Centre, the Virtual Reality Centre and the leading internet-based knowledge portal, the Collaborative Product Commerce Centre. Professor Raja is a board member of Technology Application Network (TANET), a network of technology centres providing support for the introduction of new technology in engineering and manufacturing in the UK. In 1995 he spearheaded the creation of a Warwick-based Sun European Manufacturing Centre of Excellence in conjunction with the Sun Microsystems Computer Company.