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Chasing eHealth

Finding work or a partner through the Internet is no longer something risky, and online business transactions are no longer painful. The network has earned the trust of its users, despite of the existence of interested pressures or jokes that boycott the mesh. But to a world that moves for work, love and health, the time has come to introduce its fortress to the cyber assistance and to telemedicine. In the United States they have understood for a long time now the benefits of e-health. Europe struggles to follow its steps, whilst the United Nations urges the entire planet to change the chip.

Ànnia Monreal | 4 February 2010

Telemedicine Clinic

The European Health Telematics Association was created 10 years ago. Since then, several factors have been combined to convert e-health into a concept full of meanings, functions and benefits. On the one hand, technological development. On the other, increased life expectancy and the aging of Western societies (in 2025 the current rate of European pensioners will increase by 40%, according to the European Union). And this fast sum can be completed with the lack of professionals in certain medical specialties and the low costs of health care in developing countries.

E-health will be a priority in health policies of the European Union (EU) since the 1st December, as announced by Gérard Comyn on the 11^th November, Head of the Unit of Directorate of Information Technologies and Communication of the EU. There is no turning back. "Our health system has to change”, exclaims Josep Maria Colomé, coordinator of the clúster eSalud y eDependencia from i2cat Foundation. “We have a continuing increase in demand due to demographic change, technological improvements and the need for greater efficiency and effectiveness”, assures Alexander Böhmcker, executive director of the company Telemedicine Clinic

"E-health is the use of the information and communication technologies (ICT) for health and thus, for example, it treats patients, conducts research, educates students and monitors and controls diseases of public health”, defines the World Health Organisation (WHO). "It is the management of health and the dependence to improve the welfare of any person”, says Colomé. E-health basically takes shape through four forms of dialogue: specialist-specialist, specialist- general practitioner, health worker-patient and patient-patient. And in all cases the progress has come about every time more with greater speed and sophistication.

Along with the computerized records of patient data (something that most EU countries already have in place), are new ways to improve both efficiency and effectiveness of health care and social services. Norway, Sweden and Denmark have already implemented specific ICT infrastructure for their health systems. Eindhoven, Southampton, Bologna, Genoa, The Hague, Viladecans and the Balearic Islands are part of two pilot projects of the Tele Medicine Project, an initiative covered by the European Commission to promote ICT applied to health in urban areas. And similar proposals are multiplying around the world.

Telemedicine

Among the many faces of e-health, the protagonist is telemedicine. The health care systems of each country develop initiatives according to their needs, and this is where institutions come into play like the Fundación i2Cat or the company i2Cat Telemedicine Clinic. The first is in charge of providing the engineering made to measure, while the second offers its services, focusing on teleradiology.

IA database of each hospital will centralize information from a hardware connected to patient's biological sensorsThe high occupancy of beds and boxes in hospitals is favouring home medicine in certain cases. "Whether at home or in a residence, the future involves a hardware connected to biological sensors (measuring basic vital signs) of the patient whose information is centralized in the database of each hospital”, explains Josep Maria Colomé. And these devices will add "a computer system that automatically provides the information and instructions to the doctors”, he adds. A machine instead of a doctor? "No, it is not a diagnostic system", explains the expert, "but a foothold. The computer system will help the doctors make their decisions”.

The 60 radiologists working from home or from the Telemedicine Clinic offices in Barcelona, Birmingham or Sydney are the help of hundreds of colleagues in the United Kingdom, Sweden, Denmark and Spain. No white coat, without saturation or smell of sickness, on the contrary, comfortably sitting on anatomical chairs, in silence and half light, they dictate into the dual-screen computer at which they are working on, the diagnosis and the medical report of the more than 11,000 explorations they perform each month.

Starting point

"The number of tests increase from the image, but not that of radiologists capable of interpreting them”, sustains Böhmcker. Radiology is one of the most sought medical specialties in Europe. The result of this inverse rule of three was the launch of the Telemedicine Clinic in 2003. It currently has around fifty European customers, public and private centres, who in a timeframe of 24 hours return the diagnosis of patients receiving treatment in the UK, Sweden, Denmark and Spain.

Internet is critical for telemedicine. This requires heavy technological investments, not just to allow smooth movement and abundance of the data, but especially to guarantee confidentiality. "They have to be encrypt with the utmost security”, says the engineer of i2Cat. "Data protection is essential for us”, adds the CEO of Telemedicine Clinic. To this one can add the distrust of the citizen, although for Böhmcker "what the patient seeks is the best professional, wherever he is”.

The remote doctor is a formula that is conquering the Network. In the United States and United Kingdom, there are numerous websites that give users a direct route with specialists from the computer screen, mobile phone or landline. Clinics and hospitals around the world are also employing close communication with their patients, from web pages about certain conditions or blogs where they explain the daily on goings of the institution. Even devices like the iPhone have applications to control diabetes, heart rate or certain medications.

The information online has created informed patients, but there are many false and dangerous statements. "There is a lack of trustworthy information for the patient”, warns Josep Maria Colomé, although there are companies and organizations that are taking care to ensure the medical content that fill the Network.DELOCALISED HEALTHIn the global world hunting for the cheapest worker, delocalized medicine could not be an exception. "70% of the radiographies that are taken at night in the United States are diagnosed in India", Colomé points out. They make the most of the time difference (in the Asian country it is daytime) and it guarantees that the specialists are qualified professionals, but at a lower cost. Alexander Böhmcker also knows examples of north-south telemedicine, a solution which will continue to grow in the future.

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