Hi I’m Dr. Bertalan Meskó, The Medical Futurist.
If you hope to return to the good old days
of seeing your doctor in person with every minor problem, I have bad news for you: forget
about it. Today I want to address how COVID 19 changed the way we relate to healthcare,
and how this shift actually accelerated the digital health revolution. Let’s talk about
the new norm, remote care.
Before COVID-19 hit, regulatory concerns, patient privacy, and the question of how to
compensate doctors all stood in the way of remote care going mainstream. Even though
all of the technology needed, has been here for
a while…
Even a full century ago, people were dreaming about remote care. At the dawn of the radio
age, in 1925, Hugo Gernsback, a German technologist invented the concept of the “teledactyl”
that would allow doctors to not only see their patients through a viewscreen but also touch
them from miles away with spindly robot arms. As Gernsback explained it, the device would
have made it possible to “feel at a distance”. It’s futuristic even by today’s standards,
right?
In 1989, the life of a heart patient who had stopped breathing was saved through the use
of a device that delivered an electric shock over the telephone. And today, we already
have the technology to provide live interaction with remotely-based doctors and equipment,
for ambulance teams on the field team or en route to the hospital.
So, when COVID-19 disrupted entire healthcare
systems, medical professionals had only two choices; one, providing care remotely, or
two; not providing care at all. The pandemic forced health networks to rehash their telemedicine
concepts. Not only that: in order to protect medical professionals from the exposure to
infections, the need for remote technologies skyrocketed. If you needed to go to your physician
over the past weeks, first you had to call in and describe your symptoms. And isn’t
this the first step of remote care?!
But hospitals and some governments went beyond that.
Take the case of Catalonia. This Spanish region
has always been one of the frontrunners of digital health technologies. Here, health
information has been handled electronically since the 90’s. They integrated data from
mobile apps and devices into their Digital Health Platform years ago. And although Spain
was one of the hardest hit countries during the pandemic, Catalonia was able to act fast.
To put it in numbers, in January of 2020, there were 18 thousand teleconsultations in
the region, by April it was near a hundred thousand. At the same time face to face consultation
went from a 150 thousand, all the way down to 22 thousand. They were ready not just technologically,
but more importantly, they were ready due to their medical education. By the time COVID
19 hit, they already embraced digital health.
As I’ve said many times, the digital health revolution is not only a matter of technology.
It is a cultural transformation. And disruptive technologies cannot bring change on their
own. Take a look at telehealth. We had everything needed for this kind of remote care, but we
were stuck with this old mindset that we needed to personally visit our healthcare providers
with every minor problem we had. The COVID 19 crisis pushed us to change this mindset,
and we finally took a seemingly small, but in reality, a gigantic step towards more efficient
healthcare systems.
It’s easy to see these call-ins as a bandage during the time of crisis, but the WHO says
there are more than 5 million healthcare professionals currently missing from healthcare systems
worldwide. And you don’t need to be a futurist to realize that this number is only going
to get higher. As more people get access to healthcare, and as we get better at diagnosing
them, the number of chronic patients will continue to rise. At the same time we physically
cannot train as many medical professionals as we need.
Therefore this gap is getting wider, and we have to find a way of filling it. Telehealth
is a way of doing that. We could do it with chatbots and AI, but a real doctor-patient
conversation is still a more compassionate solution. So in a way, for these overburdened
healthcare systems, at least some of the effects of the pandemic were blessings in disguise.
Otherwise, it would’ve been years before
practitioners adopt the way of providing care without necessarily seeing patients face-to-face.
Due to COVID-19, people who work in healthcare, or engage with it these days, are now realizing
how to leverage the tools that have already been available for over a decade. And just
like that, almost overnight, remote care has become the new norm.
That is certainly true when it comes to non
hospitalised patients with COVID-19. Remote care alleviated a lot of hospital space, as
most of the COVID-19 positive patients were able to be discharged to self isolation, and
were followed-up through a secure online platform.
Honestly, the only question is: why haven’t we used all this before?
But even health experts were surprised when
they saw the gigantic surge in the numbers of telehealth usage. In 2019, only one in
10 patients used telehealth options in the US. In 2020? Some providers reported a 650%
growth! And overall satisfaction rate was close to 90% too. And by now, remote care
feels just like remote work does: a no-brainer.
But the pandemic didn’t just fasten up the digital health revolution. It’s actually
making its core promise a reality. Telemedicine is the first step of seeing house calls return,
and to shift the point of care from the hospitals back to wherever the patients are. And even
in the case of drug delivery, there’s a tangible shift in how we approach it. For
example, during a pandemic, high danger demographics shouldn’t have to go to drug stores, where
they are even more likely to be exposed to sick people. And in Florida, there’s a digital
health solution for that too.
To keep that Florida retirement community safe, drones will deliver drugs from a nearby
CVS store to a safe pickup location. And it will all come back around as it further alleviates
overburdened hospitals. It’s only sad that we needed a crisis like this to reexamine
the efficiency of our healthcare systems, but at least we’re finally seeing the digital
health revolution being embraced.
And a bunch of other technologies support what telehealth promises. Electronic prescriptions
came hand in hand with teleconsultations, which allows your GP to send your prescriptions
electronically from their computer to your chosen pharmacy.
Since more and more people have smartphones
with 4G and 5G connection, we are able to get on a high quality videochat with our doctors.
We also have medical chatbots, to help us, if, for example we have a panic attack but
nobody to talk to. We also have portable diagnostic devices that doctors can take to you, so you
don’t have to commute to a hospital for a simple ultrasound test. Not to mention the
hundreds of medical apps, that can leverage the data of your health trackers and wearables.
And those who have health sensors can check their vital signs on a regular basis.
As of now, it’s not yet known how the pandemic will end, but what is certain is that masks,
social distancing and a general fear will most likely remain with us for quite a while.
We will also be less willing to go to the hospital or to see our GP personally, probably
for years to come. But in the meantime more and more people will have experiences with
telemedicine solutions and will stick to it. After all it’s fast, efficient, and everything
you need for it is in your pocket.
There is no doubt that even though it was the pandemic that proved the value of remote
care, in the long run, it will also demonstrate its effectiveness for managing chronic conditions,
follow up visits after surgeries, or to discuss diagnostic results in general.
And even in the post-pandemic world, when the need for remote care will not be as crucial
as it was, demand will remain high. Now we’re used to it, and there’s no going back. Patients
will not wait for hours to see a doctor. They’d rather stay at home and do chores while waiting
for the doctor online. And they won’t travel to a point of care if it’s in their pockets.
Overall, telemedicine is the only sustainable
method. In many cases, it’s definitely a better solution for both the patient and the
doctor. But obviously there will always be cases when patients will still need real doctors
to give answers to their questions and care for them. And doctors will have more time
on their hands, and will experience less burnout. Looks like a win-win situation, doesn’t
it?
So from the patient’s side, we have an obligation to embrace and use these new methods of engaging
with our healthcare providers, and from their end, they need to step out of their ivory
towers, and embrace these technologies, as we take the first steps into the age of medical
digitalization. Because make no mistake, behind telemedicine, there’s a flood of disruptive
solutions coming our way. So let's get used to it too.
Until then, discover what telemedical apps
and video consultation services your government, your healthcare provider, or your insurance
company recommends. Check them out, and be prepared, so you’ll know how to use them
when you actually need them.