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Long queues, patients running late, echoing coughs, sneezes and wheezes. It’s no wonder that more people are longing for a quicker, efficient and easier method of meeting doctors, which involves not having to get out of bed, let alone your house, in the morning of the cold winter months. Digital health and telemedicine consist of using remote communication such as video calling and remote monitoring, allowing doctors and patients to play a rally of tennis of questions and answers to form a diagnosis, and it may be the answer many are looking for.
In the NHS, digital medicine monitors the health of individuals, picking up readings of SPO2, blood pressure and pulse. Having a means of telemedicine is helpful in treating health problems when monitoring and looking after frail patients, without having to constantly have a health care professional near the bedside of a patient, freeing them up to do other important tasks.
In America, telemedicine was developed almost 70 years ago, where hospitals, shared information by telephone. However, the real origin of telemedicine was in Europe by the Dutch doctor, Willem Einthoven, who transferred ECGs and other data, across great areas, via radios in 1905, which was followed by Italy, Norway, and France during the early 20th century. Digital health is also used by many GPs, where they conduct telephone consultations, to evaluate the health problems through questioning symptoms and accordingly prescribing the relevant medication or arrange further appointments.
Several advantages come into perspective when discussing digital health, Appointments can be booked instantaneously, at times suited to patients, allowing for increased accessibility. According to some surveys, 51.8 % of people believed that telemedicine is more convenient and 35.3% would rather they have a virtual appointment than an in-person one. This reduces waiting times, but also reduces gaps between booking and being seen, which has been a grave problem in the NHS, due to the lack of doctors being free to see patients.
Patient ease is a fundamental part of digital health also, where patients can record appointments through an app, and the clinical records can be viewed to remind patients of doctors’ advice and medication which may be needed to be taken. Furthermore, there is a development of apps which use algorithms access symptoms through asking questions specific questions and can direct a patient to health professionals in needed or provide specific advice. This is helpful terms of having remote access to information in unsociable hours. This, therefore, means that people are less likely to come into A&E for non-serious problems, freeing up doctors and other healthcare professionals to address more serious or unstable patients. Furthermore, having a quicker diagnosis allows the medicine to be prescribed quicker. It allows for direct communication between doctors and patients, developing rapports, which may allow patients to feel comfortable and provide further details making a better diagnosis. The NHS already uses the 111 non-emergency helplines which are available 24/7, which has been able to help people in giving them professional guidance without having to go to A&E. 353,000 calls were received in the first year of launch, showing its success, and through having apps, this could be further reinforced.
Another advantage is the finances. Approximately, twelve million GP appointments are missed annually, causing losses of around £162 million. Moreover, outpatient clinic appointments cost the NHS £745.2 million, and the loss is not just financial. They cause further delays and can impact other patient’s health as well in terms of being seen quickly. Despite methods of text/email reminders contributing to a decrease in missed appointments, having access to digital health is more convenient and people are less likely to miss appointments if they are scheduled to a specific time which is convenient to them. Having money channelled elsewhere from cancelled appointments can strengthen other sectors of the NHS, such as in wards, which are understaffed.
Technology which is already present using digital monitoring and medicine has allowed for patients to become more independent with their health problems. An example of this is the recent introduction of blood glucose patches which, can monitor blood glucose levels, without having to prick every so often. It has allowed for people to monitor their type 1 diabetes more closely, as it apps on patient’s phones can show the levels of blood glucose and prompt them when they need to inject. Furthering this idea, insulin pumps have allowed individuals to regulate their diabetes without constantly having to check as the pump detects and injects accordingly. This piece of technology has allowed for many people to manage their ailment in a better and more controlled manner.
Other uses for health information are apps which track the amount of exercise a person does, through ‘wearable’ technology. Smart watches have allowed people to become healthier as they become more aware of themselves, and this wearable technology can be further developed in medicine from diagnosing heart problems to brain damage. This technology allows for the idea of personalised medicine to be further developed and ensures that patients get the best care possible, whilst working on preventative medicine also. However, telemedicine can become a problem for several reasons. For example, life-threatening disorders may be misdiagnosed, which can cause prescription of incorrect medication, being severely dangerous. People with non-life-threatening ailments may be diagnosed with higher severity problems, causing stress and difficulty in a person’s life, which increases psychological problems. Moreover, having only access to telemedicine may mean that check-ups are not conducted correctly, as the symptoms and signs seen by doctors can impact diagnosis, and may also be dangerous. More medical mistakes can occur which can affect negatively the patients and the doctors. Doctors judgement comes from years of experience and telemedicine cannot fully replace it. Despite having ease in communication, issues of connection, mishearing/misunderstanding may cause complications in translating between doctor and patient. Another problem is that doctors in training will lack in a hands-on experience during GP medical placements, making medical professionals less experienced, and therefore impacting the further generation of doctors. Additionally, patients not seeing actual doctors in their diagnosis and healthcare problems may feel overlooked because of how the methods lack in the human touch and empathy that is present when actual doctors and present.
Moreover, digital health cannot be used for emergencies for example when a person is suffering from a stroke or heart attack, they will still have to resort to direct treatment; these are times where medicine cannot be replaced by remote access. Another disadvantage, is that full confidentiality may not be met, due to the fact that conversations may be overheard by people in the
surrounding area, and having this can be uncomfortable, thus patients would prefer going to GP appointments in a designated setting. 56% in a study said they would be uncomfortable during an appointment via a smart device. Furthermore, cybercrime may increase making people warier in presenting intimate problems.
Patients may feel that data is not protected and can fall in the wrong hands and therefore they feel more vulnerable. Lastly, telemedicine also requires internet/mobile connection, which is abundant in the UK, however in developing countries, this still may be an issue. Telemedicine reduces costs, however, what is the point if not everyone can access it? This jeopardises patients’ health, as having access to a doctor may be more difficult as the
number of patients per doctor is already high. Access to healthcare in low-income countries already is difficult, so it may be unnecessary to complicate things by digital healthcare.
Despite digital healthcare reducing waiting times and providing an instantaneous personalised experience, the disadvantages and problems mean that telemedicine and digital health need to be further polished for widespread use. The possibilities and the already great impact that telemedicine has made is remarkable and countless lives have been changed and saved, but it is important to understand that is risking someone’s wellbeing does not outweigh cutting costs, timing and avoiding the mid-winter rush.Bashshur, R. and Shannon, G. (2010). History of Telemedicine.
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