The Paradox of TeleMedicine in Pandemia – beyond the buzzword, an (un)expected reality

TeleMedicine in Pandemia

There have been many expectations towards telemedicine during the last few months. While sanitary measures were rapidly put in place to decrease the spread of the disease, a suitable solution had yet to be found to ensure that sick patients would not be denied access to primary care in the pursuit of containing the epidemic. Telemedicine was expected to address this concern and make it possible for everyone to get medical help in this time of crisis. Is this really what happened though?

TeleMedicine in Pandemia: expectations vs. reality

At the edge of the second wave of the disease, the question as to whether our reality caught up with our expectations is now more relevant than ever. That is, can we say today that telemedicine has made its way to address burning needs arising from current and forthcoming lockdowns and contact minimization policies? While the adoption of tele-solutions has grown significantly in many areas, the same seems still hard to say for the healthcare sector. In Switzerland, particularly, telemedicine appears to be more of a hard pill to swallow than a widely accepted solution.

This reluctance to adopt telehealth innovations at a time of increasing need for medical care and help raises concerns at many levels. In April 2020, cardiologists were already warning about a decrease in consultations for heart disease. In their opinion, it wasn’t that there were less sick patients in this regard, but rather that these patients stayed home due to a confusion with covid symptoms or by fear of going to a hospital. At the same time, care facilities were often advising people with possible covid-related symptoms to stay put in quarantine. For people experiencing a mental health worry, accessing medical support in-person became equally far less straightforward. “So where can people find the trusted help they need?”

TeleMedicine in Pandemia: why the low-rate adoption?

If arguments referring to the complexities of remote consultations were valid at a normal time, they seem hardly convincing when they imply to deny access to primary care during a pandemic crisis. More than ever, we need to push through our fear of change and find solutions that not only “restrict” but are also supportive of the people who need it the most. For example, countries like Germany found a way to recognize “apps on prescription” and to procure doctors and insurers with an up-to-date legislative framework to foster the adoption of digital health solutions. Is this what we lack in Switzerland to make telemedicine a reality?

Either way, given the current situation, to not embrace technology enabled solutions might no longer be an option. Especially considering that adopting telemedicine could help the system absorb the increasing demand for medical help so that more patients can have access to proper treatments, whether in physical, 1-1 consultation or from the comfort of their home. For patients with chronic disease, it could even be life changing. A recent example is the HeartKinetics cardiac monitoring solution that allows patients to easily monitor the cardiac function from home in less than 2 minutes, saving time travelling to the hospital and receiving more frequent analysis.

However, despite all the benefits that such a solution might represent, the low-rate adoption still appears to persist and telemedicine itself  seems to be still perceived as limited in a number of aspects. 

“Collecting information with existing tools and helping patients when they are not physically present is common practice. During the pandemic patients would not come to the office for good or bad reasons, and more often mail photos and call for advice. This actually did grow TeleMedecine while requiring as usual accurate documentation in the existing electronic system. Why then move fast forward to engage with new applications which claim to enable better TeleMedecine? The digital transformation is an engine of economic growth. But at the scale of a general medicine practice for it to be of benefit, there must be incentives that engage the “hearts and minds” of physicians. Two hurdles remain: first, real integration of the single problem solutions, who actually match only part of the many specific needs. Second, to go beyond the digital transformation will always require a humane personal relationship even without the patient being present.”  Pietro Scalfaro, Pediatrician.

TeleMedicine in Pandemia: the privacy dilemma

Another concern that seems to contribute to the reluctance of adopting telemedicine to face the epidemic is the privacy dilemma. While technologies are certainly recognized as a valid solution in the fight against the virus, many say that privacy is a main concern. Still, solutions exist. Since the pandemia, a lot of efforts have been invested into finding privacy-preserving solutions. For example, we at Pryv made our solution available in OpenSource so that anyone can benefit from a free, privacy-by-design, swiss-made software solution on top of which they can rapidly create and build their own digital applications.

In parallel, telemedicine providers like Umana, DTHX, Riva Digital, HeartKinetics provide doctors, patients and care facilities with ready-to-use, proven telehealth solutions, having privacy at their core. Together with our partners Dreamix, Pryv is also working on a new set of module components which will allow any provider willing to launch telemedicine and digital health solutions to be ready to go to market within a few days/weeks only from the start of the project, choosing the components that they need the most while embedding a strong solution for patient consent and privacy-by-design.

Maybe now is the time to turn our expectations into a reality?

Yours,

Stephanie & Evelina

Sources:

https://www.swissinfo.ch/eng/coronavirus–a-turning-point-for-telehealth-in-switzerland/45870678

https://www.rts.ch/info/suisse/11230872-les-patients-noncovid-desertent-les-urgences-inquietude-des-medecins.html

https://www.thehtn.co.uk/2020/10/14/htn-voice-mental-health-apps-must-win-trust-in-how-they-use-data-if-they-are-to-achieve-potential/

About Pryv SA:

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Pryv.io is a solid foundation on which you build your own digital health solution, so you can collect, store, share and rightfully use personal data. It comes with must-have consent and auditing tools to keep you compliant with existing and forthcoming regulations. The software has been developed to accommodate rapid integration, allowing you to properly manage your users’ data from day one. It comes with turnkey IoT connectivity, a secure storage vault, fine-grained consent management, and comprehensive auditing capability that radically cut IT risk, development costs and accelerate time-to-benefit while addressing the GDPR and the most stringent data protection requirements.