A few weeks ago, doctors called telemedicine the “medicine of the future,” but the COVID-19 crisis has brought it in from the margins.
Rabat – A few months ago, someone with COVID-19 sneezed in China, and now, you cannot take the train to Marrakech, attend a football match, get a haircut, or visit your friends across town.
This is the downside of living in a connected world. Because of relatively inexpensive air travel, health problems in one part of the world become problems in Morocco, too.
As governments responded to the coronavirus, new ways of work, education, and medicine came to the forefront. The COVID-19 pandemic stretched the world in ways no one even thought possible and in ways totally unanticipated. It has caused companies to send employees home to work from their dining tables and has sent students to watch television and use websites like Facebook and Zoom for their lessons.
The pandemic has also raised many questions about ways to do health care.
In some areas of the world, telemedicine has come to the lead as a means of disease identification and outline of care. This has caused many in public, private, and government circles to ask, “What exactly is telemedicine?”
A few weeks ago, doctors called telemedicine the “medicine of the future,” but the COVID-19 crisis has brought it in from the margins as a better, quicker, and safer way of diagnosis and ultimately better health management.
A decade of change in one week
Recently, the New York Times European edition quoted Dr. Sam Wessely, a general practitioner in London, saying, “We’re basically witnessing 10 years of change in one week.” He continued, “It used to be that 95 percent of patient contact was face-to-face: You go to see your doctor, as it has been for decades, centuries. But that has changed completely.”
From medical emergencies to ordinary exams, telemedicine is overcoming barriers to healthcare all over the world, and Morocco especially could put it to good use. In addition to reducing costs and improving outcomes, virtual health can bring advanced care to under-served patients while relieving overworked providers. Telemedicine is an exciting and evolving technology.
Perhaps the best definition comes from the Center for Connected Health Policy, describing telehealth as “a collection of means or methods for enhancing health care, public health, and health education delivery and support using telecommunications technologies.”
The key word is “enhance,” because telemedicine is a tool that makes the work of physicians, nurses, technicians, and staff easier, faster, and more efficient. And in many ways it makes health consultations convenient for the provider as well as the patient.
Today you might hear people use the words telemedicine, digital healthcare, virtual healthcare, and telehealth interchangeably to encompass a wide range of diagnosis, management, and educational benefits. This is part of the upside of our connected 21st-century world: Using technology to enhance diagnosis and treatment.
Examples of telecommunication technologies include telephones, secure e-mail/messaging, the internet, and audio-visual conferencing. There are several modalities for telemedicine, each carrying different assets in health care and management but all focusing on prevention and wellness, which is the foundation for improved patient outcomes.
All telemedicine is not the same
There are four commonly accepted domains of telehealth delivery and application.
Perhaps most common awareness of telehealth is the “live video” or synchronous telemedicine. Synchronous telehealth uses audio-visual telecommunication between a provider and a patient or caregiver in “real-time” as a substitute for an in-person encounter. It is a Skype, FaceTime, or Zoom call using basic telephone cameras and computers to chat with the physician.
The second form of tele-healthcare is “store-and-forward” or asynchronous delivery. This involves sending recorded health history on a secure platform (such as an encrypted email) to a practitioner who evaluates the information to give services outside of real-time interaction. Specialists and clinicians also use asynchronous delivery for consultations.
The third modality, known as remote patient monitoring (RPM), is where a patient’s medical data is collected and securely sent to a provider in a different location to develop or change a plan of care. Although RPM can use technologically advanced hardware, it is not needed.
More subtle low-tech (and often disregarded) forms of RPM include a patient using a blood pressure cuff at home and logging daily values, which providers collect from the patient via phone call or secure e-mail. Providers use the data to adjust blood pressure medication regimens without the patient actually coming into the doctor’s office.
This also works collecting data from the patient with a home glucometer for insulin regimen adjustments or oral antidiabetic agent changes.
Of course, remote patient monitoring requires the on-going cooperation of the patient and the office staff.
Lastly, mobile health (mHealth) combines healthcare services and mobile technology such as smart phones, tablets, and wearables. This form of telehealth relies on mobile apps for integration and provides real-time information.
While simple video calls can handle a range of issues quickly and efficiently, it is no longer necessary for doctors to diagnose patients using only the symptoms they report. Integrated and interactive devices can deliver an evidence-based consultation and securely send medical information such as lab results, x-rays, videos, or MRIs for evaluation.
Doctors can also monitor chronically ill patients at home by remotely collecting data like blood pressure, blood sugar, heart rate, weight, or oxygen levels.
Moving telemedicine upstream
Nobel Prize winner Desmond Tutu once said, “There comes a point where we need to stop just pulling people out of the river. We need to go upstream and find out why they’re falling in.” This is where early telemedicine diagnosis, prescribed treatment, and digital monitoring move the diagnosis “upstream.”
Old strategies have not worked; it is time for new approaches that put modern technology to its most valuable use.
In Morocco, both public sector and private sector healthcare can improve through greater use of telemedicine. Through various levels of telemedicine, the Ministry of Health can lighten the workload of doctors and at the same time extend care to under-served areas of society.
Using skilled remote doctors throughout the country, Morocco could implement telemedicine by putting mHealth clinics and mobile teams in place almost overnight. Trained nurses and technicians with digital infrastructures can be in place anywhere in Morocco where there is a 3G mobile phone connection.
One of the most important benefits of telehealth is it can help reduce the need for in-clinic appointments, improving access to care for patients. Not only that, but allowing less critical patients to get care with telehealth visits opens up space for more complex patients to see a doctor with less delay.
With a low barrier to entry and minimal learning curve, telemedicine offers every provider a road to more effective medicine.
Telehealth can remove common obstacles patients have such as the need to find rides to the clinic, babysitters, time off work, or extra cash to travel for specialist appointments. It can eliminate the need for in-clinic follow-up for stable patients.
For example, if a patient has been tracking his home blood pressure levels, and the levels are satisfactory for the doctor, the patient can accomplish his three-month follow-up for medication refills over the phone. This, in turn, limits patient exposure to communicable diseases in crowded waiting areas: No travel and no waiting.
Virtual interaction increases opportunities for patient teaching, health coaching, and motivational interviews. Telemedicine provides more opportunities to address patient concerns, questions, and barriers. Telehealth can improve patient satisfaction, and the additional telephonic outreach increases patient-provider interaction, giving patients a sense of provider investment in their overall health and wellbeing.
More connections with patients lead to better outcomes.
Telehealth can also provide opportunities for clinical research and can assist with physician shortages.
In regards to staffing a clinic, telehealth can remove limitations on employment, increasing staff quality and allowing administrators to fill positions quicker.
It is just a matter of getting started.
The views expressed in this article are the author’s own and do not necessarily reflect Morocco World News’ editorial views.
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