Hospitals Everywhere with Telemedicine- ARTICLE GATE

 

Technology is transforming the healthcare industry, as it does every other industry. Technologies such as artificial intelligence, big data, internet of things, virtual and augmented reality open new horizons in the medical world. Telemedicine is one of the technologies that revolutionized the healthcare industry.

Telemedicine is the name given to healthcare professionals to examine, diagnose and treat patients remotely using communication technologies. Parallel to the development in communication technologies, this method, which has made great progress especially in the last 10 years, is starting to become an integral part of the health infrastructure.

Telemedicine primarily enables underprivileged people in developing countries and rural areas to benefit from health services. Considering that nearly half of the world's population cannot benefit from reliable and accessible health opportunities despite the developments in the field of health, the importance of telemedicine services becomes clearer.

Improves Quality of Life

The fact that today's internet generation wants to spend less time in hospitals, wants to reach the doctor from where he is instead of going to the doctor's feet, and wants to reach the health service immediately in case of emergency increases the importance of telemedicine applications. In this way, patients feel that their health is under their control. Follow-up of patients at their homes has reduced hospital visits in all areas from depression to heart diseases.

According to the data of the American Center for Disease Control and Prevention (CDC), 84 percent of the elderly population in the USA has been to the hospital at least once in the last year. These visits totaled 990.8 million. Telemedicine applications have proven to be beneficial in keeping chronic diseases such as diabetes and heart diseases under control in the past years, and increase the quality of life of the elderly who need to undergo regular control but do not give up on their independence.

In addition to increasing patient satisfaction, these initiatives will also create a significant saving opportunity for health institutions by reducing the number of patients who are hospitalized again and have to be hospitalized for long periods. Considering the projections that one-third of the population will have diabetes by 2030 and that the number of heart patients will triple from today's level, the amount of this savings increases even more.

65 Percent Reduction in Hospital Admissions

Within the scope of the telemedicine application, which was carried out in an area of ​​100,000 kilometers, mostly in rural areas and far from hospitals, in Northern Arizona, the number of hospital admissions was reduced by 65 percent, while saving $ 92,000 per patient. Thanks to telemedicine applications, doctors who can get opinions from other experts can find more time to evaluate the condition of patients.

It is calculated that 65 percent of interactions with hospitals in the USA in 2018 took place via mobile devices. According to research conducted in the USA by Spok, a company specializing in health communication solutions, 91 percent of doctors use mobile phones and medical applications when serving patients. 46 percent of the respondents state that these applications save time, and 40 percent say they save money. Hospitals and insurance companies move patient records to the cloud, allowing patients to access test results online 24/7. This saves money by reducing bureaucracy and paper usage.

First Telemedicine Application

The history of the idea of ​​telemedicine dates back to the invention of communication tools. An 1879 Lancet article wrote that the use of the telephone could reduce unnecessary office visits. Almost 100 years ago, in 1922, an American inventor named Hugo Gernsback talked about the idea of ​​​​the device he called “teledactyl”. Teledactyl would allow doctors to see patients far from a screen, treating them with robotic arms.

The first application that can be called telemedicine emerged in the 1950s when some hospitals in the USA began to share information and images over telephone lines. The first notable success in this area came when two hospitals in Pennsylvania succeeded in sharing X-ray images over telephone lines. This method, which was used in the early periods for doctors to consult specialists in other places, provided great benefits especially for patients in rural areas to reach specialist doctors.

Landed from Space to Earth

The first modern application of telemedicine began in the 1960s, with NASA sending humans into space. The health status of the astronauts was measured with devices on the spaceship, and the results were sent to doctors on earth by satellite technology. Deciding to bring this technology to the ground, NASA sent a minibus to Native American settlements in Arizona, which lacks health services. The measurements made in this minibus, which was equipped with X-ray and EKG devices, were transmitted to specialists via microwave and necessary treatments were recommended in this way.

With the Internet age, telemedicine services have also undergone a great transformation. The proliferation of smart devices and high-definition video transmission has created many new possibilities for both patients and doctors.

Research shows that telemedicine applications are at least as good as face-to-face examinations. Cochrane, a body that evaluates the clinical evidence of medical practices, revealed in the research conducted in 2015 that telemedicine applications are as successful as face-to-face examinations in areas such as heart diseases, stroke and blumia, and give better results than face-to-face examination in the control of diseases such as diabetes.

USA and Asia Leads

This method is quickly adopted by patients. According to the data, while the number of patients using telemedicine tools was 350,000 in 2013, it reached 7 million in 2018 with an increase of 19,000 percent in five years.

Telemedicine services are implemented to a certain extent in all countries of the world. The level of prevalence is determined by the technological infrastructure and legal regulations. The USA leads in this field. Asia Pacific is the second largest telemedicine market . Europe lags behind. This difference stems from the fact that the legal dimensions of telemedicine applications are not clearly defined. For this reason, the number of companies that have the opportunity to agree with the social security institutions of the countries is decreasing. There are also significant differences between countries in this area. While the UK and Switzerland, where private health insurance is common, support telemedicine solutions, the inability of social security systems to cover telemedicine expenses in Belgium and the Netherlands prevents this practice from becoming widespread.

The regions that should benefit most from telemedicine applications are developing countries that do not have adequate health services. For example, although Africa is home to 14 percent of the world's population, 24 percent of patients globally are located in this continent. Despite this, only 1% of the world's health expenditures occur in Africa. This problem becomes even more evident in rural areas, where there is only one doctor per 7,700 people.

However, despite the obvious advantages of telemedicine applications, high cost, lack of infrastructure and expertise prevent telemedicine applications from becoming widespread in developing countries.

For this reason, only 31 of the 248 countries in the world are making tangible progress in this area. However, important steps have been taken recently in countries such as Brazil, Cambodia, Ecuador, India, Nepal, the Philippines and South Africa.

For example, Nepal's Ministry of Health provides health services to 25 regions of the country from the telemedicine center established at Patan Hospital. The information of the patients who reach the specialists in the city of Patan with the video conference system is stored online on a portal.

In rural Cambodia, patients and doctors can receive opinions via email from volunteer experts at respected US universities. An open source communication technology called GeoChat is used for information exchange between health centers. The Malaria Consortium, on the other hand, informs other regions about emerging epidemics via SMS and ensures that measures are taken.

With the Mobile Surgery Program in Ecuador, doctors in rural areas can reach volunteer specialists 24 hours a day. As a result of interviews, patients who are determined to need surgery are operated in mobile operating rooms that come to rural areas. The post-treatment follow-up process is also carried out remotely with the Mobile Surgery Program.

Those who download applications such as Dokita and Doctor Gratis in Indonesia can access doctors for free whenever and wherever they want.

Patients Are Very Satisfied

According to the research, telemedicine also achieved very high scores in terms of patient satisfaction. The rates of those who benefited from telemedicine application to visit the doctor for later examination and emergency service applications were at a similar level with the patients who received a face-to-face examination.

Currently, the most common use of telemedicine is for patients to meet with doctors via video chat platforms. In this way, the patient can both explain his/her complaint to the doctor and show visible symptoms. In this way, doctors can diagnose patients or direct them to the necessary places.

But this is just the beginning. According to estimates, by 2025, the global telemedicine market will reach a size of 113.1 billion dollars and a new era will be opened in the field of health with brand new possibilities.

According to a study conducted by Reach Health in 2018, 45 percent of health professionals see telemedicine applications as a priority issue, and 86 percent plan to increase the quality of service by using telemedicine applications.

New Horizons Opening with Artificial Intelligence

The introduction of artificial intelligence takes telemedicine services one step further. New generation telemedicine systems not only collect data through a series of questions, but also interpret this data to create a comprehensive file about the patient. In this way, when the patient comes to the doctor, the doctor has already reached many necessary information and evaluations.

Experts do not only have to be content with what patients tell or the answers they give to questions. Wearable technologies and sensors measure all vital data of the patient and automatically transmit them to the screen of the video-interviewed specialist. It is even possible for the applications to directly warn the doctor in case the data deviates from the normal, without the patient needing to do anything.

Another development in this area was the modular laboratory sets used at home. Thanks to these sets, patients can make their own analyzes such as urine and blood tests and send them to specialists.

60 percent of healthcare organizations in the world already benefit from the savings and innovation opportunities offered by the Internet of Things. Administrators monitor the hospital occupancy rate instantly with smart sensors. Thanks to these tools, doctors can monitor the patient's condition in a healthier way after the operation and keep chronic diseases under control.

With the increase in companies investing in this field, robots equipped with screens, cameras and microphones have taken their place in homes. Smart patient beds equipped with sensors have also started to be used in hospitals and homes. The smart bed makes more than 100 measurements per minute and transmits the results to the doctors, and warns the officials about the measurements outside the normal values.

According to Statista data, as of March 2018, Apple's app store has 47,911 mobile health apps. Some of these apps require users to enter their own data. Others collect, store and transmit vital data themselves. In any case, thanks to such applications, individuals and specialists can access patients' health data from anywhere and anytime.

Big data and analysis systems, another big trend in the world of technology, enable data collected from patients to be analyzed over cloud systems. The analysis of the patient's medical history also warns experts on issues such as the risk of heart attack5. In this way, the automatic determination of risk factors for certain diseases allows doctors to make healthier diagnoses and recommend more appropriate treatments.

This process seems to lead to the emergence of virtual hospitals soon. Mercy Hospitals in the USA has taken the lead in this regard. At the center in the city of Missouri, the data compiled by the virtual medicine method of patients in four states are examined and the patients are treated where they are.

Three-dimensional printers are another factor that increases the possibilities offered by telemedicine. For example, it will be possible to transfer the data of a patient living far from full-fledged hospitals and in need of a prosthesis to specialists through telemedicine, to make the necessary prosthesis with three-dimensional printers in line with these data, and to attach it to the patient where he is.

These practices bring with them some risks as well as many advantages. The collection of millions of data on patients through telemedicine services makes data security critical. In order to ensure the security of patient data, besides encryption methods, scans that detect unusual activities, protocols that enable the recovery of lost data, and backup systems against cyber attacks are used.