5 Factors For The Successful Implementation Of Telemedicine

Wednesday, April 20, 2022
Is digitalization in health just a "nice-to-have" or a "must-have"? We don't really have a choice. We have entered the digital era, and healthcare and health promotion must evolve to stay relevant. So it is not an issue of "whether or not," but a matter of "how." We must make sure that the principles and values from the health domain are preserved: benevolence ("first, do no harm"), equity, etc. This is particularly important as we develop artificial intelligence applications for health. At which points of the patient path in healthcare could we use the potential of telemedicine and e-health better? Most eHealth tools mainly aim at improving the continuity, safety and efficiency of care by helping to bring the right information to the right persons at the right time so that the optimal decisions can be taken. This includes both decision-support tools for care professionals as well as empowerment tools for patients and their families. Telemedicine works best when expertise is difficult to move physically but can be accessed remotely, e.g., in large countries with insufficient specialized healthcare professionals outside of the main cities. But also when hospitals are overwhelmed and cannot accept all patients, as was the case during the COVID-19 crisis. Despite the acceleration of virtual care during the COVID-19 pandemic, there are rising digital gaps rooted in socio-economic inequalities. So what should be done to make the promise of better access to care through telehealth come to reality? The risk of leaving the non-connected behind – the digital divide – is a real issue when deploying digital health tools. However, there are also multiple cases where these tools can actually reduce inequalities by providing easier access to healthcare for underserved populations or facilitating access to relevant health information for care professionals and citizens in remote settings. There is still much to do in healthcare to improve the quality, safety and efficiency of care processes. Can computers help? For more than 150 years, there has been evidence that lack of quality, safety, and efficiency of care is primarily linked with deficiencies in communication and information management. It is often said that "information is care." So, the availability of health and healthcare-related information in digital form, eventually processable by computers in such ways that they can augment the capacities of humans, has the potential (and also some evidence) to improve care processes. Let's talk about implementing medical information systems in hospitals. What comes next after electronic health records and telecare that could significantly support the work of clinicians? EHRs and telecare are the foundations on which various added-value services can be built: decision-support tools, real-time notification of potential clinical issues, real-time management of patient flows, predictive tools able to detect issues before they happen, tools that help patients become partners with the care team, e.g., for shared decision making. Technologies are advancing quickly, and the solutions that medical students learn today may be obsolete in a few years. So how do we prepare the new workforce for the innovative health care of the future? Students have to be taught to learn how to learn, as most knowledge they acquire will become obsolete at some point. Then, regarding digital issues, they need to develop basic competencies, such as computational thinking and the basics of data science. They also need to understand the potential and limits of AI and specific ethical issues related to the digital society. Could you please share one fascinating project you are working on now? We collaborate with Terre des Hommes (a child protection NGO) on predicting local outbreaks of infectious diseases based on clinical data collected by primary healthcare workers in Burkina Faso, augmented by satellite observation and weather data. This is an excellent example of connecting clinical care with data-driven public health. What are the five conditions for the successful implementation of telemedicine? As for most digital health interventions, conditions for success include:
  • Institutional support (and strategic alignment)
  • Buy-in from the care professionals (including incentives)
  • Sustainable business models
  • Proper capacity building of all stakeholders (including patients)
  • Demonstration of impact (evaluation, evaluation, evaluation)
  This interview was developed in collaboration with The Geneva Health Forum (3-5 Mai 2022), organized by the Geneva University Hospitals (HUG) and the University of Geneva in partnership with 30 global multisectoral organizations.