Is TeleMedicine the future of healthcare ?
Picture this scenario from a doctors’ perspective.
A 61 year old man comes into the room complaining of his feet slowly changing shades to a brownish red. On examination there is swelling of both feet, the marks are scattered brown flecks on otherwise normal colored feet, however it is definitely spreading from the toes upwards.
The doctor will collect a history, which tells us that the patient had an Inguinal hernia procedure three years ago, it was corrected by placing a mesh to keep things in place.
There is also history of a Transient Ischemic Attack ( Stroke ) two years ago, this was handled by blood thinners. The patient remembers being allergic to one of them.
Carrying on the examination the heart and lungs are fine, all nerve reflexes are in place and the patient has sensation on the tips of toes on both feet. Circulation is also fine.
If the patient has his records things like these become important;
- Which medicine was he allergic to
- How was the mesh placed, do the scans show any slipping
- Blood clotting variation ( INR/PT/PTT blood tests ). Given that the patient had a stroke these would be regularly monitored.
- Any infections in the area and what antibiotics were used to treat them.
If he doesn’t have records, then the diagnosis can still be made to a skin deposing of iron, not before things like a venous Doppler, MRI of the lower leg, and a few other inconclusive tests will be done. Chances are the dermatologist will be one of the last people consulted if the records are not at hand.
Medicine is the integration of clinical practice as a doctor would see it with the story each patient presents. Telemedicine takes this entire interface and places it online for easier access, diagnosis, something that can be working twenty four hours a day, anywhere in the world if so needed.
The integration of various parts of healthcare are becoming more and more important now that there is so much travel, leading to different doctors and scattered records.
Most important of all, now diagnostic medicine has developed a virtual arm where a complete health capsule of the patient can be portrayed, making for peace of mind to distant loved ones or even a second opinion from a family doctor. All it takes is internet access to lead to better diagnosis wherever a person is.
It is often important for doctors to know the past history of a patient. Knowing things like the last series of blood test results makes it easier for doctors anywhere to monitor and adjust doses for things like diabetes, hypertension, cholesterol etc. medication. This often gives people the security to travel in peace.
Healthcare is an ever changing thing, and often not one we can plan. Telemedicine helps a little in that area by keeping a complete set of your records online. This makes things easier for the entire healthcare community, not just the doctor.
In case of emergencies it is good for the nearest hospital to have prearranged access to your records. Paper degrades, ECG’s will fade away within a year. Good health goes on a lot longer.
There are several reasons why Telemedicine is the wave of the future. To summarize here are a few scenarios where it would be of use.
- Elderly parents in another city.
- Chronic disorders like diabetes, hypertension, where the medical records become the size of novels.
- Emergencies for things like blood group, allergies, current medication assuming the patient is not conscious.
- Frequent travelers with issues that need monitoring.
- Second opinions from doctors in different cities.
From a doctors perspective it is important to focus on the complaint which the patient has currently, it is however invaluable to have the history on hand for all the reasons above. This leads to quicker diagnosis.
The advantage of quicker diagnosis is quicker treatment, the advantage of quicker treatment is that the wear and tear on the body while treating the problem is reduced.
If a diabetic can be monitored better no matter where he or she travels then the chances of long term damage to the eyes, kidneys or other sensitive organs are dramatically reduced.
Where does telemedicine fit into all this? It’s best compared to traffic policemen at intersections of the doctor, pharmacy, laboratory and hospitals. Making sure the right information is being passed on from one to the other. Reducing the chances that the wrong dose of medicine isn’t given in a different city or that all tests in the long lists of blood tests are done.
Healthcare is a serious business, there are always new pillars being added to the foundations of good health and the quicker easier access of personal health data in a secure manner is definitely one of these pillars. It will save lives.
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