Telemonitoring

The internet has revolutionised the way that people communicate in a way that could not have been envisaged even a few years ago. The rise in the use of information technology means that many tasks which used to require a physical presence – banking, shopping, booking travel – are now routinely carried out from home or work. This kind of connectivity is also being applied to patient care. The rapid development of telemedicine, where medical information is transferred via electronic media for the consultation and diagnosis (and even remote medical procedures or examinations) is changing many aspects of healthcare and healthcare delivery.

The use of telemedicine offers numerous potential benefits to healthcare practitioners and citizens alike. These include:<:p>

• Telemonitoring: by allowing much of the work to be done remotely, telemonitoring can reduce hospitalisation time and help patients avoid travelling long distances for routine check-ups and testing
• Telehomecare: this allows patients to access care directly from home by linking them directly to healthcare practitioners; for the elderly and those with limited mobility, this greatly improves quality of life
• Teleconsultation: This can allow healthcare professionals to provide patients in remote locations with healthcare services including evaluation, diagnosis and treatment; teleconsultation can also makes it easier for a family doctor to share information with experts and specialists where necessary

The use of telemedicine brings considerable opportunities for reducing the cost of healthcare delivery while at the same time improving many aspects of patient quality of life. It can reduce demands on hospital facilities and allow healthcare professionals to make more efficient use of their time. For patients with chronic conditions, there are considerable benefits in not having to travel to receive routine healthcare.

Implantable cardioverter defibrillators provide an excellent example of how telemedicine can make a real difference to patients. Each year, around 500,000 people in the European Union receive an ICD to regulate their heartbeat in some way. The vast majority of these patients have been fitted with pacemakers, but other devices include resynchronisation devices, and implantable defibrillators which can prevent sudden cardiac arrest and possible death. Constant innovation has seen these devices become ever smaller, lighter and easier to live with; the medical technology industry is now investing in using telemedicine to further improve their usefulness.

Traditionally, these implants needed to be inspected by the patient’s physician at regular intervals. These check-ups involved verifying that the device was working effectively, and if need be, making adjustments. However, by using remote telemetry, the monitoring can be done by transmitting data via the telephone line. Furthermore, by using a digital format, the data can be more easily analysed and stored with other patient information. All of these will ensure that the patient’s disease management is optimised, especially where the ICD may not be the only therapy. While telemonitoring saves both physician and patient time and provides a better level of care, it will not wholly dispense with physician involvement. They will be intimately involved with interpreting the information and deciding any refinements to therapy that may be required.

Clearly, this will have implications for the way in which physicians work and relate to their patients, and will require wider change and investment, but will ultimately bring benefits to all of those involved. There are also costs associated with setting up telemetry; patients require data transmission facilities, healthcare providers need the technology to make use of the data. However, at the same time, the opportunities for improvement and long-term savings should outweigh the outlay in the long-term. As healthcare costs continue to face pressure from increasing levels of chronic disease in an ageing population, such efficiencies will be invaluable. The European Commission recognises the value of IT in delivering healthcare, and its initiative on eHealth is a positive demonstration of support for this approach. If strong action and support from the EU can overcome existing inertia, the full potential benefits of eHealth for citizens and healthcare systems can be realised.