In Spain we are still far from living with the so-called one minute clinics that China has spread throughout the country.
228 million citizens make use of them to remotely contact a medical professional – random – and receive in just a few minutes – without leaving this kind of photo booth – a diagnosis and a prescription. However, here too we have already started a process towards virtualization of healthcare . The trend invites you to get used to visiting the specialist less and less, as long as the severity of the case allows it and without detriment to the necessary personalization.
Telemedicine, although with a long way to go, is not new. Although virtual consultations or therapeutic monitoring through data provided by wearable or wearable applications and devices – bracelets, smart watches and other devices with which the physician can have real-time knowledge of the evolution or specific parameters of the patient – have accelerated during the most serious phase of the pandemic, it is not a bet exclusively attributable to this crisis. As + Salud has been able to verify, regional health services are scheduling medical check-ups for almost a year in a telematic format .
Now, in which cases should we get used to seeing our family doctor or specialist more frequently through the screen or listening to him through a mobile phone? At the moment, this option is reserved for consultations of certain specialties, periodic check-ups, attention to symptoms –a priori– mild … And as long as the circumstances of the patient – if they habitually handle technology, how far is it from their residence to the health center , whether or not it is affected by the digital divide … – encourage it.
According to a recent study carried out by the Doctoralia platform, in which the opinion of healthcare professionals themselves has been obtained, the specialties that are best adapted to remote care would be dermatology, gynecology, ophthalmology and cardiology . These evaluations coincide in a good way with the SEIS 2019 Index of the Spanish Health Informatics Society – made with data prior to the arrival of COVID-19 -, which indicates that the specialties of teledermatology, tele stroke and teleophthalmology are the most common in regional health services: all three can be found in twelve communities.
Specifically, dermatology was one of the first disciplines to adopt telemedicine, since it is a specialty where images are the gold standard for diagnosing skin-related ailments. Determination of the skin disease and subsequent follow-up are therefore possible if these images are of good quality. According to specialists, approximately 90% of dermatological cases can be assessed remotely.
This is how, for example, Gloria Abad, a dermatologist at the Teknon Medical Center, in Barcelona, and a member of Doctoralia considers it: “Through the online consultation, people suffering from chronic ailments, such as psoriasis and atopic dermatitis or seborrheic , but it is also possible to make diagnoses of skin infections –fungal or herpes–, allergies, hives or acne ”.
Regarding cardiology, patients with chronic disorders can undergo recurrent treatment at a distance. Luis Calvo, specialist at the Cardiology Service of the Hospital Universitario La Paz, in Madrid, and also a member of Doctoralia, points out that “the most suitable patients are those who are in a stable situation and with a chronic cardiovascular disease, such as arterial hypertension and hypercholesterolemia ” .
In other areas identified above, such as gynecology, this virtual assistance is also possible to start with, but the patient’s precision when describing what happens to them plays a greater weight.
The most useful wearables, those controlled by the doctor
There is no doubt that technology is being used more and more to monitor health in real time. However, in order to ensure its effectiveness in clinical practice, the experts do a first screening: differentiate those apps and wearable devices in which only the user manages and interprets the data – more focused on leading healthy lifestyles – from those that do allow access and supervision of the records by a third party. In this case, the doctor.
Be that as it may, the role of these tools in the control and prevention of health problems continues to grow . Recently, the prestigious scientific journal Annals of Internal Medicine included the project of the Spanish cardiologist Miguel Ángel Cobos, from the Hospital Clínico San Carlos, in Madrid, to perform complete electrocardiograms with a state-of-the-art smart watch. Its reliability index is similar to that of a test carried out in a health center.
However, this area is also affected, like drugs, by adherence problems, that is, consistency in their use. Various studies that show that, after six months, the percentage of patients who continue to use these devices and apps is small – around 30% -.
By Alberto Cornejo.
