As doctors go virtual, pandemic turbocharges telemedicine

In a matter of weeks, the coronavirus pandemic sparked a technological revolution in healthcare systems across the world that might otherwise have taken years.

Spurred on by fears of contagion in wards and waiting rooms, many health practitioners are replacing the face-to-face meetings that have always underpinned general practice, with patient consultations by telephone and online video apps.

Some of the most radical changes have been in primary healthcare, where doctors have often faced shortages of protective equipment, but specialists in everything from mental health to eye care have also turned to technology to treat patients at a distance.

"General practice has undergone significant changes in the way GPs and our teams have delivered patient care during the pandemic -- and the speed in which these changes were implemented has been remarkable," Professor Martin Marshall, Chair of Britain's Royal College of GPs told AFP.

As the virus spread, health authorities in the UK, Europe and elsewhere updated guidance on everything from data protection to how to build trust remotely.

The United States rolled back restrictions on access to telemedicine, and eased privacy regulations to allow people to use platforms like Skype and FaceTime.

"People are now seeing this model, which we thought would take years and years to develop. And it's probably been accelerated by a decade," Chris Jennings, US policy consultant and former White House health care adviser told STAT news recently.

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Globally, 58 percent of surveyed countries are now using telemedicine, the World Health Organization said Monday, adding the figure was 42 percent among low income nations.

Layla McCay, a director at the NHS Confederation representing British healthcare services, told AFP that most of the UK's 1.2 million daily face-to-face primary care consultations were done remotely "in the space of weeks".

But there were challenges.

"My first video consultation was a mess. Builders were drilling, the microphone failed, a colleague walked in, and lockdown was imminent," Camille Gajria, a doctor and clinical teaching fellow at Imperial College London, told the British Medical Journal.

She said teleconsultations can be efficient but warned of "cognitive bias" -- a doctor, for example, might assume that a child playing in the background is the one being discussed.

There are also concerns that vulnerable patients might find it difficult to talk about mistreatment at home, while elderly people could struggle to navigate unfamiliar technology.


- Not going back? -

Internet-connected thermometers, pulse oximeters to measure oxygen levels, and smart devices that monitor vital signs are all widening the scope of what is possible in remote medicine.

In an April article for JAMA Neurology, experts from the Netherlands and US said telemedicine could be a useful tool for in-home training, such as activities for survivors of stroke. Patients, they noted, could be monitored via sensors in watches or phones.

"We hope that this current COVID-19 crisis will soon be resolved. However, it is as the old saying goes: 'never waste a good crisis'," they said.

"Telemedicine for chronic neurological disorders should become part of the new normal rather than the exception."

Marshall said there are still many routine procedures -- vaccinations, blood tests and physical examinations -- that cannot be done remotely.

"Those living with multiple conditions and other complex health needs really benefit from seeing their doctor in person -- and this is helpful for the GP, as well," he said.

But he added that research supports the use of remote consultations for patients with simple conditions, or who have "transactional" needs like a repeat prescription.

Many say they want at least some of the changes to stay.

"It has certainly turbocharged the digital transition nationally," said McCay of the NHS Confederation.

"Lots of feedback from our members shows the culture has fundamentally changed, and clinicians who were perhaps previously resistant to digitisation are now realising its benefits."

"We can't go backwards," she added.

Agence France-Presse.