Remote Monitoring Is Just the Beginning - Where Else Medical Digitization Needs to Go
Prof. Miloš Táborský, Head of Cardiology at Olomouc University Hospital
Long after the COVID-19 public health crisis is solved, whether through medicine, vaccination or other developments, our current pandemic moment may well be depicted in future medical textbooks as the moment we got over our lingering skepticism of digital medicine.
In my own native Czech Republic, discussions over “ePrescription” or digital medication records provoked emotional public debate only months ago. Now, the pandemic has made the adoption of such modern technologies necessary to facilitating high-quality care. As I advocated during a recent Czech television appearance, the time has come for us to speed that process up.
The pandemic’s effects are particularly striking in cardiology, from both the perspective of hospitalization figures and new momentum for digitization. Significantly fewer patients are being admitted for suspected arrhythmias, heart attacks or strokes (perhaps due to patient fears of contracting COVID-19, as described by fellow cardiologist, Dr David Hayes, here). In June, heart rhythm societies across the world issued a joint practice update for telehealth and arrhythmia monitoring, in order to keep patients safely at home unless a clinic visit was absolutely necessary. The last few months have also seen the release of the “At Home” study*, where researchers in Japan followed one group of pacemaker patients conventionally and other group remotely, finding no significant safety difference between the two groups.
Arrhythmia management specialists are no strangers to how remote monitoring can improve patient outcomes while making care more efficient and cost-effective. But COVID-19 has made it clear the digitization discussion needs to be wider across medicine in general. Systems now exist that allow us to share data across entire health systems, from cardiologists, to diabetes specialists, to general practitioners. We are in the process of adopting one such system in the Czech Republic. Such streamlined digitization would allow us to respond quickly to patient needs while saving costs and capacity. It includes the possibility of videoconferencing with patients and prescription requests, with fewer administrative snags when requesting patient medical records or prescriptions. It would allow better teamwork between regional hospitals, general practitioners and specialized care centres.
Our current pandemic moment may well be depicted in future medical textbooks as the moment we got over our lingering skepticism of digital medicine.
Despite the case for digitization, the take-up process can be slow - even in specializations where highly innovative technologies are available. To use cardiac rhythm management as one example, only 40 percent of BIOTRONIK pacemakers currently implanted in the Czech Republic make full use of Home Monitoring, a technology that was first invented 20 years ago. This is despite the technology’s health system reimbursement and support from Czech Society of Cardiology guidelines.
So it is also up to us to educate our patients on how certain innovations can facilitate speedier and safer care. In my experience, age is not an obstacle to this. There are a number of patients over 80 years of age in own clinic, who manage the digital aspects of their care very well. The next phase of digitization in healthcare - both during and after the COVID-19 pandemic - is safe, necessary and achievable.
*Disclaimer: This study utilized remote only follow-up of patients for 24 months. Remote only follow-up for 24 months has not yet been approved for the product labeling and cannot be recommended by BIOTRONIK at this time.