Telemedicine and digital health: the future has finally arrived

Ticino Management

December 2023

Driven by the pandemic emergency, the rapid spread of telemedicine has highlighted its unexplored potential, and the benefits for patients. There is no shortage of obstacles, primarily technological, but it would be a shame to let these block a revolution.

Why not turn to the experts?

‍Telemedicine, a vision of a future now present, is one of the most striking examples of how technological innovation can revolutionise medical practice. However, although it represents a modern and innovative tool in the collective imagination, it is not such a new concept. Already in some representations of the 1930s, artists and scientists imagined a world in which remote communication between doctor and patient was no longer confined to the pages of science fiction, but became an integral part of everyday reality. Over the decades, this vision has taken shape, evolving from simple exchanges of written information to complex real-time audio-visual interaction systems. The very definition of telemedicine has undergone a metamorphosis, moving from being a mere abstract concept to becoming a widespread clinical practice that uses telecommunication technologies to transmit medical information and provide remote care services, as defined by Perednia and Allen as early as 1995. The use of telemedicine for remote healthcare, for example, has a long history.

"One of the earliest experiments was a monitoring project developed in the Mercury space programme (1959) when NASA began to carry out physiological monitoring of its astronauts remotely. The same technology was used in a pilot project involving the Papago Indians, known as STARPACH. This involved the use of a mobile medical unit made up of non-medical personnel connected via two-way television, radio and remote telemetry to a hospital 100 miles away, to make medical care available in remote areas of the Indian reservation".

began Francesco Costa, physician and founding partner of Security Lab Health Tech.

A decisive step forward, in concrete terms probably the real beginning, was the agreement signed between the Nebraska Psychiatric Institute and the Norfolk State Hospital; psychiatric consultations were provided via a closed circuit television link between the two institutions. It was still the late 1950s. As in other areas, however, the recent years of the pandemic emergency played a decisive accelerator role in the spread of technology. The pandemic has acted as an accelerator of a process already underway, pushing telemedicine beyond all expectations in terms of adoption and diffusion, albeit with modalities and differences that remain important even between neighbouring states.

"France, England, Italy, Denmark, Japan and the United States relaxed regulatory limits for teleconsultations in the wake of the pandemic. In France, restrictions on the reimbursement of healthcare services (which previously required an in-person visit at least once in the previous year) were lifted so that patients could consult any doctor providing telemedicine services. These changes increased the number of teleconsultations from about 40,000 between February and March 2020, to more than 600,000 between April and May, according to OECD data."

Costa points out.

Hospitals, outpatient clinics, and primary care services have therefore had to rapidly convert their operations to meet the new challenges, finding in telemedicine an agile and effective answer. However, the process of adaptation from face-to-face visits to virtual interactions has not been without difficulties, some of them very real.

"Our company, Security Lab Health Tech, which deals with finding IT solutions to support doctors and hospitals in solving everyday problems, has identified the main obstacles to the spread of telemedicine as the lack of user-friendliness of the software currently on the market and the problems related to privacy, especially after the new Lpd law came into force. We therefore devised and developed streamlined and reliable teleconsultation software, with the aim of breaking down the technological barrier while maintaining the highest safety standards. We wanted to create software that would take less than 10 minutes to familiarise oneself with its operation, so as not to further burden the already complex daily practices of healthcare professionals."

notes the expert, who is well acquainted with the dynamics of the sector, being himself a doctor. Notwithstanding the difficulties, which in many cases are significant, the transition to this new hybrid model is bringing important benefits to the system as a whole, as well as to the customer. Waiting times are in fact decreasing, while accessibility to care for patients living in remote areas, or with walking problems, is rapidly improving.

"The adoption of such practices, by definition more flexible and resilient than the previous model, has in some cases even improved the quality of care provided, even during a global health emergency, and across a wide range of medical disciplines. For example, family doctors have steadily adopted it for the management of chronic diseases, improving monitoring and continuity of care, and thus also the quality of life of patients. However, it easily bridges geographical barriers, adapting to very fluid clinical needs, for example in emergency and home care. By using connected devices, patients can receive care in real time, limiting transport and hospitalisation, and enabling faster mobilisation of medical resources in emergencies".

reflects Costa.

However, it is not limited to generalist examinations and also has important applications in the surgical field, traditionally considered to be a bastion of direct physical interaction, which is now undergoing a major transformation.

"Surgeons around the world are beginning to integrate telemedicine technologies into the patient care pathway, especially in the postoperative phase. Remote monitoring and remotely guided rehabilitation sessions have become valuable tools to ensure optimal recovery and reduce the risk of complications. This innovative approach not only improves the efficiency of surgical follow-up, but also provides ongoing support to the patient who can be constantly monitored without the need for frequent hospital visits. Telemedicine in surgery is proving its effectiveness in various specialities, showing how technology can be a valuable ally in patient care and well-being."

highlights the expert.

Overcoming suspicions and mistrust, telemedicine can therefore be said to have fluently surpassed initial expectations, marking itself out as a tool that is not only necessary in exceptional circumstances, but also extremely effective and useful in everyday medical practice.

"Initial obstacles, mainly related to digital literacy and the acceptance of a new paradigm of care, have been overcome thanks to the commitment of professionals and the resilience of healthcare systems. Its future looks bright, with still largely untapped potential. If the past saw innovation as an option, the present and future see it as a necessity. The benefits in terms of accessibility, personalisation and quality of care are already a reality for many patients and promise to grow further as it becomes more widespread. The medicine of the future is already here and telemedicine is one of its key pillars. It will continue to evolve, adapting and anticipating the needs of a rapidly changing world, helping to shape healthcare in ways we can only begin to imagine today."

concludes Francesco Costa, Partner and founder of Security Lab Health Tech.

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"If innovation was an option in the past, today it is a necessity. The benefits in terms of accessibility, personalisation and quality of care are already a reality for many patients and promise to grow further. The medicine of the future is already here, and telemedicine is one of its key pillars".

Francesco Costa