Every time you use a digital service to seek advice from a healthcare facility, such as a chat or a video call with a doctor, you are using a technology that will be of major importance to care in the future. Digital care meetings help to increase security – and can make care more effective. But there are challenges as well.
Digital care does not just involve straightforward apps and other services that make it possible to get answers to questions more or less 24 hours a day – for many people who are chronically ill, digital care meetings are a big help and mean greater security, no less.
Easier lives for people with chronic illnesses
One area where new technology has proven to be effective is in the treatment of patients with COPD, a chronic lung disease that around half a million Swedish people are living with. People with serious COPD often experience oxygen deprivation, and when this happens they either have to seek emergency care or attend regular repeat appointments; which is both costly for the care unit and frequently stressful for the patient.
In a situation like this, new digital technology can make a big difference. What if the patient could monitor their own values from home and report regularly to a healthcare unit to let them know the situation, instead of turning up regularly or seeking care when their health is already failing? And what if they could talk to a personal care contact over a video link instead of having to leave home and attend hospital regularly?
This is been tested with COPD patients as part of a care method devised by RISE in partnership with Karolinska University Hospital and around 20 other stakeholders, with good results. Patients felt more secure, and health data gathered gives the care service a better overview of how the disease is developing.
“For anyone who suffers from a chronic disease, which does not pass, this makes life easier and they can establish a more lasting relationship with their care contact. The patient gets to know their caregiver, and the caregiver gets to know their patient. This is slightly different to what happens with the apps or other web-based services where people phone in and make contact themselves, and are then referred to someone else or prescribed care or medications,” says Per-Olof Sjöberg, head of business and innovation area Digitalisation at RISE.
More than just a doctor on the phone
Apps and other web services where people can contact a doctor outside clinic opening hours and without having to travel to an A&E unit and wait there are perhaps the form of digital care that most people have experience of nowadays, and if used correctly these can be a good way of relieving strain on clinics and A&E units. But this is only one way in which digital care can be used.
“The technology offers major opportunities, in particular more access to care. You can get in touch with a specialist more easily – and specialists from all over Sweden, or all over the world. You can invite an interpreter or a doctor who speaks another language if necessary, or go for audiovisual interpretation, and you can link various image analysis types. We have looked at COPD as far as regular chronic diseases are concerned, but I am absolutely certain that this care method could be applied to patients with diabetes or heart failure as well,” says Per-Olof Sjöberg, who is also of the opinion that not only people with chronic or acute illnesses could be helped by digital care.
“Measurement-related services could be useful for changing behaviours, such as helping people give up smoking or change their diets or exercise habits. A digital service could then help to coach people in different ways.”
Care is facing both changes and challenges: not least, many county councils are facing financial difficulties. Relieving the burden on clinics with the help of digital care and allowing patients to handle part of their care of themselves are just two examples of how digital solutions could be one way of getting the finances under control.
And financial benefits are not the only thing that digital technology has to contribute; the primary concern is to provide more and better care. The green aspect is a bonus, too. Less travel is needed if some appointments take place remotely.
“There have to be broad benefits if services like this are to be introduced to care services. Patients have to like the system, but caregivers, relatives and companies delivering the technology all have to benefit from it, too. If this is to pay off, everyone has to get something out of it,” says Per-Olof Sjöberg.
“As one of the patient involved in the COPD project said: ‘For the first time, I am able to take part in my own care’. And that is where we want to head, while also saving money and giving better care.
It goes without saying that digital care will not replace face-to-face meetings. Rather, it would be more accurate to say it will complement and improve.
“Digital care can bridge gaps and streamline procedures, and it can give more and better care. It is not possible to do away with face-to-face meetings, but we can supplement them effectively and avoid unnecessary physical encounters such as emergency transport by ambulance, for example.”
The care apps have sometimes been criticised for only taking on patients with simple problems, while primary healthcare providers still handle the more difficult cases. And of course, the new technology presents challenges. Above all, security is an important issue.
“I would say the biggest issue is security. All companies currently running digital care services have security high up on their agendas, but this does not mean that failure cannot occur in different ways. When anything is done remotely and you do not meet people physically, you have to know you are talking to the right person, for example,” says Per-Olof Sjöberg, who reckons that besides security, the issue of coordination is another problem that remains to be resolved.
“We have to get different systems to talk to one another when more agencies have to keep records systems, and we have to find a way of sharing patient information on patients’ terms.
That said, one issue that has not created any major problems – contrary to what you might think – is the privacy aspect of being monitored and online and sharing health data.
“The accessibility of care creates peace of mind. We asked ourselves whether people would really want to allow lots of measuring equipment into their homes and be monitored while they sleep, for instance. But people are extremely accepting when it comes to their own health, if it means they get help and peace of mind. Instead of being woke up several times a night by care staff carrying out checks, they can sleep through – patients found that to be a positive thing, not something that infringes their privacy,” says Per-Olof Sjöberg.
Future health avatars?
There is no way of knowing how care will be structured when the next generation has grown up, but it is highly likely that it will be very different to how it is structured at present.
“I think we will be using technology to help us to a far greater extent than we do at the moment. If people can get an early warning about cardiac fibrillation, why would they not want that help? But this has to be implemented in a natural way so that we do not feel we are being monitored. Personally, I think this will be extremely common – not just video appointments, but monitoring patients so that we can optimise their peace of mind,” says Per-Olof Sjöberg.
Given how quickly developments have progressed – a generation ago, we could never have imagined what could be done with our mobile phones today – predicting the future is all but impossible.
“In 30 years’ time, I might have an avatar, a health agent, who keeps track of what is good for me. Or maybe people will find that concept laughable? All we know is that predicting what will happen is almost impossible.”