Over the past two decades we have heard terms like telemedicine and eHealth more and more often. Concepts fundamentally born out of the use of technology in health care, which somewhat resemble each other and which to the uninitiated might more or less mean the same thing, but are actually very different from each other.
The Wikipedia definition of eHealth is: a term used to refer to the practice of health care through the support of information technology tools, specialized personnel, and physician-patient communication techniques. Thus, the set of networked information technology resources, solutions and technologies applied to health and health care.
As defined by John Mitchell (Mitchell J., From telehealth to e-health: the unstoppable rise of e-health, Canberra, Australia: National Office for the Information Technology; 1999)eHealth is a term for the integrated use of “electronic communication” and Information Technology in health care, the use of digital data that are transmitted, stored and retrieved electronically, for clinical, educational and administrative purposes, both locally and remotely.
The Wikipedia definition of telemedicine is: the set of medical and information technology techniques that enable the treatment of a patient at a distance or more generally the provision of health services at a distance.
Ace Allen, editor-in-chief of Telemedicine Today Magazine and Associate Professor in the Department of Medicine at the University of Kansas Medical Center, highlighted another difference between telemedicine and eHealth in 2000: telemedicine remains linked to medical professionals, whilee-health is also driven by nonprofessionals, namely patients (or, in e-health jargon, consumers) whose interests promote new services in the health sector as well, mainly for their empowerment through access to information and knowledge.
I started from these two concepts by taking a cue from an article last week in Quotidiano Sanità where the success of the pilot project (of telemedicine in the title, of eHealth in the subtitle) “Health Neighbors,” desired by Pfizer, a pharmaceutical company, and Philips, a Health Technology expert company, implemented with the contribution of the School of Management of the Milan Polytechnic.
As reported in the article, results show a marked improvement in clinician-patient compliance, with treatment adherence close to 100 percent. Patients felt more involved, even feeling part of a group, and perceived more attention from clinicians, as well as being an educational tool for patients and caregivers.
So far so good. In fact, I would say excellent! Excellent case of success given by synergies of different skills and experiences and, certainly, by the desire to foster the efficiency and effectiveness of a treatment pathway for patients, in this case, with chronic diseases. The thing that puzzled me, reading the article, was that expertise in Pharma by Pfizer, expertise in Health Tech by Philips, adherence to patient therapies and improvements according to various parameters are mentioned, highlighting the usefulness of the digital tool to support the “chronic” patient. (I apologize for the quotation marks but it’s a professional strain of mine: I always struggle a bit when a disease is turned into a quality of patient identity; in the sense that linguistically “chronic patient” is obviously quite different from “patient with chronic disease,” but that’s okay.)
I did not participate in the project, so I am just making a guess or simply asking myself a question: how were these patients recruited who then diligently used the digital tools, adhered to the therapy, etc.? Did they receive an email or a text message, or was there someone from the medical team who talked to them, explained, clarified doubts, built a trusting relationship, was able to motivate them, established that famous therapeutic alliance that is so much talked about, and then…. could what actually happened in the six months that followed happen?
Maybe I’m wrong, but I have the conviction that yes, behind that efficient and effective use of the tools, behind the resulting results of empowerment, engagement, education and therapeutic adherence, there was a determining factor upstream: human beings who had to deal with other human beings, with their pathology, with their needs, with their fears, with their concerns, with their motivations and with their demotivations … and have been able to do so by building a trusting relationship with them, and this has enabled them to efficiently and effectively use (and have them use) the tools for exactly what they are: tools.
I have been dedicated for years now to training health professionals for interpersonal and communication skills, for those skills better known as “soft skills,” and I happen to meet doctors, nurses, who really make a difference in the lives, illnesses and, in many cases, even deaths of their patients. Of course, alas, I also happen to see the opposite. I am an advocate of progress and also of technological advancement in medicine, so welcome the advances in telemedicine, eHealth and anything else that can benefit the health of patients and the quality of the work of professionals, as long as, at the risk of coming across as a bit ancient, the priority that Hippocrates emphasized as early as the 5th century B.C. remains unchanged:
It is more important to know what kind of person has a disease,
than knowing what kind of disease a person has.
Thank you.
Emanuela
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