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Laurent Marini, Managing Director, Saudi Arabia, Oman & Bahrain, Orange Business Services
15 February 2017
Healthcare services around the world are facing unprecedented demand from growing and aging populations and the rising costs of supporting them.
Can telemedicine and e-health be the answer to improving the efficiency of services for providers, while keeping the patient at the heart of the system?
Providing healthcare for an aging population is a growing challenge.
According to the UN, the number of over-60s is expected to triple to two billion by 2050. Thanks to medical progress, once-fatal illnesses, such as diabetes, breathing difficulties and kidney failure, are now considered chronic diseases.
However, this progress means that people live longer with their diseases, and treatment becomes a part of their daily lives. Giving them the opportunity and confidence to enjoy life outside the hospital environment, while also reassuring them that help is always at hand, is crucial.
The number of doctors, and notably specialists, has not grown with the global increase in healthcare spending. In 2030, it is estimated that there will be 32% fewer dermatologists and 35% fewer ophthalmologists than today. A report by the Economist Intelligence Unit found that less than one third of medical professionals think their country’s healthcare system has the capacity to cope with the rapidly growing demand for care.
how is technology helping
To help meet these challenges, new developments in e-health are being pioneered, integrating communications, infrastructure and software solutions into hospitals and clinics.
Technology can add further value by improving healthcare delivery.
Information technology (IT) solutions enable more effective collaboration in traditional healthcare networks. In practice, this means healthcare professionals can make informed decisions, avoid costly mistakes, and get on with the job of caring, while meeting their legal obligation to preserve and secure confidential medical data.
In addition, we IT solutions can help providers offer home-based care. This creates a greater focus on prevention rather than reactive treatment and encourages people to participate in their own health and wellbeing as a more progressive rather than passive kind of care.
IT solutions for healthcare must enable the secure access and seamless transmission of sensitive medical information, whilst interconnecting infrastructures, enabling improved coordination, cooperation and fluidity of information exchange.
IT-enabled healthcare services outside the usual treatment environment – at home for example – should allow patients to stay in permanent contact with healthcare professionals, making it possible to provide the highest quality care to a wider population. These tools give patients the ability to manage their own health and well-being. For example, Connected Health Center is a secure platform for the aggregation and exchange of health data. Medical information from various medical devices is transmitted directly to the health platform and to and from any device (smartphone, PC, tablet), enabling the continuous confidential monitoring of remote patients by their physicians.
Coping with an ageing population
The ageing populations of developed societies, because of increasing life expectancy, are now presenting huge challenges in terms of funding and structure of our social welfare and socio-medical systems.
For example, by 2050, one in every three French people will be over the age of 60. But old age is becoming less and less synonymous with illness or disability. People are staying independent until much later in life.
However, whether they are active, vulnerable or dependent, senior citizens can also create value for society and addressing their needs can be a driver for economic growth.
The Silver Economy is, therefore, the economy geared towards the elderly. The issue is crucial: to enable and encourage innovations to support people as they grow older and to reduce the numbers of people losing their independence.
Ageing well with digital technology
When people talk about the Silver Economy, they don’t often think of innovation. However, these days more than half of all senior citizens have a smartphone and a quarter are on Facebook; use of digital technology is, therefore, already a reality, even for the over 65s.
The innovations in products and usage generated by this technology mean that they can age well at home in safety. Digital links offer senior citizens access, either directly or through their carers, to a wide range of information and services, and to maintain social connections with their friends and family.
Technology can help provide reassurance to people who are suffering loss of independence with tele-assistance service or companionship and reassurance services over their land-line phone; enable the efficiency of homecare services to be managed and monitored using a timestamp service;
use digital technology for the benefit of old peoples’ homes; or to assist with setting up service platforms to help keep dependent elderly people and/or patients with chronic conditions in their own homes.
These types of platforms are crucial to structuring the services available for prevention, supporting an ageing population and medical monitoring. Telemedicine solutions are rolling out all over France, mainly in gerontology departments. This is another example of how indispensible information and communication technology is to the healthcare pathway approach.
Tomorrow’s challenge: achieving the life-style digital switchover
Healthcare, social and socio-medical services are sectors that have still not taken full advantage of the digital revolution.
Although initiatives are being developed and some solutions are already working, there are still major steps to be taken to digitalise life-styles and so to place the citizen-user-patient at the heart of the system and in so doing to join up well-being with living well and ageing well.
Nowadays, there is a vast range of services available. They are all ambitious, but they lack coordination. In fact, in the current climate of a boom in digital-based services, the real value of these services for the user will lie in how they are integrated into a care and healthcare pathway.
Over and above how the services are structured, coordinating care and monitoring patients are even more crucial for elderly people than at any other stage in life. In the end, then, it is by taking an approach based on a shared intermediation platform that synergies can be established between the worlds of social and socio-medical services.
A shared information and orientation platform can help address the demands of diminishing independence at home (in terms of well-being, prevention, vulnerability, dependency and chronic illness). It makes it possible to set out processes whereby human help interacts with technical aids to prevent interruptions in treatment, avoidable admissions to hospital and to facilitate admission and discharge when hospital is necessary.
Moving from cure to prevention
According to the World Health Organisation (WHO) in 1948, prevention is “the range of measures aimed at preventing or reducing the number and seriousness of diseases, accidents or disabilities”.
There are three types of prevention:
Primary prevention: is the range of actions directed towards decreasing the incidence of a disease in a population and to reducing, as far as possible, the risk of new cases emerging.
Secondary prevention: seeks to reduce the prevalence of a disease in a population. This stage covers action designed to take effect when the disease or disorder first appears in order to arrest its development or to eliminate any risk factors.
Tertiary prevention: comes in when it is important to reduce the prevalence of chronic conditions and recurrences in a population and to reduce complications, disabilities and relapses caused by the disease.
In 2012, only 2.4% of healthcare expenditure in France was for prevention initiatives, which demonstrates that even now our healthcare system still prefers to take a curative approach to care. However, increasing interest is being shown in prevention initiatives and countries in which the healthcare system is less robust than ours are paving the way in this regard. Digital technology is one of the building blocks of moving from a curative model to a preventative one.
3.4 billion people worldwide will have smartphones and half of these will use mobile health apps by 2017.
Digital technology: the cornerstone for dissemination of prevention initiatives
Technological innovations change the context in which disease is prevented and treated. In many developing countries, electronic applications are already widely used in the field of healthcare.
PwC recently stated that mobile healthcare could save one million lives in Sub-Saharan Africa by 2017. In fact, mobile phone penetration is very high in this area. A mobile phone, an easily-used personal device is, therefore, a powerful tool for improving access to healthcare. All the more so since the countries concerned are vast and healthcare facilities are often located far away from the patients that need them most. Due to the range of services offered, the mobile phone is becoming the most effective way of accessing healthcare and public health information.
And so SMS messages are widely used by the Ministries of Health to inform people about how they should behave if an epidemic breaks out. They also help to improve treatment compliance, especially for patients receiving antiretroviral therapy, and make it easier to remind patients about appointments and when to take their medication.
Healthcare professionals use mobile phones as a working tool, and so there have been examples of dermatological diagnoses being made remotely on the basis of photos sent by SMS, or of epidemiological data being uploaded via mobile phone.
African healthcare systems are developing solutions that use the 600 million mobile phones in circulation on the continent to their best advantage. In Cameroon, for instance, customers have access to My Healthline, an anonymous SMS hotline they can use to ask a team of healthcare professionals questions on all their health concerns, and receive a personal response.
Mobile phones are also used in the fight against malaria in Kenya, Senegal, Burkina Faso, Ghana and Tanzania. A big pharmaceutical company can also monitor the side effects of their new vaccine in 40,000 children and confirm that this is a suitable treatment in Africa.