Buzz e-sante

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C’est une authentique révolution que vit depuis un an le CHRU de Lille. Près de 2 000 terminaux multimédia sont en train d’être installés dans les chambres des douze hôpitaux du centre hospitalier. Ils remplacent l’ancien réseau télé, qui datait de 1992. Aujourd’hui, depuis leur lit, les patients peuvent surfer sur Internet, télécharger une émission ou se raser grâce à l’effet miroir de la webcam. Et demain, ce sont les professionnels de la santé qui pourront accéder aux données des malades depuis ces tablettes.

Health care providers should be making use of new mobile technologies that can facilitate higher quality of care in every patient interaction. A look at what's available now.

A doctor's time is increasingly scarce and expensive. The only scalable, near-term solution is to enable physicians to be more efficient and manage more patients, while empowering them to improve the quality of care they can provide.

What if doctors used powerful mobile applications to remotely track their patients' treatment compliance and progress? What if they could provide patients with remote access to their expertise, or to other medical knowledge they trust? What if they kept in- person office visits to the time they're really required for longer, in-depth consultations?

There are already some incredible startups developing mobile products that facilitate more efficient (and more economical) delivery of care. While these products, some of which are still in the early stages of development, won't replace or automate a doctor's job, they are great precursors for fostering a more transparent doctor-patient relationship.

For example, through patient monitoring and self-tracking, smartphones may help doctors catch early signs of disease. Ginger.io has developed a mobile platform that collects active data (patient-reported) and passive data (who you interact with through your phone and how far you travel during the day), right from a smartphone. This data is available via a web dashboard to authorized doctors and other health care providers who can use it to efficiently manage hundreds of patients. By tracking personal behavioral data, doctors can better understand the health of their patients, provide improved diagnoses and care recommendations, and be alerted quickly to signs of pending health issues.

What is person-centred eHealth?

Does the wording imply that ehealth in general is not person-centred. Well. To elaborate these questions further, I need to make some assumption and define what I mean by person-centred care and eHealth. 

Ehealth is according to  Eysenbach et al (2001) ” an emerging field in the intersection of medical informatics, public health and business, referring to health services and information delivered or enhanced through the Internet and related technologies. In a broader sense, the term characterizes not only a technical development, but also a state-of-mind, a way of thinking, an attitude, and a commitment for networked, global thinking, to improve health care locally, regionally, and worldwide by using information and communication technology”.

EHealth is not a technical solutions per se, it is also a state of mind and attitude about how we want to communicate and in that sense it could be a good tool in providing support for PCC. 

The core in my exposition is grounded on the definition of PCC found within GPCC. I have already discussed this in my previous blogs, and will for the matter of simplicity call it gPCC (Gothenburg person-centred care approach). The most central aspect in gPCC is the mutual acceptance that a person always is intradependent of the other person. At the core of the definition is the concept of partnership.

The juridical meaning of the word is that two persons reach an written or verbal agreement (contract) to perform certain commitments. Within the gPCC approach, this agreement would be manifested by a health and care plan that is agreed upon by all involved stakeholders.  So partnership needs at least two people that agree upon a certain approach in order to reach a certain outcomes.

Massachusetts Eye and Ear researchers have developed a simple technique of fundus (retinal) photography in human and rabbit eyes using a iPhone, an inexpensive app, and instruments that are readily available in an ophthalmic practice, as described in the Journal of Ophthalmology (open access).

Commercial fundus cameras can cost tens to hundreds of thousands of dollars, making the technology out of reach for smaller ophthalmic practices and to physicians in third-world countries.

But previous techniques of fundus imaging were often difficult to repeat, partly because video capture using Apple’s built-in camera app in iPhones cannot independently control the focus and the exposure, which results in glare and poor image quality.

“Our technique provides a simpler and higher quality method to more consistently produce excellent images of a patient’s fundus,” said senior author Shizuo Mukai, M.D.,Mass. Eye and Ear retina specialist and Harvard Medical School associate professor of Ophthalmology.

“This technique has been extremely helpful for us in the emergency department setting,  in-patient consultations, and during examinations under anesthesia as it provides a cheaper and portable option for high-quality fundus-image acquisition for documentation and consultation. The technique is well tolerated in awake patients most likely since the light intensity used is often well below that which is used in standard indirect ophthalmoscopy.”

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