eHealth Meets Public Health
21 September 2017
Posted by: Heather Smith
Until recently, public health and eHealth had little in common. Representatives of the field with long traditions and academic foundations distrustfully watched a fast developing but still young branch of healthcare, treating technologies in health more like gadgets not to be taken too seriously. However, as the social acceptance and use of digital tools keeps growing, and furthermore the resulting advantages are related to the crucial aspects of population health management and of global challenges, it is clear that no branch of medical science can function sustainably in isolation from new technologies. In May this year, the European Public Health Alliance (EPHA) published a report on the use of digital solutions for health and disease management. Here we will discuss the most important conclusions arising from the document with Martyna Giedrojć (Policy Officer for Health Systems, EPHA), the co-author of the report.
As long as mHealth remains merely a fashionable consumer trend for the well-educated and well-off, health inequalities will continue to increase.
Why did the subject of digital solutions in healthcare catch the interest of the EPHA – a public health organisation?
Whereas the population is ageing and many qualified health professionals are migrating to regions or countries that offer better career prospects, the application of eHealth technologies is becoming increasingly common and viable. Digital health plays an important role across Europe, even though there are still many questions when it comes to the technical, legal, ethical and financial aspects.
One of EPHA's major objectives is to reduce health inequalities, which is why we are in favour of integrating digital solutions into healthcare systems in order to make them available to everyone. Our vision of Europe includes policies and practices that help improve people's health and facilitate access to an efficient, high-quality healthcare system. So-called mobile health, or mHealth – implemented in particular through smartphones, tablets and computers – is a chance to support carers and health professionals in health and disease management of their patients. Furthermore, in a cross-border Europe where healthcare services can also be received abroad, digital solutions will be of considerable importance. The key to success is to consolidate the knowledge and skills of patients, medical staff and the whole society in using eHealth tools.
What are the main conclusions from the report?
Digital eHealth solutions ensure wider access to health information and medical consultations, and they can help reduce the waiting time for receiving treatment. Routine visits in the traditional model can entail costs, long queues and unnecessary patients’ stress. Digital solutions allow health professionals to monitor chronically ill patients remotely.
Use of mobile health applications requires patients to be more involved in their own health and raises their awareness. Applications can help patients better understand their disease and receive information about healthy nutrition and physical activity . They also provide tips on how to assume the responsibility for prevention and treatment. As a result, many users feel more motivated to lead a healthier lifestyle. In this regard, we can see many potentially positive effects.
However, to take advantage of the opportunities offered by eHealth, patients and health professionals must have a certain level of digital skills in terms of searching for and understanding online information, as well as being able to make the right decisions and take appropriate actions. All this comes down to conscious use of digital solutions.
Use of mobile health applications requires patients to be more involved in their own health and raises their awareness.
The authors of the report also point to the potential threats related to mHealth, including insufficient digital education leading to digital exclusion of certain groups, or to the threats arising from self-interpretation of the results from health monitoring devices. How can the negative aspects of eHealth be minimised?
As long as mHealth remains merely a fashionable consumer trend for the well-educated and well-off, health inequalities will continue to increase. We must remember that technologies devoted to health should be designed primarily in response to the needs of patients and healthcare staff rather than to boost the turnover of the start-up market.
EPHA recommends establishing domestic and European repositories of digital health solutions as a form of guidance for patients and health professionals who seek safe and time-tested solutions. Integration of digital solutions into domestic healthcare systems must also include a commitment to protect patients' data.
The development of digital education is crucial for the maximisation of benefits and minimisation of risks for patients. The initiatives in this respect should be coordinated and should include all relevant stakeholders. The dialogue between the representatives of legislators the industry, particular groups of healthcare workers, patients, consumers and civil society organisations should be strengthened to ensure a consensus in terms of safe and effective use of digital solutions.
Is it possible to identify groups of patients who would particularly benefit from digital solutions?
Digital solutions could offer special added value to chronically ill patients. The need to continuously monitor one's health is stressful, for instance for diabetic patients. Checking the blood glucose level, injecting insulin or monitoring the time of taking medications are only some of their day-to-day duties. It can be easier to organise and remember all this thanks to simple reminders sent by mobile applications.
For the mentally ill, digital solutions offer anonymous access to medical advice without fear of being stigmatised by society. Some solutions involve interaction and exchange of experience with other patients, whether on an anonymous or open basis. Other tools, referred to as “serious games”, assist in the therapy of certain phobias and in the treatment of traumas using virtual reality technology.
Digital solutions could offer special added value to chronically ill patients.
In the report “Digital Solutions for Health and Disease Management”, the EPHApresented its legislative recommendations for politicians and guidelines for the creators of mHealth solutions. Could you mention the most important ones?
In the context of the report, EPHA suggests the following recommendations addressed to decision-makers and regulatory bodies on both domestic and European levels, developers of digital health solutions and other entities involved in the creation of guidelines, standards and legislation in this area:
- Guarantee of patient data and privacy protection integrated into all the digital health initiatives.
- Guarantee and improvement of access to healthcare through incorporation of digital health in domestic healthcare systems.
- Improvement of the ability to use digital technologies, development of eSkills among professionals and patients, and digital education of society.
- Guarantee of safe and ethical use of the health databases created for treatment, testing and innovation purposes.
Are doctors prepared for new methods of communicating with patients, i.e. through e-solutions, such as telemedicine devices, teleconsultations, and systems that monitor patients' health 24/7?
By being able to view and analyse information that has been partially gathered by patients, health professionals can better coordinate patient care, communicate with each other, make quicker decisions and choose treatments that correspond with patients' needs. However, communication through digital solutions also means supporting and educating health professionals to let them become more competent advisors in dialogues with patients. To encourage healthprofessionals to use e-tools, greater emphasis must be placed on their education both as part of higher education and within professional development programmes. Depending on the country, physicians, nurses and representatives of other helathcare professions are only partially prepared for new communication methods within eHealth.
However, it is not difficult to find general practitioners who are sceptical of digital solutions. For many, the use of e-tools means additional task, for which they have no time. Mistrust for technology is also connected with concern about the patient's welfare and safety, which is why these solutions must meet all the legal requirements in terms of gathering, accessing and transmitting patient data. What is equally important is the interoperability of platforms and devices which allows various systems to work with one another and exchange information.
Mistrust for technology is connected with concern about the patient's welfare and safety.
What are the benefits of digitalisation in healthcare from the point of view of public health, health policy and health prevention?
Out of all the general advantages of digital health solutions, we may list the involvement of society and individual patients in active health monitoring and management, and the general improvement of education regarding the issues related to disease prevention and health promotion. Digital health means better methods for controlling a disease and of improving the communication between patients and their carers or health professionals.
eHealth solutions introduce continuity to the entire patient care process (hospitals, medical practices, nursing homes etc.) and provide access to healthcare for patients living in the rural areas or in places isolated from well-developed medical infrastructure.
The final positive aspect is access for health professionals and institutes to public health data and the opportunity to use them for health research.
The “Digital Solutions for Health and Disease Management” report by the European Public Health Alliance (EPHA) provides an overview of the benefits of using digital solutions for chronic disease management. The authors analyse the applicability of mHealth from the perspective of six chronic diseases, the ageing society and digital exclusion. Click here to download.
Article Source: https://www.linkedin.com/pulse/ehealth-meets-public-health-artur-olesch/?published=t
Article Author: Artur Olesch,
Digital Health Journalist & eHealth Expert