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Distant yet close(er) thanks to IT options

Many patients worry that telemedicine will take them further away from their doctor. Might telemedicine actually help them to get closer instead? What are the obstacles?

Enrico G. Caiani

Department of Electronics, Information and Bioengineering Polytechnic University of Milan

By June 2021July 27th, 2021No Comments
Photo by Lorenzo De Simone

Many habits had to be changed since the beginning of the Covid-19 pandemic: tele-work, distance learning, even university exams and graduations take place in front of a screen because it is the only way to carry out these activities. We had the opportunity to test new tools that actually enable us to work, teach and learn. They all come with advantages and disadvantages. On one hand you are no longer tied to the need to physically be in a place in order to get your things done (and that comes with saving money on the commute, transport and on having to eat outside). You might even be free from time constraints in that you do not have to be available at set times in order to access lessons as these are recorded. On the other hand there are issues around juggling family and work life in the same space, sharing IT tools, and the lack of an interpersonal relationship based on proximity and communication- even non-verbal one.

Covid-19 accelerated policymaking and the related bureaucratic processes- that had been on a standstill for years on end- around the opportunity to use new communication tools.

The interaction with one’s doctor changed, especially during the initial phase of the pandemic, as there would be much less contact and visits, only in cases of extreme necessity and under appointment, in order to avoid the risk of mutual infection. However, Covid-19 accelerated policymaking and the related bureaucratic processes- that had been on a standstill for years on end- around the opportunity to use new communication tools also in the healthcare sector. In March 2020 the Civil Protection Service already gave the ok for medical receipts to be sent via email- or go paperless- without the need for patients to go to their doctor to pick them up. After that, in September 2020, the Conference of the Independent Regions and Provinces implemented the financial equalisation between services provided online and the clinical ones offered in the traditional way. This meant that the National Healthcare Service reimbursed tele-visits as if they were normal in-person visits.

What is meant by tele-visit and where does it apply? A tele-visit is a way for a doctor to conduct a remote visit with the patient (and the caregiver, where relevant). It is only an option for patients that already have a confirmed diagnosis whereby the physical assessment (inspection, palpation, auscultation and percussion) at the clinic is not required. The potential benefit of such instrument is clear, especially for patients with chronic conditions (which are over 20 millions in Italy) who need regular check-ups with their treating specialists to assess how their pathology is progressing, to adjust or change their current treatment, to let the doctor know about symptoms or to ask for more information. In such cases being able to contact the doctor via an Intern-based tool (desktop, laptop or smartphone) and from anywhere undoubtedly represents a way to save time for both the patient and the potential caregiver. This often enables one to avoid challenging commutes (for example in cases where the patient is elderly and has been having difficulties to walk for years) and being exposed to microbes and viruses, and it allows effective communication with one’s doctor to take place.

This approach is obviously not feasible in cases where patients need to get a clinical examination or the diagnosis did not take place yet so the only possible solution is the conventional in-person visit.

Telemedicine might be a facilitating factor to ensure even more communication takes place between patients and those who look after their chronic conditions rather than being a divisive element to be worried about. However, ensuring equal access to it requires us to overcome some obstacles.

In light of these observations one can see how telemedicine might be a facilitating factor to ensure even more communication takes place (in cases of pandemic related risk it constitutes the only channel available) between patients and those who look after their chronic conditions rather than being a divisive element to be worried about. However, ensuring equal access to it requires us to overcome some obstacles. For example citizens need to have adequate access to the Internet. There should also be IT skills training available where needed so that these new communication tools can be used effectively (not just to learn how to use new technologies but also to communicate through them). The provision of this training should take place both on the patients and the doctors’ side, intervening on the educational journey of the future generations of doctors by providing specialised skills. That is the only way to “close” the circle, which is still open for now.

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