Politicians often think that telemedicine would be relevant for paediatrics. What can be done with it?
We are used to talk about telemedicine as if it were a form of “tele-visit”. This aspect was developed during the pandemic to try and follow up with patients, especially those affected by chronic conditions, and family paediatricians like myself also made some progress in this regard. Today there are software programs that enable you to make visits remotely. This allowed us to- at least partly- elude the challenges of in-person visits and to take care of small issues such as skin problems, which can be seen really well on video, thus sparing the patient a trip to the clinic. I think that the notion of telemedicine can be developed even further in family paediatrics. The remote relationship with patients- or with their parents in our case- could also be utilised for other activities such as consultations, as parents often ask to come and see us to discuss specific issues. Up till now we would ask them to come to our clinic so we could dedicate enough time to the consultation, but this could easily be done from remote.
In addition to this, we need to learn to develop telemedicine to provide some educational and prevention/awareness raising activities. Prevention is key to family paediatricians and we always do it during follow-ups and normal visits. We provide health education, trying to define the right goals for a healthy lifestyle, and we do this for each individual patient. In order to optimise resources and time- both for us and the parents- we could provide these activities remotely. This could be achieved on platforms where today it would be very easy to meet moms and dads that are facing the same issues. Therefore applying telemedicine within the family paediatrics context does not just equal to management of acute conditions. I believe that its applications could be extended to managing chronic patients- such as asthma sufferers- that require very frequent visits and present low needs and also to provide health education and prevention related activities.
Therefore applying telemedicine within the family paediatrics context does not just equal to management of acute conditions. I believe that its applications could be extended also to provide health education and prevention related activities.
What challenges did freely chosen paediatricians experience with the use of telemedicine during the pandemic?
Before Covid-19 even sending online receipts was a big challenge. During the pandemic, instead, the difficulty we faced concerned the software companies that manage our clinical charts as they struggled to provide the instruments we needed. It is not enough to just connect on Skype or a similar platform. These tools need to be protected. They should be linked to a management system where one can track what the paediatrician did during the visit, as the online consultation is as valid as the in-person one. What I would suggest is not to rely on software programs or specific applications, but rather to utilise the programs that were developed and designed for these purposes.
Telemedicine could prove helpful to also assist hard-to-reach patients.
Covid-19 triggered the increased use of telemedicine. What is your forecast for the coming years?
I think that in the coming years the use of telemedicine will become compulsory to reach patients who live in more disadvantaged conditions because it will definitively be more challenging to provide support services in mountainous areas and in smaller towns. I expect that there will be a greater concentration of paediatricians in big cities because their number will tend to go down, as the amount of those retiring is not counterbalanced by the influx of new specialised paediatricians. Telemedicine could therefore prove helpful to also assist hard-to-reach patients.
In this regard could telemedicine turn out to be a great tool to create a closer relationship between physicians and patients?
I believe that the concept of proximity should be interpreted as proximity-based care. It should not be viewed as a physical type of proximity because nowadays no one can afford to provide every single service at the patient’s doorstep. In fact, specialties and expertise should be concentrated together. Family paediatricians are able to be physically close to patients because today the vast majority of children have their own paediatrician. Let’s hope that this will still be possible in the future. If that is not the case we would have to find other ways to make that possible while also meeting the needs of the population and individual patients.
Edited by Rebecca De Fiore