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Advancing healthcare through telehealth

By Chukwuma Muanya
18 August 2022   |   2:47 am
The reality of 2020 and the challenges that occurred during the coronavirus outbreak raised a question of what the future holds for healthcare and care delivery. Healthcare providers

How to improve quality, and affordability of healthcare with new technologies, by Evoke eHealth Solutions

• Global Report on Assistive Technology identifies priorities for actions to advance access worldwide
• When COVID-19 emerged, the use of digital health strategies exploded in many countries, say researchers
• Scientists develop, and evaluate the digital tool, which helps individuals reduce alcohol intake

The reality of 2020 and the challenges that occurred during the coronavirus outbreak raised a question of what the future holds for healthcare and care delivery. Healthcare providers had to come up with a pandemic response and speed up the digitalisation processes.

Telehealth is critical to health care transformation CREDIT: https://www.aha.org

It is obvious that the development and implementation of telemedicine and digital health developments have a lot of advantages and bring great value for both practitioners and patients, but the main question is how to incorporate them into the existing workflow successfully and what difficulties and challenges may occur.

How to improve the quality and affordability of healthcare with the help of new technologies? What innovations should healthcare providers prioritise? How has the use of healthcare mobile apps changed during the pandemic? Is Telemedicine fully replace face-to-face communication with patients? What is the role of insurers in the health ecosystem and well-being? These are some of the main questions the experts are raising.

As part of efforts to advance healthcare through Telehealth in Nigeria, Evoke eHealth Solutions had a pre-launch on August 6, both virtual and in-person at Sheraton Hotel Abuja.

Speakers and delegates at the event brainstormed on the potential of digital health, Artificial Intelligence (AI) integration in healthcare, opportunities for digital health and telemedicine for the insurance industry, as well as telemedicine and digital health regulation. They also discussed insurance policies and reimbursement as a key concern in telemedicine, eHealth partnerships and important issues.

The Evoke eHealth Solutions team include Dr. Tony Oketah, Co-founder and Co-Chief Executive Officer (CEO), United Kingdom; Dr. Ifeoma Obanozie-Amadi, Co-founder and the Co-CEO United States; Dr Nonye B. Egenti, Chief Medical Officer, Abuja; Nkiru Nwankwo, Chief Financial Officer Lagos, Nigeria; Chinasa Ekete, Regional Director of Operations Southern Region, Nigeria; Gertrude Amadi, Chief Nursing Officer Enugu, Nigeria; Miss Rahila Rachel Adamu Director of Home care Services United Kingdom; Chisomaga Onyinye Ekpe, PT Regional Director of Operations Northern Region, Nigeria; and Miss Chisom Amadi, Director Customer and Patient experience United States.

Oketah said telehealth solutions offer high-quality telehealth technology that enables virtual consultation and treatment to eliminate time and distance between remote patients and their providers.

He said delivering innovative technology solutions to securely connect patients and providers—anytime, anywhere— and to enable the collaboration of medical professionals across the country and around the world is how “we fulfil our commitment to helping advance healthcare through the facilitation of research, education, and communication in the medical community.”

Oketah said Evoke eHealth Solutions enables healthcare professionals connect with patients remotely; provide convenient clinical healthcare from a distance; and provides a full range of solutions to meet the requirements of different environments.

He further explained: “We offer remotely managed services to support all your technical A/V communication systems.

“For customers needing access to a provider network, we partner with a preferred provider group in all medical and surgical specialities and the use of our telehealth technology.

“We provide you with a fully customised telemedicine programme—hardware, software and provider network.”

Obanozie-Amadi said for many patients, access to high-quality medical care can often be complicated by financial, geographical, or situational hurdles— challenges that can dictate when, where, and even whether those patients are able to seek physician care. She said Evoke e-health solutions are designed to overcome those hurdles by providing access to professional healthcare services, regardless of the patient or physician’s location.

“We aim to eliminate time and distance factors in healthcare for remote patients by enabling real-time examination and treatment through virtual consultation,” Obanozie-Amadi said.

The co-founder added: “We provide audio/visual and video communication services that combine the latest hardware and software to optimise collaboration and information sharing in any healthcare environment

“Add major impact to communication in public spaces with the visual power of dynamic, multi-screen systems over several screens or as separate displays.

Clear, uninterrupted, quality sound is a necessity. We offer professional audio system design.”

Meanwhile, on July 14 and 15 the World Health Organisation (WHO), together with the Global Alliance of Assistive Technology Organisations (GAATO), co-led several sessions at the Joint International Conference on Digital Inclusion, Assistive Technology and Accessibility ICCHP-AAATE 2022 in Lecco, Italy, to disseminate the findings of the recently launched Global Report on Assistive Technology (GReAT).

“The WHO-UNICEF Global Report on Assistive Technology: Moving Forward Together”, brought together panelists from different organisations to open a dialogue on the GReAT recommendations, exploring their implementation and identifying priorities for actions to advance access to assistive technology worldwide.

Two scientific sessions on July 14 and 15 presented the work WHO and partners have done to collect data on population access to assistive technology. Eleven countries presented their experiences and the findings of their investigations using the WHO rapid Assistive Technology Assessment tool (rATA). The methodology and findings are published in the open access conference proceedings available here.

The inclusion forum on July 15, “Measuring population access to assistive technology”, engaged global stakeholders to reflect on the methodology, process and outcome of measuring population access using the WHO rATA tool and to set up an action plan for data collection for the WHA Progress Report on improving access to assistive technology in 2026.

Also, a recent study has examined the impact of COVID-19 on digital health adoption.

Healthcare has begun to undergo significant changes in the 21st century. A cultural revolution known as digital health has occurred because of a rise in the number of patients with chronic diseases, more access to new technologies, medical information, and peer support via the Internet. Patients’ and medical professionals’ roles have shifted because of this.

The passive patient, who only seeks medical help when a symptom emerges, is evolving into a proactive, empowered patient who wants to be involved in their own treatment. They have access to technology and information, are specialists in their field of health or illness management, and can collect data using electronic equipment.

Instead of being the key-holders to the ivory tower of medicine, the function of a burnt-out physician is evolving into that of an e-physician, who guides their patients through the jungle of digital information.

In a recent study posted on the preprint server JMIR*, the researcher analysed the impact that COVID-19 has had on the adoption of digital health. When COVID-19 emerged, the use of digital health strategies exploded. Even though telemedical applications and services, health sensors, 3D printing, protective clothing, and at-home laboratory tests became part of everyday care in a matter of weeks in March and April of 2020, it was a necessity not a choice.

In less than a month, telemedicine in Catalonia replaced face-to-face primary care consultations. Early in March of 2020, they had roughly 18,000 telemedical and 150,000 face-to-face visits; four weeks later, the number of telemedical visits had risen to over 100,000, while the number of face-to-face visits had dropped to 21,000. Consultations on telemedicine services like PlushCare and Amwell surged by 70 per cent and 158 per cent, respectively, in the United States.

Remote testing was the next major disruptor after remote care. Waiting in line for a biological sample put people in danger of contracting the virus. At-home lab testing was prioritised whenever possible. COVID-19 antigen and antibody testing, as well as companies offering direct-to-consumer blood test samples and analysis, have all surfaced on the market. Many tests, ranging from food allergies to genetic studies, are now being collected at patients’ homes.

Disinfectant robots began to wander hospital floors, lowering infection risks for patients. When conventional manufacturing or availability is limited and health institutions are overburdened, DIY organisations around the world began making 3D printed products such as medical equipment, protectors, and nearly anything else needed.

Artificial intelligence has also risen to the frontline. BlueDot, a Canadian start-up, was the first to report on a possible epidemic in Wuhan. To discover public health trends and threats, it utilised a machine-learning algorithm to filter through news reports, airline booking data, and reports of animal disease outbreaks.

A.I. has also been used to arrange supply chains, sort out ventilators in a country, find new medicine combinations that could help sick patients via network science; analyse, monitor, screen, and triage COVID-19 patients; and help hospital infrastructure in resource allocation. Researchers at Massachusetts Institute of Technology (MIT) even built a speech analyser based on artificial intelligence to identify asymptomatic COVID-19 patients using cough recordings on their smartphones.

Although digital health investments had been progressively increasing year after year even before the pandemic, 2020 set a new high. According to Mercom Capital Group, venture capital funding increased by 66 per cent to a record $14.8 billion raised globally. The leading investment goal, of course, was telemedicine, which received $4.3 billion in venture capital funding in 2020.

The adoption rate of digital health has reached new heights. This optimism, however, is not reflected in clinical reality. Worldwide, healthcare is overburdened; physicians quickly burn out under the strain, patients with chronic illnesses go untreated, therapies are delayed, and medical professionals do their best to keep the system running.

Also, a digital support tool on one’s phone can be of help if alcohol consumption is reduced. This has been shown in a study by researchers at Linköping University. They have developed and evaluated a device, which helps individuals reduce their alcohol intake on their own.

Leader of the study and an associate professor at the Department of Health, Medicine and Caring Sciences at Linköping University, Sweden, Marcus Bendtsen, said: “At the beginning of the study, the participants indicated that it was very important for them to reduce their alcohol consumption. But most indicated that they didn’t know how to do it. Those who got access to the digital support began to feel more self-assured about how they could go about actually changing their behaviour.”

Bendtsen believes that there is too little discussion about concrete methods of creating long-lasting change. Warning messages and communicating the risks of various behaviours aren’t enough.

In Sweden, the sale of alcohol is regulated by the state, and the tax on alcohol is relatively high. Despite this, alcohol consumption has remained at the same level for a long time.

Around three in 10 adults, or three million Swedes, drink alcohol in such a way that it is classified as risky drinking. In such cases, the risk of diseases such as cancer, stroke and heart problems is considerably higher. People who are risky drinkers are also at a much higher risk of other physical and psychological negative consequences, and so are family members and other people close to the drinker.

The researchers behind the study, which has been published in the journal BMC Medicine, looked for a new way to reach those who want help to drink less.

“People who want to quit smoking are encouraged and supported by those around them. But there is a stigma around wanting to stop drinking alcohol. There is a common conception that one should be able to handle one’s own alcohol consumption, and many don’t seek help, even if they want to change their behaviour,” said Bendtsen.

Digital support, such as a mobile app or support online, could be one way to reach more people who need help. Digital tools can be scaled up and used by many, without costs increasing much. They can also work better for people who do not want to turn to the healthcare system because a digital tool can be used without personal contact. No one else needs to know that one uses the tool, which reduces the stigma barrier to seeking help.

To investigate whether their digital tool could contribute to reduced alcohol intake, the researchers wanted to reach out to people at the very moment when they were motivated to reduce their alcohol consumption.

The study participants were recruited online through targeted adverts shown to people looking for information about how to drink less alcohol. Those who chose to participate in the study were randomly allocated into two groups. One group was immediately given access to the new digital tool. The other group was offered existing web-based resources and was asked to motivate themselves to reduce their consumption. They later received access to the digital tool.

Those who were immediately offered digital support received a message every Sunday. In a neutral tone, the message encouraged them to assess their alcohol consumption during the past week.

After participants had reported their drinking, they received feedback and access to several tools. Among other things, the tools included helping participants set goals for themselves and keep track of their alcohol consumption over time.

Participants were also able to learn more about the social risks of being under the influence of alcohol, and about the risks to one’s own health. The participants could write messages to themselves and choose when to receive them — for example, a reminder to take it easy with the drinking on a certain day or a motivational reminder about why they wanted to drink less.

It turned out that the effect of the digital support tool, after four months’ use, was comparable to other digital interventions from international studies — but also a little better than the evidence for face-to-face interventions.

“Those who had access to the digital tool had roughly 25 percent lower alcohol consumption than the group which didn’t, which is a slightly larger effect than we expected. This kind of tool won’t change the overall societal situation when it comes to alcohol consumption, but it is a very good tool for individuals who want to change their own lives,” said Bendtsen.

The researchers are now developing an app to make the tool available to individuals who feel the need for it. They also want to adapt the app to individual needs. There was a broad age range among the participants in the study, and the reasons for drinking alcohol vary between 18-year-olds and 80-year-olds. The researchers are also performing health economic calculations to see what the effects on healthcare savings and quality of life would be over a 30-40 year period if the tool was used widely.

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