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Potentialities and criticalities of telemedicine after COVID-19 outbreak

Telemedicine is increasingly establishing itself as one of the most important directions that healthcare will take globally: a new model of distance healthcare, as Eric Topol writes on The Economist, which will incorporate the benefits of digital technologies and data. Much of the technology needed for telemedicine already exists, and the COVID-19 emergency has accelerated its development, especially in the field of infectious diseases.

Telemedicine in an epidemic context, for example, could be instrumental during a first consultation, and consequently reduce the risk of spread of infection, reducing the exposure of both patients and healthcare professionals. As Topol points out, video visits have proved to be efficient from the point of view of quality and personnel employed, thus lightening the work of healthcare workers. The smartphone itself can become a useful technology for medicine: the microphone – continues Topol – can be used by patients, for example, to analyse their cough and understand if there is pneumonia, just as fitness apps have come to measure heart rate:

At Scripps Research, we recently published a study of over 47,000 people that showed that data from smartwatches on a resting heart-rate (which typically increases before abnormal body temperature or fever) predicted the onset of flu-like illnesses in geographic clusters as well as, or better than, established means. We just launched a large smartwatch research study in America to determine whether the same can be achieved for predicting clusters of the covid-19 outbreak. That could help promote precision quarantines, better containment and eventually, if a treatment becomes available, its use at the earliest possible time.

Not only that. Before the COVID-19 emergency, Artificial Intelligence applied to health and health care was also a rapidly growing area of research, and could even come out even stronger from the COVID-19 emergency: partly because of the speed of assessment it allows in contexts such as the pandemic, and partly also because of a possible – and feared – shortage of personnel that could happen at the end of the pandemic. As Karen Hao points out in the MIT Technology Review:

Deep learning, in particular, has demonstrated impressive results for analyzing medical images to identify diseases like breast and lung cancer or glaucoma at least as accurately as human specialists. Studies have also shown the potential of using computer vision to monitor elderly people in their homes and patients in intensive care units.

While telemedicine is necessary, socially accepted, and constantly improving, some obstacles remain: most health care systems globally have not yet built digital platforms for television, not to mention the issue of privacy. And there remain real economic and social challenges, such as the price and accessibility of technologies that enable a certain level of telemedicine: people who are less literate in technology and the poorest people could be excluded – and these are often the most vulnerable groups also from a health point of view.

There is another level of criticality, namely that telemedicine has a limit. As Topol correctly notes, for millennia hands have represented the essence of the doctor-patient relationship, even before the clinical gaze took over: but this touch is a connection of non-verbal stimuli able to transmit empathy, trust, warmth, presence, and this telemedicine can hardly replace it.

Although there is an open debate on how to maintain empathy through telemedicine or online psychotherapy sessions (and this even before the COVID-19 emergency), the touch, presence and intimacy of the treatment will remain something unique. On the other hand, it is essential that the technologies at the service of telemedicine can offer ever better support when physical presence is possible, as we have recently experienced on our skin.

Concluding with Topol,

The hope that the pandemic passes quickly is misplaced-the reality is that it will take well over a year. It is important to acknowledge that other pandemics will be part of our future. Now is the time to harness the potential of the technology to provide better and more efficient care.

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