Telehealth is an exciting development in healthcare – it removes geographical and access boundaries, meaning that housebound patients, those in rural areas and people with health conditions who travel frequently can retain the benefits of rapid communication with healthcare professionals, wherever they are.
In the UK, telehealth solutions are being taken up by a variety of NHS organisations, and these range from do-it-yourself blood pressure monitors in GP waiting rooms, to comprehensive monitoring systems that can be used at home by patients with chronic diseases.
An example of a telehealth initiative in Russia
Such systems are becoming increasingly popular globally, and an initiative in Russia is seeking to combat the twin issues of heart disease and timely access to appropriate medical care that are current for the nation. Heart disease is a major cause of death in Russia, as in many other countries, and there are a number of programmes that tackle this at the root – with public health campaigns to educate the population about healthier lifestyle choices, and to support individuals to make changes. The St Petersburg Cardiac Monitoring Service looks at the problem from another perspective, providing a useful resource for those with established heart disease, or for those at risk. It also addresses the difficulties posed by geography for a country as large as Russia with a significant population in remote areas
The service, delivered in partnership with Aerotel Medical Systems, an Israeli company that provides telehealth solutions globally, is based on portable electrocardiogram (ECG) monitoring. ECGs are an important tool for doctors – they can highlight heart rhythm problems, as well as heart attacks, and where problems are suggested by the trace, timely intervention can save lives.
People over 35 who have heart disease or cardiac risk factors (such as a high stress lifestyle or obesity) and those who do not have easy access to appropriate medical care are considered suitable for the service. Traces are recorded as required, and information from the portable monitor is sent via landline or mobile telephone connections to the Cardiac Monitoring Centre, and within a few minutes a message detailing the recommended course of action is received by the patient. At the same time, the patient’s GP or cardiologist is notified.
Figure 1: Explanation of how the cardiac monitoring service works. The site also features a number of options for making contact, including ICQ and Skype, and instructional videos
Patients benefit by having access to 24 hour advice, which can be accessed from anywhere in the world. GPs and cardiologists benefit from having instant access to information about their patients’ conditions, and input from specialists at the centre. Healthcare organisations reap similar rewards, as well as cost savings in terms of equipment.
ECG traces are stored online in a “Private Office”, to which only patients and doctors have access. This function adds value from the perspective of both doctor and patient – doctors have the assurance of having instant access to important information about their patients, and patients have the security of knowing that wherever they may be, their heart condition can be monitored, and the resulting data analysed.
Telehealth and mobile health – current pharmaceutical involvement
In the developed world, telehealth solutions are generally considered as adjuncts to other forms of care delivery. Their appeal lies in the potential for cost savings, and their ability to reach large numbers of patients. In countries such as Russia, where it is popular to retire to remote country cottages for the summer, or in developing countries where there is a high ratio of patients to doctors, and poor infrastructure, telehealth could become a cornerstone of how healthcare is delivered.
A number of pharmaceutical players are already involved in the area of telehealth and mobile health. Merck, Sharpe and Dohme sponsor Text to Change, an initiative focused on helping people in countries affected by poverty and conflict to access healthcare information via SMS, and the US government, along with several pharmaceutical companies (including Johnson & Johnson and Pfizer) support Text4Baby, a programme that provides information via SMS to improve health during pregnancy and early life. See here for more information on these initiatives.
Figure 2: The Text4Baby campaign uses mobile technology to improve maternal and child health
Pharma and telehealth – the future
Pharmaceutical companies with an interest in using telehealth to improve healthcare and engage with healthcare authorities, practitioners and patients should consider where such initiatives would have the greatest impact – in terms of both geography and application. In the above examples, communities in both the developing and the developed world have benefited from telehealth interventions. (Read more about the differing applications of mobile health solutions in the developed and developing world here)
In addition to sponsoring initiatives, pharmaceutical companies could look at using telehealth channels to support and interact with doctors, including those in remote areas. In the St Petersburg example, patients receive a message from the service with recommendations – pharmaceutical companies could engage in a similar manner with healthcare professionals, being “on call” to answer questions about particular therapy areas, or if linked into the system itself, there could be the potential for medical departments to provide additional information to the physicians. Whilst any form of interaction between pharmaceutical companies and patients, the public or doctors must adhere to guidelines, there are precedents for such remote interactions – in the US, doctors can use ePocrates software on their phones and tablet PCs to interact directly with Pfizer medical information departments, and similar software has been developed for Amgen.
Conclusion
Telehealth solutions are becoming increasingly widespread. In developed countries, they can help create efficiencies, but in the developing world, their role may be more central to the delivery of care. Pharmaceutical companies should remain aware of telehealth developments in their areas of interest, and consider how they can use these emerging technologies to engage with healthcare professionals and patients.
Creation Healthcare advises pharmaceutical marketers, communicators and business leaders about improving outcomes in a changing engagement environment. If you would like to talk with a member of our team about how we can help you to develop a healthcare engagement strategy, contact us now.