Ms Rao, your doctor will see you now...online

The World Health Day is a global health awareness day celebrated every year on 7 April, under the sponsorship of the World Health Organization (WHO), as well as other related organizations. World Health Day is acknowledged by various governments and non-governmental organizations with interests in public health issues. The theme of World Health Day 2019 is: Universal health coverage: everyone, everywhere. The slogan of World Health Day 2019 is "Health for All"

The scenario described above is already a reality in some parts of the world. Including India. Internet connectivity and rapidly evolving technology have dramatically changed healthcare delivery. It will continue to do so, far into the future, in ways we can barely imagine today.

Medicine and advances in technology have been intertwined since time immemorial. However, the biggest impact of technology on healthcare, has occurred in the last hundred years or so. The discovery of antibiotics and their safe, mass scale production is a prime example. Vaccines and their impact on many life-threatening infectious diseases, is another.

Development of various imaging modalities from the humble X-Rays to Ultrasound Scans, MRIs and PET CT Scans have changed the way a physician can look inside the human body. Open Heart Surgery would have been impossible without the development of the Heart and Lung Machine. The list of examples is long, indeed. In the new millennium, we are witnesses to another paradigm shift in healthcare technology. Access to, and delivery of healthcare is now being facilitated though electronic means.

Adoption of Electronic Health Records (EHR) to store all the health related information of patients has made it easier both for the treating physician, as well as the patient, to access and act upon their past and present medical conditions. This data can be stored on local servers or the Cloud to enable access across different healthcare providers.

The doctor or the patient no longer has to go through handwritten paper records which may be incomplete at the best, illegible at the worst! Several, low-cost diagnostic kits and handheld scanning devices have been developed for large-scale screening and diagnosis of many infectious diseases and some cancers.

The data from these devices can be fed electronically into remote servers and experts can access, analyse and opine upon the same in real time, if required. Health camps can now be easily conducted in far-flung areas by trained, community-based healthcare technicians or nurses. The physical presence of a qualified doctor may no longer be necessary for initial screening camps.

Telemedicine or consulting a doctor via the internet is gradually on the rise, to provide health-related advice to urban patients, who are short on time due to varying work schedules. Patients from remote areas will be the main benefactors of this technology, if they are connected to the now ubiquitous cellphone network. They can easily get access to expert medical advice without the need to make expensive and time-consuming travel arrangements.

Another major change in the healthcare field has been the development of various applications (Apps) which one can easily download on a smartphone. Today, there are thousands of Apps for chronic diseases like Hypertension or Diabetes, for long term management. Medication Management Apps remind you take your medicines on time.

There are Apps to store your personal health records for easy reference. Apps for fitness and weight loss are the most downloaded ones. However, the jury is still out on whether these apps (especially the fitness/weight loss ones), actually have an impact on one's health or they just further clutter up phone screens!

A few words of caution now

Implementing newer technologies in medicine has its downsides as well. To roll out any innovation in the healthcare system, there always is an additional cost. For an impact to be made on the general population, the technology needs to be scaled up. Replacing old equipment or systems, re-training of personnel, hiring additional personnel, all impose a substantial financial burden on the healthcare budget. The rising healthcare costs are a source of concern for the patients, healthcare providers, and policy makers. EHRs may seem very efficient and secure, but in the real world, data entry is a tedious process and is also prone to human errors.

Keeping confidential data safe is a major challenge and medical data theft is a reality, even as we speak. It is said that the value of a stolen medical record is several times more than the Credit Card details of an individual. Break in connectivity with a local server or the Cloud can bring an entire hospital's operations to a halt. A common feedback from many patients in modern hospitals is that, during a consultation, their doctor seems to be more interested in the computer screen than in themselves!

Point of care hand-held devices or diagnostic kits can malfunction or produce wrong results in the field, leading to unnecessary anxiety for all concerned. With new technology, a lot depends on the operator as well, for reliable, reproducible results.

Consultation via Telemedicine has its own pitfalls. The internet connection might be great, but the emotional "connect" between a patient and physician is very difficult to establish. It is a big challenge to convey the empathy, a caregiver feels towards the patient's suffering, in such circumstances.

Impersonal perusal of reports to offer an opinion, go against the basic ethos of a medical consultation. To see a patient in person, listen to the history, observe the clinical signs and then order tests to form an opinion and direct treatment, is what medicine is all about.

Overall, I would say that innovation and implementation of better technologies in healthcare is not a new phenomenon. While the initial costs may seem high, but there are substantial cost savings in the long run, because a healthier population is a happier, more productive population. Moving forward, we must continue to work to make our healthcare delivery systems cost-efficient, user-friendly, secure and most importantly, more empathetic. Never forget, the human touch conveys much more than any screen, and adds significantly to the healing experience. (Writer is Senior Consultant Cardiovascular & Thoracic surgeon, Continental Hospitals, Hyderabad)