Table of contents:
Video: How Telemedicine Improves The Quality Of Life Of Chronic Patients
How telemedicine improves the quality of life of chronic patients
Boris Zingerman, General Director of the Association of Developers and Users of Artificial Intelligence "National Base of Medical Knowledge", talks about technologies that on a daily basis change the lives of sick people for the better.
Photo: Intel Free Press /
While the Watson supercomputer is spectacular, but rarely demonstrates the power of big data-driven diagnosis, there are technologies that are changing the lives of chronic patients on a daily basis. How exactly this happens, says Boris Zingerman, General Director of the Association of Developers and Users of Artificial Intelligence "National Medical Knowledge Base".
Q: Why did you decide to focus on helping patients with chronic conditions?
Answer: In an American magazine I came across an article that presented a very close idea to me about changes in the very structure of the health care system. The fact is that initially it was built around assistance in acute cases requiring urgent intervention: surgery or treatment of infectious diseases. For this, hospitals were created, where they provided assistance to urgent patients. Today, half of the population of developed countries suffers from chronic diseases, and a quarter - more than one chronic disease. Accordingly, medicine should be reoriented to provide assistance to just such patients. But she is not ready for this.
Q: What, in your opinion, prevents medicine from building a system around helping chronic patients?
A: The provision of medical care is completely tailored for face-to-face interaction. A patient with a chronic disease should regularly visit a doctor, bring him a diary of observations, so that the doctor can adjust the treatment based on these records. Given the current level of technology development, these visits are unnecessary. But doctors are used to communicating with the patient in person, so any attempts to transfer part of this communication online are rejected. The second point is related to the fact that doctors are overloaded with full-time work and they do not have the opportunity to engage in telemedicine as well. And the third key aspect - and this is a global trend - is not clear who will pay for it. Telemedicine services are not included in the compulsory medical insurance tariffs. Payment is possible only at the expense of the patient or through VHI.
Q: What are the current technical capabilities for remote monitoring of patients with chronic diseases?
A: Now there are sensors that allow you to remotely monitor the patient's condition and, based on the data received, prescribe and adjust treatment. This is, for example, a glucometer that can non-invasively measure the glucose level every 15 minutes for two weeks, this is about two thousand measurements per period. If we correlate the data obtained with its help with the indications of the patient's activity, his nutrition, it is possible to adjust the doses of insulin. And thus, remotely for many years to provide a chronic patient with a normal full-fledged life. The problem is that there are not enough doctors who can prescribe these sensors and understand how to work with the data array obtained with their help.
Q: What other wearable gadgets can we talk about?
A: Gadgets are not always needed to provide remote assistance. Take chemotherapy as an example. Today, in some cases, the treatment looks like this. The patient has to come to the day hospital every day to get a pill there, eat it and go home. And this is an oncological patient who takes the hardest chemistry. It is difficult to imagine how he maintains this road and, most importantly, why. On the one hand, "why" is clear. This is a very difficult and dangerous treatment. Physicians should monitor the patient's condition. But it can also be monitored remotely, in a much more favorable home environment.
There is a service for remote monitoring of cancer patients with chemotherapy or immune therapy in the postoperative period. The essence is very simple: the doctor prescribes the frequency and determines the type of questionnaires for specific tasks, based on what complications and side effects may be. And every day or on the basis of the constructed schedule, he interrogates the patient. On the basis of the identified symptoms, he can neutralize various abnormal situations, he can give targeted recommendations in non-critical situations. For example, if a patient complains that he has nausea and vomiting in non-critical volumes, then he can be given a link to the material "How to deal with nausea", which will explain what exactly needs to be done in this situation. If the patient complains of incipient skin toxicity, then you can begin to fight it beforehow it will require hospitalization, tell what creams to use, what gloves to wear, how to care for your skin. This solves two important points. On the one hand, the patient does not waste energy on the road. And on the other hand, doctors are able to pay attention to urgent patients with acute cases who need help here and now.
Q: In what areas, apart from diabetes and oncology, is the transition to remote patient management available now?
A: In addition to oncology, similar projects have been launched in transplantology. These are services for the management of patients after kidney and liver transplants, with plans to make similar products for patients with lung and heart transplants.
Transplantation is a rare, complex operation performed by rare specialists of the highest class in Moscow or St. Petersburg. And it turns out that the patient was operated on and then discharged home, to the regional center, where no one understands how to monitor such a patient, or how to manage him. Remote support service implies periodic consultations with a doctor who understands what to do. And if artificial intelligence is added to these processes, it will relieve the doctor. Artificial intelligence is connected to the doctor-patient communication channel. It filters the questions into simple and complex. The first takes on the solution, while complex questions are sent directly to the doctor. In my opinion, the introduction of artificial intelligence and the transition to remote assistance in all cases, except acute ones, is a ubiquitous trend.which will become a reality in the next decade.
Boris Zingerman, Head of Digital Medicine at INVITRO, General Director of the Association of Developers and Users of Artificial Intelligence in Medicine, National Medical Knowledge Base, member of the Expert Council on Information and Communication Technology of the Ministry of Health of the Russian Federation, owner of TelePat - Telemedicine for Patients.