The Covid-19 pandemic had implications for public health on two levels:
- the fight against a pathogen not yet fully known, the fight in which unprecedented financial, human, and scientific resources were thrown into the game
- the challenge of dealing with a large number of patients with chronic diseases that no longer had access to the hospital (the healthcare systems in Eastern Europe are centered on in-hospital care) and for which solutions had to be found, especially in 2020
The introduction of telemedicine overnight (after years of procrastination) represented a step forward, but an incomplete one, in the absence of integration with other data sources: electronic files, wearable devices, or other mini devices used at home by chronic patients, to monitor the evolution of the disease.
It’s very important that the investments and prioritization for Covid-19 offered important results – vaccines, diagnostic tests, oral treatments, etc., but one effect was the deprioritization of patients with chronic diseases – cancer, cardiovascular, diabetes patients, and the list can go on and on.
The data are eloquent: hundreds of thousands of excess deaths in Eastern Europe in 2020-2021, two-thirds of which represented excess mortality as a result of uncontrolled chronic diseases.
It is clear that the solutions identified in the pandemic crisis, such as telemedicine, have not reached their potential. There are multiple reasons for this.
(1) Probably the most important reason is the inertia and reduced adaptation to change of medical doctors, but also of patients, even in a crisis situation.
(2) During the pandemic, there was no standardization of the use of digital solutions such as telemedicine. For example, a law was promoted during this time, but the application rules were published only last week in Romania.
The next step is the professional’s opinion, for each therapeutic area, regarding when, and how telemedicine should be used. For this, we probably need pilot projects, implementation research, and real-life use of various digital tools, with the aim of increasing the quality of life of patients.
Creating models based on real life is essential for increasing trust (of people in technology, but also of patients in doctors and the health system) because it takes into account cultural, social, and environmental factors that influence attitudes, perceptions, and individual behavior.
The pandemic has shown us how important individual behavior is in relation not only to classic public health measures but also in relation to innovations – mRNA vaccines, genomic surveillance of virus circulation, the use of the Covid-19 digital certificate or the use of applications that signal proximity to an infected person.
I think there are lessons from the pandemic that we are still learning – and one of them is that innovation and the digital component of innovation must start from our needs, but also take into account individual behavioral elements. Without these elements, digitization and innovation will remain at the stage of buzzwords.
The version in Romanian: Telemedicina, una dintre lecțiile pandemiei Covid-19 pe care încă nu am învățat-o în România