Future Directions in Health
Annotated Bibliography:
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Baer, Julius [Julius Baer]. (2020, August, 10). Three trends defining the future of healthcare [Video]. YouTube. https://www.youtube.com/watch?
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This video identifies three areas of improvement for healthcare in the near future which are digital health, genomics, and extended longevity. Digital health was expanded to include telemedicine, mobile health, and med tech. An example that was provided involved wearable devices post-surgery. These devices can measure information including blood pressure and heart rate then these findings can be viewed by medical professionals through an app. A potential use of advancement in gene-based therapies included tailor-made treatments based on unique DNA composition. These treatments could target infectious diseases, such as COVID-19. In terms of improving lifespan, the video talks about how seniors in nursing homes can benefit from remote monitoring. Healthcare professions can remotely analyze the blood glucose levels of these senior via wearable devices to help manage diabetes. Although pursuing newer technologies and artificial intelligence is exciting, the importance of the human element to patient care is emphasized this video.
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Canada Health Infoway (2021). Rapid response to COVID-19. Retrieved from https://www.infoway-inforoute.ca/en/solutions/rapid-response-
This website is a national resource that explains how Canada Health Infoway is working with provinces and territories to implement remote systems for virtual care solutions in response to COVID-19. Canada Health Info helped more than 85,000 clinicians adopt virtual visit tools and facilitated more than 4.3 million virtual visits. The mental health services and tools were highlighted since COVID-19 was detrimental to many Canadians due to financial instability, social distancing, and stress. Electronic visits and remote monitoring were described as being a safe way to connect patients with a healthcare team during the COVID-19 pandemic; this includes video visits, secure messaging, and remote monitoring since these methods do not involve direct contact. Funding for these projects to expedite their implementation was in part due to Canada Health Infoway reallocating existing funds to create the Rapid Adoption of Virtual Care Fund. Canada Health Infoway continues to work with Health Canada to improve virtual care solutions across the country.
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Cisco [Cisco]. (2019, November 7). The future of healthcare [Video] YouTube. https://www.youtube.com/watch?v=Xksm8ZGgLmw
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Advancements in information technology (IT) infrastructure is necessary to improve virtual care. This video explains how collecting data and tracking wellness will change how chronic disease is managed, how patient's experience care, and how clinicians deliver health services. Meeting with a doctor from home using telemedicine will become increasingly more common. IT operations plays a role in creating accessible high quality healthcare as well as reducing healthcare costs in the longterm. This video also touches on some of the applications of augmented reality and virtual reality. For example, these technologies can be helpful in treating phobias, post-traumatic stress disorder, and addiction. Moreover, doctors can practice surgical techniques and understand anatomy better using augmented or virtual reality. Surgeons will be able to perform complicated procedures with guidance and enhancement from robotics and artificial intelligence. In general, artificial intelligence will be used as a supportive tool for clinical decisions such as automated symptom triage.
Crawford, A. & Serhal, E. (2020). Digital health equity and COVID-19: The innovation curve cannot reinforce the social gradient of health.
Journal of Medical Internet Research, 22(6). Retrieved from https://doi.org/10.2196/19361
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This commentary praises digital health innovations but cautions that some vulnerable groups may remain underserved if health equity is not a priority. The authors propose a digital health equity framework that can help minimize health disparities during the shift towards virtual care solutions. The benefits of virtual encounters as opposed to in-person meetings are highlighted, particularly in relation to the COVID-19 pandemic. The limitations of virtual health are mainly felt to be poor engagement, lack of digital literacy, lack of access to digital health, and poverty. The digital health equity framework takes into account the social determinants of health. The authors hope to minimize unintended consequences of implementing digital health practices and ask that future measurement-based approaches are used to ensure that the social gradient of health is not reinforced. The aim of this commentary was to stress the importance of health equity and to encourage further investigation in this emerging field.
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Kuchenbuch, M., D'Onofrio, G., Wirrell, E., Jiang, Y., Dupont, S., Grinspan, Z.M., Auvin, S., Wilmshurst, J.M., Arzimanoglou, A., Cross, J.H.,
Specchio, N., & Nabbout, R. (2020). An accelerated shift in the use of remote systems in epilepsy due to the COVID-19 pandemic.
Epilepsy & Behavior, 112(107376). Retrieved from https://doi.org/10.1016/j.yebeh.2020.107376
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This study looked at remote work systems prior to and during the COVID-19 pandemic and evaluated the implementation of virtual care solutions across clinics, education, and scientific meeting activities. A cross-sectional survey was conducted through the European Reference Center for Rare and Complex Epilepsies Network, the International and the French Leagues Against Epilepsy, and the International and the French Child Neurology Associations. The survey was completed by 172 epileptologists from 35 countries. The proportion of remote systems for both institutional and personal use increased significantly during the COVID-19 pandemic for the majority of respondents. Also, most of the academic epileptologists altered their classes to an online platform at the onset of the COVID-19 crisis. The authors describe how virtual operations impact scientific discovery and dissemination. A comparison between France, Italy and China was made, examining remote system use in epilepsy before and after COVID-19 hit. Interestingly, China used remote systems significantly more than France or Italy prior to COVID-19. However, during the pandemic, all the countries started to use remote systems at similar rates.
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Rametta, S.C., Fridinger, S.E., Gonzalez, A.K., Xian, J., Galer, P.D., Kauffman, M., Prelack, M.S., Sharif, U., Fitzgerald, M.P., Melamed, S.E.,
Malcolm, M.P., Kessler, S.K., Stephenson, D.J., Banwell, B.L., Abend, N.S., & Helbig, I. (2020). Analyzing 2,589 child neurology telehealth
encounters necessitated by the COVID-19 pandemic. Neurology, 95. Retrieved from https://doi.org/10.1212/WNL.0000000000010010
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This article discusses the findings of a cohort study with retrospective comparison of 14,780 in-person encounters and 2,589 telehealth encounters. The vast majority of the telehealth encounters involved audio-video calls but some were simply telephone calls. Patients and clinicians were asked to fill out a questionnaire that asked about satisfaction, technical quality, overall experience, follow-up plans, and if there was a need for in-person assessment. The findings were very supportive of telehealth and found that this approach was very effective for a large proportion of child neurology care. The authors mentioned that racial or ethnic minority groups were less likely to participate in telemedicine encounters. A limitation that will need to be addressed in the future is the technical challenges such as poor video, poor audio, and lost connections. A variety of neurology patients have benefited from telehealth, especially people with epilepsy or migraines. The authors argue that telemedicine will benefit pediatric neurology care beyond the COVID-19 pandemic.
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Patterson, V. (2019). Managing epilepsy by telemedicine in resource-poor settings. Frontiers in Public Health, 7(321). Retrieved from
https://doi.org/10.3389/fpubh.2019.00321
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This article describes epilepsy management across countries with low, middle, or high income. The author explains that resource-poor settings require the empowerment of non-physician health workers and the implementation of telehealth. The World Health Organization created an app that helps diagnose and manage epilepsy. Some villagers in Myagdi, Nepal were trained on how to use the app and were provided with basic education on how to identify someone with possible epilepsy. These locals are referred to as epilepsy field workers. The app would generate a probability score of epilepsy being the diagnosis, then they would telephone an epilepsy specialist in Kathmandu. Based off the telehealth visit, the epilepsy field workers would then arrange for prescribed treatments. The benefits of email, webservers, remote electroencephalograph review, short message service (SMS) messaging, and videoconferencing are discussed. The author concludes that traditional healthcare delivery systems are not practical in poorer countries. Alternative methods will vary based on local circumstances including the location and available personnel.
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Sattar, S. & Kuperman, R. (2020). Telehealth in pediatric epilepsy care: A rapid transition during the COVID-19 pandemic. Epilepsy & Behavior,
111(107282). Retrieved from https://doi.org/10.1016/j.yebeh.2020.107282
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This article discusses some of the barriers that clinicians have faced which have prevented them from adopting telehealth practices. In terms of vulnerable populations that are at heightened risk, telehealth is viewed as being crucial in order to give them rapid access to their healthcare providers. The authors focus on epilepsy management in pediatric patients during the COVID-19 pandemic. They propose how to improve screening, prepare for visits, obtain a medical history, and perform an examination via telehealth. Both the advantages and disadvantages are discussed regarding the use of telehealth for this patient population. The advantages were specific to COVID-19 pandemic conditions as well as broader conditions beyond this public health crisis. The authors conclude that telehealth was a necessity during the COVID-19 pandemic to limit exposure and minimize transmission. However, the effectiveness of telehealth during this time has made it more likely that this approach will continue to be used with some recommendations to medical practices to optimize patient care.