Mr Schwietzke, when did you last go to the doctor’s?
My last visit to a doctor was three months ago. It was a routine medical examination where my blood and urine were taken along with my pulse and blood pressure. My eyes, ears and joints etc. were also checked.
Did the visit to your doctor help you or would you have preferred to save the time and communicated with the doctor from the comfort of your own home by telephone or laptop?
Of course the visit and the talk with the doctor had helped – but it did take up a good two hours altogether, and that is not including the journey there and the waiting time. On the whole, many visits to the doctor can be avoided or could at least be reduced in terms of time. This need not mean that no personal contact between the doctor and patient should take place, simply that this does not necessarily require the presence of both parties. With these considerations in mind, we started the telemedical pilot project with the “Caring me” platform.
How does this project fit in with the overall digital transformation change?
By using new technologies, many processes of patient care can take place through other channels such as online, telephone or video call or through chat. This is a win-win-win situation: the patient saves on journey time, which is a particular advantage in rural areas. The doctor can see and monitor the health condition of their patient at any time of day and, incidentally, more savings are achieved in the health system.
Which areas of sickness does this project address?
In this project we support patients with depression. We have selected this disorder because there has been a rapid growth in the number of people affected over the last few years. The World Health Organisation (WHO) estimates that in 2020, depression will become the main reason for illness-related absenteeism. But the responsible institutions simply do not have access to sufficient resources to adequately care for these patients. For this reason, many patients with depression are simply prescribed an antidepressant after a brief examination and sent home. Of course this is a long way from ideal support and, consequently, many patients come back to the doctor after a few weeks with their state of health considerably worsened.
What individual services does Arvato provide in connection with this solution?
The project was carried out in partnership with a state-run hospital in the Barcelona metropolitan area. We have developed both the “Caring me” online platform and its contents, along with the organisation of the treatment procedures, in close cooperation with the hospital.
The doctors explain the programme to the affected patients and register them on our platform. The patient receives an email with the access details to their personal profile and, from that moment on, they get to enjoy all-round support through Arvato. The patient receives a phone call to welcome them, which we use to explain the therapy and give them an introduction to the platform. After that we contact the patient when a module begins or ends, if they do not adhere to the approach prescribed by the doctor or if we observe any irregularity in their state of health. In this case the doctor giving the treatment is also informed, so they can contact the patient if necessary. We also analyse the patient’s adherence to the medication, to be sure that they implement the measures prescribed by the doctor. If the patient has any questions or problems, they can contact us through various different channels.
On top of that, there is a home page for the programme that is open to the public, where family members and friends can find out about symptoms and therapies.
What would you describe as the greatest challenge in this project?
Telemedical solutions are new territory for both the patients and the doctors providing the treatment, so a great deal of explanatory work has to be carried out for both parties. But this is fundamentally a pleasant task, as both patients and doctors quickly recognise the advantages of this solution. It has been really exciting to adapt the respective traditional stages of treatment to the digital conditions. In the development of the procedures, we had to take special care to enable the broadest possible individual support alongside some standardised therapy elements.
You have mentioned the advantages of the solution for doctors and patients. What advantages are they exactly?
The patient’s medical condition can be seen round the clock, without them having to visit the doctor’s surgery. The patient is optimally cared for and can carry out their treatment from the comfort of their own home, saving the journey to the doctors’ surgery and the waiting times. The patient is put at the centre of the care programme and becomes actively involved with their symptoms and the appropriate solutions. They can also contact our care team at any time through various channels.
There are also many advantages for the doctor, as they now have an insight into the state of health of their patients at any time, without the patient having to be present. This also relieves the strain on the doctor, because they can rely on themselves and the patient being contacted by an Arvato employee immediately if the patient’s medical condition worsens. Consequently telemedical solutions also offer enormous potential for savings through more efficient deployment of resources.
At what point does the process get stretched to its limits? Or which stages of treatment can it not afford?
All the patient needs is a telephone, an email address and a computer, so the technical requirements are not very high. Beyond a certain degree of severity, however, in-patient treatment for depression is necessary.
Medical information is among the most sensitive personal data there is. How do you guarantee data security?
The Spanish data protection directives are considered to be the strictest in Europe. With patient data we must comply with the highest level of these data protection directives. Our employees in patient care also receive a special training to raise their awareness of the specific aspects of the care of patients and of dealing with patient data.
How has the project been received so far – both by the patients as well as the specialist medical world in Spain?
The project has been taken up and introduced both in the daily news media and in specialist medical publications. Both the patients and the doctors are convinced by the merits of this solution and the advantages of telemedicine. The fact that we are addressing the depression syndrome has been seen as very positive, as the number of people affected by this has risen sharply, especially due to the economic crisis in Spain.
What insights do you hope to gain from the pilot project?
The question arises here, of whether telemedicine can only complement traditional medical treatment or if it can even replace it in certain areas. The merits of telemedicine have so far been demonstrated mainly in pilot projects in North America and northern Europe. For this reason it is important for us to show that the principle also works in the context of the Spanish health system. We measure three indicators here: patients and doctor satisfaction, the development of people’s state of health and the optimisation of resources. In our view telemedicine still only represents an extension of traditional medical care – and by no means a total replacement
Published in Arvato healthcare news 02-2015