Professor Benoît Diebold, of the Georges-Pompidou Hospital in Paris, has a problem: his patients are getting older. Nothing unusual about that, you may think. But it is a problem that is shaping public policy in France and in developed nations around the world.
And it is a problem which Cisco may be able to help solve using a technology called HealthPresence.
As part of his work at the Georges-Pompidou, part of the largest hospital group in Europe, AP-HP (Assistance Publique Hôpitaux de Paris), Diebold provides assistance to geriatric doctors based in hospitals such as Vaugirard, several kilometers away.
These doctors need all the help they can get. Aside from the fact that older people tend to have more cardiac troubles (and, indeed, more healthcare issues generally) than younger individuals, the overall number of older patients is mushrooming.
An alternative solution
United Nations figures show the number French citizens aged 65 or over will rise from 16 percent today to more than 25 percent in 2050.
Looking after all these people would require a big increase in the number of doctors, which is difficult to envisage at a time when France’s population is shrinking and a growing proportion of its healthcare workers, in line with the general populace, is nearing retirement age.
Last year, however, a pilot involving Pompidou Hospital, Vaugirard Hospital, Cisco, and the systems integrator Orange Business Services showed there could be an alternative solution.
Instead of sending patients from Vaugirard to Pompidou for appointments, Pompidou-based specialists carried out remote consultations at Vaugirard’s geriatric ward using HealthPresence, which is essentially a Cisco TelePresence platform adapted for use in a medical setting.
The system not only allows doctors in two different locations to talk to each other (and their patients) as if they were in the same room, but also provides a way to share medical images and patient records.
Less travel, lower ambulance costs
And because the patients did not need to travel from one hospital to the other, there were fewer delays between consultations and specialists were able to get through more appointments, as well as seeing emergency patients or those too frail to travel.
In the six months that the pilot lasted, 35 specialists from 16 medical specialties at Pompidou carried out more than 300 remote orthopedic, dermatological, and vascular cardiology sessions, treating 200 patients.
Since each session would have previously required a round trip in an ambulance, AP-HP saved in transportation costs. But the real winners were the patients.
Before the pilot, a patient might set out from Vaugirard to Pompidou at 10am and not return until five hours later.
Throughout this time, the patients—mostly frail and around 40 percent of who suffer dementia—would be in unfamiliar surroundings without the support of familiar medical staff.
Time per consultation
With HealthPresence, the average time per consultation went down to just 30 minutes and patients were seen in the comfort of their own ward, with their usual doctor in attendance.
“Patients immediately accepted the solution,” says Dr. Pierre Espinoza, the Pompidou-based specialist in emergency, gastroenterology and internal medicine who headed up the HealthPresence pilot.
“Telemedicine is an effective response to managing the health of an aging population.”
— Dr. Pierre Espinoza, head, Georges-Pompidou Hospital HealthPresence pilot
In addition, he says: “We were able to extend the use of this multi-use platform to specialties like cardiology by customizing the stations to meet the clinician’s requirements.”
As a result, for example, cardiologists such as professor Diebold were able to analyze live data from remotely connected ultrasound devices, while dermatologists used IP-enabled cameras to diagnose skin lesions, so that travel for biopsies was cut down to less than 10 percent of cases.
Access to care
“Telemedicine is an effective response to managing the health of an aging population and offers equitable access to care for various specialties,” Dr Espinoza concludes. And it could be on the rise, not just in isolated areas in France.
The AP-HP pilot was inspired by a similar exercise carried out by the National Health Service in Scotland and the Scottish Centre for Telehealth, which carried out the first-ever trial of HealthPresence in 2008, working with the Cisco Internet Business Solutions Group.
And in 2009, the French president Nicolas Sarkozy declared telemedicine a ‘national priority’.
At Pompidou Hospital, Diebold and his colleagues will be hoping this priority is realized, and not just for the sake of the growing legion of older patients. “Before HealthPresence, geriatric doctors felt alone,” he says.
“Now we are able to discuss and provide guidance, to review images, and re-scan patients as needed. The doctors and staff have more confidence now. There is a great demand from their side for HealthPresence.”
Jason Deign is a freelance writer located in Barcelona, Spain
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