Technology 'can't replace' doctors

2012-08-29 10:21

Cape Town - Telemedicine technology can make doctors more accessible, but cannot replace medical professionals, an expert has said.

"There's a misnomer that this [telemedicine] will overtake doctors. It will never overtake or replace a medical practitioner, a nurse; a physiotherapist. However, it will make them more accessible," Jill Fortuin, director of Telemedicine and mHealth at the Medical Research Council told News24.

Telemedicine employs a range of technologies to increase a patient's access to healthcare and is particularly suited to rural areas where there is a chronic shortage of adequately trained medical professionals.

"The waiting time to receive specialist care is quite long [in rural areas] so in essence, what this does is it uses ICT [Information and communications technology] to improve healthcare service delivery. That's it," Fortuin said.

South Africa has about 77 doctors per 100 000 patients (compared to 40 for neighbouring Botswana) but most of the medical professionals are concentrated in urban areas, making availability in rural districts difficult.

Sophisticated technologies

The use of internet technologies to provide assistance in these communities though, is negatively impacted by the lack of infrastructure.

"You're not going to put a petrol station in a rural area where people don't have cars. Likewise, you will not put a technology that is so sophisticated in a rural area," said Fortuin.

She added that less sophisticated technologies than internet-based surgery could have a beneficial impact, particularly as far as primary healthcare was concerned.

"However, there are very simple things that one could do. For example, someone needs to access their anti-retroviral medication; they can't access it. By simply receiving an SMS to say 'Your medication is ready to be collected' or they could send an SMS to the clinic and the clinic could prepare the medication is advance."

Communication with patients who are obliged to take medication for diseases like TB usually increases compliance and News24 observed the effect of a low-tech approach in Strandfontein, 25km outside Cape Town.

South African National Tuberculosis Association (Santa) trained DOT (Directly Observed Therapy) workers consistently engage with TB patients to ensure that they take their medication.

But workers constantly fight the stigma of the disease and often find that patients have deliberately avoided taking their medication.

Technological infrastructure

"Many of them don't go [for treatment] and many people who get the medication from the clinic do not use it. Many of them, when they have died, and we clean the house, we find the tablets thrown behind the bed or behind the cupboards," DOT worker Betty Jansen told News24.

Compliance has a direct impact on patient health and tools that ensure observance of treatment plans are critical.

"The more compliant the patient is the more likely they are to get well and the less likely they are to get complications in those particular areas.

"I think there are really simplistic applications that can be used to save lives and there are really sophisticated applications that can also be used, but in a completely different setting," said Fortuin.

Many parts of SA are underserved in terms of technological infrastructure and this has a limiting impact on the rollout of telemedicine, but once a needs analysis is complete, a more effective delivery of service could begin, Fortuin said.

"One has to match up a particular technology to what infrastructure is actually available in that area to actually to what is the need of a particular community."

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  • Tony Lapson - 2012-08-29 15:07

    Maybe not for the next 10 years, but certainly in the future.

      Aphrodite - 2012-08-30 09:43

      Really? What about differential diagnosis. Who takes responsibility?

      K9Lakhan - 2012-08-30 17:34

      Agree with you... In SA, we can do this in 5years time - if we work towards it. ICT is been put into place, remote operations would be the next logical step. Consulting a Docter via "Video Call" in a remote area should be looked at.

  • K9Lakhan - 2012-08-30 17:28

    When I have a symptom... I go to my good old Docter ...APP! A docter is just needed to sign for the prescription. ( People should push for cheaper and better treatment. ) Examples: - Next 5 years we would have an auto-surgery, like auto-car assembly points. - DIY surgery kits. ( NaviKnife, voice speaks you through it! ) "There's a misnomer that this [telemedicine] will overtake doctors. It will never overtake or replace a medical practitioner, a nurse; a physiotherapist. " Offcourse, technology wont replace Docters ...somebodies got to sign your prescription. a machine does not have a high ego, aswell. Telemedicine technology is the way forward - Less OPEX , and more profit for the ICT Hospital in the long run.

      liels - 2012-08-31 15:51

      K9Lakhan, people cant be compared to cars (re your comparison to auto-surgery). Unlike cars, where the car is exactly the same than the one in front of it in the assembly line, people come with a variety of different hereditary, location-specific as well as historical diseases or complications. A machine can't think on its feet, know what to do when a person goes into cardiac arrest or fits for no apparent reason, etc. Also, one must keep in mind that bedside manner, camaraderie and personal touch cant be substituted with technology.

  • john.morreira.9 - 2012-09-02 07:52

    As Gregory House says: "Patients lie".

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