"Virtual" Healthcare Mar05

There are vast differences in the access, quality, cost and extent of healthcare in the 25 Member States of the EU. Regulations affecting qualifications, training and registration of health professionals vary from one Member State to another. Regulations for manufacture and sale of medicines show marked differences. Patients have little knowledge of their illnesses and they rely on their Doctor’s judgement – a judgement that is often made without diagnostic tests. Doctors cannot access data on new patients or updated information on availability of specialist consultants and hospital beds.

Appropriate EU guidelines must be established for availability of detailed information on chemical constitution of medicines, efficacy, toxicity, contraindications, dosage, availability and cost that can be readily accessed on the internet by patients and doctors. Safeguards on patient’s privacy; authenticity and validity of consultation; accuracy in dispensing of prescriptions and verification of patient identity are some aspects requiring new EU directives. The EU needs legislation for a “virtual” primary healthcare system to ensure the highest minimum standards for its citizens wherever they may be in the EU.

A medical diagnostic machine (MDM) - the size of a 50cm Television screen – mounted as a standard fitting on the bathroom wall has a digital camera, phone, email, and ports for diagnostic testing of body temperature, blood pressure, blood and urine. The MDM digital camera can take high-resolution pictures of skin or other body parts. It allows instant transmission of data to the family doctor’s surgery and the local hospital emergency centre. The MDM, owned by the medical insurer, is regularly serviced for inputs by service contractors

The body temperature, blood pressure, blood and urine analysis data are electronically transmitted to the diagnostic laboratory of the hospital where it is analysed by a team of consultants who can diagnose and prescribe appropriate medication and treatment. The diagnostic test results, diagnosis, the prescribed medication and treatment data are recorded electronically in the patient’s database with the family doctor. The patient can sweep his EU health card through the MDM to update it to reflect new data.

The prescription is emailed to the appropriate manufacturer of medication for delivery by courier to the patient, complete with instructions for dosage, storage and an explanatory note of tests and the nature of the illness. In case the patient requires hospital care, then he is informed of the hospital and consultant who can receive him. In an emergency, an ambulance is alerted so that it can take the patient away. Payment for services is made by the medical insurer who identifies the patient’s cover, receives and records all data on the patient’s database.

All of us, with our health card and pin number, can use these MDMs wherever they are situated – in offices, factories, shopping centres, schools, clubs and hotels. Therefore, even when we are away from home, travelling in our own country or in the EU, we can access in a medical emergency our medical data to allow those who can help us immediately.

The MDM offers the prospect of a “virtual” primary healthcare as visits to both family doctor and pharmacist would be unnecessary for most illnesses. It would offer substantial savings for government health budgets struggling with rising patient expectations and ageing populations. Governments could offer fiscal incentives to citizens to secure private medical cover i.e shift the burden of risk from the state to private insurers. The private health insurer would outsource services for information technology (IT) and pay for patient treatment by doctors, pharmacies and hospitals. Patients with health cover would seek the best doctors, consultants and hospitals. This would encourage competition and force government hospitals to apply private sector discipline to employment, management of resources and marketing their services. Standards of clinical care would rise and there will be no waiting periods for surgical treatment. The healthcare profession would once again attract and retain well qualified nurses, pharmacists, doctors and surgeons.