Put a doctor in his pocket thanks to its smart-phone

  • Photo Anne Caroline Desplanques
    Gestational diabetes, Heather Watkins has been followed at a distance by the centre hospitalier de St. Mary while she waited for her little Samantha.

    Anne Caroline Desplanques

    Monday, 17 July, 2017 06:30

    UPDATE
    Monday, 17 July, 2017 06:30

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    Consult a doctor, get a diagnosis and a prescription in order at any time and anywhere from Montreal to Kuujjuaq, without a queue, is now possible from any smart phone.

    “With all the technology they have now, I would have been surprised not to have it during my pregnancy. For me, it was quite natural,” says Heather Watkins, talking to the bottom. In the next room, her little Samantha, eight months, sleeping soundly.

    A few months before his birth, analyses have demonstrated that the mother was suffering from gestational diabetes. The mother was immediately taken care of by the team of telemedicine in the hospital of St. Mary, who has followed throughout the pregnancy.

    From the comfort of his apartment in the Plateau-Mont-Royal, Ms. Watkins was his blood sugar four times per day, and sends the results to the hospital thanks to a software installed on his computer.

    The program adjusted instantly his insulin doses and produced a report sent to his doctor. The nurses also respond daily to questions from the patient via the same computer system.

    “My follow-up is done in real time, on a daily basis. So, yes, it has had a positive impact on my health and the health of my baby. It made me save time and energy too, ” says Ms. Watkins.

    Exploding market

    This Montreal is a pioneer, but she is not alone. In 2016, between 14 and 22 % of Canadians have used health services digital, according to the organization Canada Health Infoway. These services range from simple appointment scheduling online or the renewal of a prescription to the very complex operation controlled remotely or with medical consultation via videoconference.

    “In a five-year horizon, there will be a lot of services in telehealth, it is coming very soon,” predicted Benoit Brunel, president and founder of Hello Health, an online platform that allows you to take an emergency appointment in a clinic close to home without having to queue.

    For the moment, the telehealth public in Quebec, as has been the experience Ms. Watkins is in its infancy, but elsewhere, governments and private companies share the market in a full, rolling boil.

    In the United States, the giant consortium of private health Kaiser Permanente already provides 50 % of its health services to its 8 million customers at a distance.

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    Millions saved

    In France, insurer AXA offers its clients a service of tele-consultation 24 hours on 24, seven days a week. On the basis of a phone interview, the doctors of AXA may make a diagnosis and upload a prescription to the pharmacist of the patient without charge. In Canada, the British Columbia already reimburses the medical consultations, telephone and video conferencing.

    In Québec, the RAMQ does not support this type of service. However, since October, the montreal-based firm Dialogue Technology markets a virtual platform that allows you to do a medical consultation by chat or video-conferencing with general practitioners and specialists from a mobile phone. Dialog sells its services only to businesses in order that they might benefit their employees in their bouquet of benefits.

    “It doesn’t cost a dollar to the government and it comes to take the pressure off the public health system,” says the co-founder of Dialogue, Cherif Habib. According to him, ” 70 % of all medical visits in the first line can be handled over the phone without physical examination “.

    Overall, the benefits of telehealth in terms of accessibility, quality, and productivity amounted to more than $ 2.5 billion in the whole of the canadian network for health in 2015, says Infoway.

    Telehealth by the numbers

    The digital health is the application of information technologies and communication for health. These include telemedicine (téléexpertise, remote monitoring, teleconsultation and tele-assistance) as well as the medical records digital.

    870 267 consultations at a distance between patients and physicians in 2016, up from 187 385 in 2010.

    $65 Million in hospital costs saved by the emergency services in the Quebec, Ontario, Alberta and British Columbia through telehealth in 2016.

    14% to 22% of Canadians used the services of digital health in 2016, compared with 6% to 7% in 2014.

    47 million kilometres in travel and $ 70 million in related costs saved thanks to telehealth, in 2010 only.

    93% of physicians who use electronic medical records argue that this tool allows them to provide better care to patients.

    100 000 new applications for mobile health have been established in 2016 in the world.

    Sources : Canada Health Infoway, Research2Guidance, WHO

    A cabin medical near you

    Photo courtesy

    Imagine passing a medical examination, sitting in a Booth in the corner of the street without meeting any doctor. Instead of a series of small photos, the device prints your medical record and sends a copy to your doctor. It measures your blood pressure, your weight, your heart rate, and much more.

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    Far from being science-fiction, this cabin of the future called the “Consult Station” exists and is in function in the region of the Roannais, in France, a territory in the throes of desertification medical. It was installed in the winter of 2016, to alleviate the shortage of doctors. It helps in the monitoring of chronic patients and provides a service of local health, in particular.

    Innovation in telehealth braked

    A young doctor in montreal will launch by the end of the year an invention that will allow patients to write their own medical history on their cell phone or their computer before you go.

    Entitled StoryDoc (for medical history), the invention is in development, and was recently acquired by the firm, Hello Health, has learned of The Journal.

    Communicate better

    “The goal is that the patients can express themselves with the time they need in the middle of a media that is part of their lives,” explains Dr. Vincent Dumouchel, the creator of StoryDoc.

    Photo Anne Caroline Desplanques

    Dr. Vincent Dumouchel

    Creator of StoryDoc

    “It will save you in the office of the basic questions on the history and allergies for example, but above all it will help the doctor to know more about who you are. Therefore, it is an aid in the diagnosis. “

    55 % of medical errors would be due to a lack of communication between health care providers and patients, according to Trina Diner, manager of telemedicine Center, regional health sciences Thunder Bay, and speaker TEDx renowned. StoryDoc and Hello Health could therefore help avoid many errors.

    Currently, Hello Health allows you to make an appointment without having to queue in a clinic near you, paying 17,25 $ plus taxes. Including StoryDoc, the platform will invite patients to respond to a health questionnaire that will generate a report. It will then be forwarded to the physician in order to help prepare the consultation.

    Pushed to its limits, StoryDoc opens the door to the preanalysis and the virtual consultation. “I do not hide from you that the virtual consultation is part of our business plan,” says Benoit Brunel, president of Hello Health.

    SMES in search of support

    But, “instead of investing in innovation, I have to spend in legal fees at this time,” says the entrepreneur. Hello Health is the subject of an inspection conducted by the Régie de l’assurance maladie du Québec.

    The SMES of Boucherville is in a standoff with the Régie de l’assurance maladie since it has decided to implement a service similar to its own, Rendez-vous santé Québec. To expand, the RAMQ has awarded a contract of $ 4.5 million for CGI.

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    “Innovation comes from SMES, the government must have a role of propellant. It should be there to support us, help us to prosper, not to sue us or try to remake with public funds what we do already, ” said Mr. Brunel.

    Regulatory barriers

    Impossible, however, to Monsieur and Madame Tout-le-Monde to subscribe individually to the service of Dialogue Technology, because ” telemedicine is not a service provided by the Régie de l’assurance maladie. So the doctors may not be reimbursed for their services, ” says Mr Habib.

    “The barriers are not really technological, but regulatory and billing-related. If a physician cannot charge for a service to the Governed, it is certain that he was not going to offer, ” adds Mr. Brunel, Hi-Health.

    The North on the cutting edge

    He points out that, technologically, Québec is on the cutting edge of technology in digital health.

    Since 2009, the McGill university health Centre (MUHC) offers a variety of telemedicine programs to aboriginal communities in the far North of quebec, from neurology to ophthalmology, through to obstetrics, gynecology, and cardiology. Through its program, the university is saving millions to the State.

    “It costs an average of 4500 $ for the plane trip and the stay in Montreal for a pregnant woman who comes from the James bay to come and do an ultrasound to Montreal,” illustrates Dr. Robert Gagnon, director of the division of obstetrics of the MUHC. “All women should have a minimum of two ultrasound scans during their pregnancy. Because of costs, this was not the case earlier in the communities of the North “, he adds.

    Marginal

    “But it’s still a project very marginal. We’ll never see the benefits as it will not be applied to large-scale, insisted Mr Brunel. For that, there must be changes in policies and laws. “

    Challenged by The Newspaper, the spokesperson of the ministry of Health, Noémie Vanheuverzwijn, explains that ” the approach adopted by the MSSS has been to develop the projects and then deploy on a larger scale and to systematize them. It is here that Québec is made “.

    In the areas of compensation, Ms. Vanheuverzwijn indicates that the MSSS has already agreed with the Federation of medical specialists of Quebec (FMSQ) of a memorandum of agreement which provides for compensation for the medical services provided remotely by a specialist consultant, through the interactive video.

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