Whether it’s mobile-health, e-health, telemedicine, the possibility of being visited and perhaps treated without the need for a visit in person is today more important than ever, especially in remote areas of the world. It took a pandemic to point out that digital connectivity, access and telemedicine are great tools, and that lacking them can sometimes mean the difference between life and death. It is estimated that 31 of 54 African countries have a doctor-to-patient ratio of around 1 doctor in 10,000 people compared to more developed countries such as Germany (1 doctor every 417 patients) and Italy (1 doctor every 270 patients).
The problem is that whoever could benefit most from these systems is not yet connected.
Broadband technology offers a unique opportunity to countries and areas without fixed line communications networks. However, according to recent data, 72% of Internet-connected households are located in urban settings, and only 37% in rural areas. In the least developed countries of the world (the so-called Low Income Countries), 17% of the rural population has no mobile coverage, while 19% only has access to a 2G network. Already in 2018 a review published on The Lancet on the huge global database Global Burden of Disease 2016 clearly showed that the countries with more difficult access to services and poorer quality of health care are also the least connected.
There are also internal gaps, primarily the gender gap. The Mobile Gender Gap Report 2021 shows that women in the world’s poorest countries are 7% less likely than men to own a mobile phone.
Cardiovascular health can greatly benefit from telemedicinein particular to reduce acute episodes and pressure on hospitals, as well as lower the impact of mortality from potentially treatable events in areas of the world where access to health services is difficult.
A recent review of the scientific literature on the subject, published in Journal of Personalized Medicine , covering the last 10 years (2011-2020), examined the benefits of telemedicine in the prevention of cardiovascular diseases and recent advances in telemedicine services for the personalized treatment of these diseases. The results showed that timely delivery of care, which can also be implemented virtually, significantly reduces morbidity and mortality. This could also reduce the pressure on hospitals by decreasing the occurrence of acute cardiovascular disease in the general population.
Many apps currently on the market can help monitor patients remotely and in non-invasive ways. Digital platforms can connect pharmacies and enable pharmacists to improve their skills in providing patient advice. In addition to remote counseling, wearable devices such as smartwatches can read the wearer’s data via built-in microchips and sensors. More sophisticated examples include handheld or chest-applied electrocardiogram (ECG) devices that can be connected to smartphones to record heart rhythms and help diagnose irregular heartbeats caused by atrial fibrillation.
An example of cutting-edge telemedicine can be found for example in Argentina. The Telemedicine Project of the University of San Juan, located more than a thousand kilometers from Buenos Aires, supports clinicians in remote villages in the area. The Project connects the health personnel and teachers of the Argentine University and Ministry of Education, the Municipalities involved, the NGOs present in the area and the patients, guaranteeing a solid connection possibility for medical consultations and specialist visits even at a great distance. Electrocardiograms, tele-auscultations, tele-oximeters and pressure monitoring with Holter system are performed at a distance. Some local people (in the health center in the town, or in the village) are trained to connect the patient to the machine, and act as a link between the person and the outside by transferring the data online to the doctor miles away, who then evaluates the results and makes a decision on the next steps to follow for treatment. For example, continuing to treat the patient remotely, without having him move from the village, or transporting him to a nearest hospital that can offer the necessary care for the specific case.