Page 5 - MEH_Supplement_Nov-Dec_2012

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M I D D L E E A S T H E A L T H |
children, and has already been tested with
physicians in Bangladesh, Cambodia,
Lebanon, Laos, Vietnam and Yemen.
This kind of on-demand training
provides immediate benefits. For example,
a doctor in the Middle East who needs to
understand how to correctly use a venti-
lator could watch a video demonstration,
read about ventilator best practices and
train with a web-based ventilator simu-
lator to increase his or her reflex speed.
He or she can hook up to a curated social
network, enabling the incorporation of
new information, exchange of ideas on
best practices and peer discussion.
In the future, the platform will include
information on-demand on the care of
children, a digital and video social
network capability for collaboration and
knowledge exchange and curricular path-
ways for training clinicians on essential
concepts related to the care of children.
The Internet serves everyone. Now, for
sick children and their parents – including
those in rural parts of the world – quality care
doesn’t have to be dictated by geography.
Improved physician collaboration
through telemedicine
Imagine yourself in an emergency depart-
ment taking care of a very sick child.
Should he be transferred to a higher-level
care setting? Can he safely go by ambu-
lance, rather than helicopter? As a doctor,
you would like to consult virtually with
colleagues and experts at remote locations.
Transmitting a child’s medical images,
conducting an educational seminar,
seeking health advice from a pediatric
specialist in an emergency and manage-
ment of health data are all examples of
how telehealth has made its way into the
foundation of pediatric care. With web-
based modules and mobile technology,
sharing medical expertise with someone in
Africa isn’t much different from sending
radiology images across town. Also, elec-
tronic medical records are starting to help
physicians and patients track symptoms
more easily and systematically, and incor-
porate this data into decision-making.
Telemedicine is inherently cost-efficient
and has helped achieve better outcomes for
children. However, the implementation and
maintenance of telemedicine requires dedi-
cation. Developing a system that works can
involve extensive coordination between
hospitals and physicians at each site who
understand the political, operational and
clinical landscape of their respective institu-
tions. In addition, telemedicine requires a
robust training program for everyone
involved, as well as research, support and
workflow adoption.
When physicians collaborate in a timely
way on technological innovations, they
establish a partnership that benefits
patients like never before, establishing
more affordable, timely and high-quality
care to all patients – both locally and
globally. Already, collaborations have
developed new standards for sharing
knowledge and making informed treat-
ment decisions.
Robotic technology: Connecting
with children at home
While physician-to-physician communi-
cations and education are vital to
improving care for children, so is the
ability to communicate and educate
patients themselves – whether they are in
the hospital or at home. New develop-
ments in telecommunications and remote
monitoring technology can provide that
bridge between a clinician at the hospital
and a patient at home.
Recently, robots have helped children
make transitions as they leave the hospital
and move to their home environments,
where they can recover in familiar and
comfortable surroundings. In the hospital,
children have around-the-clock care and
monitoring, but after discharge, families lose
contact with their physicians and nurses
unless there is a problem or complication.
Now, patients can take a robot home
with them that uses videoconferencing to
connect them with their clinicians.
Physicians can talk to and monitor
patients, view their home environment
and help parents assess their child’s status
and answer their questions and concerns.
Follow-ups that would normally require a
doctor’s visit can be replaced with real
time conversation and observation.
Doctors can even identify errors and avoid
complications before their patients require
emergent and costly medical attention,
which has the potential to prevent costly
hospital readmissions.
Although simple videoconferencing
While physician-to-
physician communication
and education are vital to
improving care for
children, so is the ability
to communicate and
educate patients
with patients’ personal computers and a
platform like Skype can provide a similar
function, it isn’t always enough. In some
situations, there are clinical advantages to
moving the device to where the patient is
– for doctors to be “embodied” by the
device as if they were actually in the
room. An orthopaedist or a physical ther-
apist may want to see a patient walk up
the stairs. A pulmonologist or a respira-
tory therapist may want to evaluate a bed-
bound patient on a ventilator.
The difference between simple videocon-
ferencing and a robot lies in the quality of
the clinical interaction. Patients and fami-
lies have been shown to interact with
mobile robots as though they were a virtual
manifestation of their health care provider.
They tend to connect better intellectually
and emotionally with the robot than with a
computer, and commonly report feelings of
closer communication with their health
care provider when using it. Since these
robotic systems exist in the child’s home,
they transform families’ roles and their atti-
tudes toward participating in their chil-
dren’s care.
Sometimes, simple attributes – the
robot being able to move, see and live at
home – can promote a greater sense of
trust, and reinforce the patient’s and
family’s perception that their healthcare
providers are paying attention to their
concerns and questions. Children in
particular seem to bond to the robot
(which, at 4’6” high, is an approachable
height) and communicate better with it
than with a computer screen.
Results are similarly successful when