Case study: Is e-health a cure for European healthcare?

E-health – the use of technology in healthcare – has so far failed to fulfil its potential. But that could be about to change

It has been hailed as the next big thing for many years but, it is fair to say, e-health – the use of technology in healthcare to improve services delivered to patients – has failed to fulfil its potential. Issues around cost, ease of use and privacy have held back its adoption.

Now, however, Telefonica is hoping to kick-start the e-health revolution. The company has acquired a stake in Saluspot, a health community which aims to connect doctors and patients via a question and answer service.

César Rodríguez, head of e-health at Telefonica, says the Saluspot system is like a social network for the health industry. Users can post details of their ailment on the site to seek advice – for example, “I’ve had a sharp pain in my left knee for three days” – and Saluspot will flag it to a doctor specialising in that area. The doctor will do their best to determine what the problem is by asking further questions and then recommend potential treatment.

If medication or even medical treatment is required, the user will have the option to schedule a face-to-face meeting with the doctor they were talking to, or one closer to their location. Telefonica says once a face-to-face meeting has taken place, the user becomes an “e-patient” of the doctor, meaning their personal health record can be shared and more conversations can take place.

All doctors using the service have to authenticate themselves by matching the unique code on their medical licence with their National Identity Number.

Latin American potential

Saluspot already has a large presence in Spain and Chile, and the agreement will enable both parties to push the service further into Latin America, particularly the Spanish-speaking nations, where Telefonica’s brand is already well known. Rodríguez says the Latin American market is a good fit for this sort of service.

“In Latin America the public healthcare system is not on the same level as in the US or Europe, where there are higher standards and lots of hospitals and doctors,” he says. “So the only solution is to have private insurance, but most people don’t have the financial capacity for that. This is a new approach to patient management.”

Rodríguez likens Saluspot to HealthTap, a similar service that is offered in the US. HealthTap has 55,000 registered doctors and users have so far asked over 1.3 billion questions. Saluspot has the potential to reach the same numbers across Latin America and Spain, he says.

The service is currently offered free of charge, but a premium subscription service is likely to be added in the next few months. Details of the premium model are still to be determined, but Rodríguez says it is likely to involve users having access to more services, such as the ability to enter into a private conversation via email with the doctor, and to choose which doctor answers their query.

Prices for the premium model have yet to be revealed publicly, however Rodríguez says Telefonica has to remain aware of its users’ financial situations. Prices will have to be much lower than private healthcare to make it seem more attractive and are likely to be under €5 per month. Existing Telefonica customers will have the option to add the cost to their bills, Rodríguez suggested.

Keeping private data private

Privacy has been seen as a barrier to e-health for many years; patients are rightly worried about what data they need to provide and how secure it will be online.

Saluspot can be used completely anonymously – users can ask a question without providing any personal data. Subscribers to the service, however, are required to provide their age, gender, location (limited to their city) and an email address. Those users who pay for the premium model, when it eventually launches, will need to provide more details, such as a name and address, for billing purposes.

In terms of looking after that data, Rodríguez says: “We adhere to all the data protection rules for each country we operate in and Saluspot has a legal department that checks we’re meeting all the policies each country has. Additionally, Telefonica has a huge cyber security division, and data protection was one of the big points during the due diligence process before the deal was completed.”

The sensitive nature of information being uploaded to e-health systems means data protection will remain an issue for the foreseeable future. Despite this, there is hope that technology such as Saluspot will help the e-health sector grow over the next few years.

Doctor Josep Morera Prat, a pulmonologist based in Barcelona, says this sort of technology is useful for interacting with patients across the world, particularly those who may require a specialist doctor to talk to.

“I think use will grow in the future, with some limitations. It depends on the speciality; some may be better suited to it than others,” he says, adding that while the technology is providing a valuable service it can still be improved.

Changing of the guard

One thing Prat is keen to stress is that technology like this, while useful, is not a replacement for face-to-face doctor-patient meetings. “It’s not the same as face to face. Maybe some specialities, such as dermatology, could work that way, but overall it would be very difficult; we would need information we cannot get over the internet,” he says.

That is a point Telefonica’s Rodríguez agrees with, and he says that getting older medical professionals to accept and use this type of technology is one of the challenges the company faces.

“We are employing doctors to help with [adoption],” says Rodríguez. “The conversations are not about technology, they are about healthcare needs. We will respect all rules and processes doctors work to in that country, such as only prescribing medicine after a face-to-face meeting. So the model of the relationship between doctor and patient is still the same.

“Some doctors just prefer to deal with patients face to face, but the younger generation of doctors are perhaps more open to helping patients to get answers in this way.”

And that seems to be the biggest draw for e-health at the moment – using technology to open up new ways of delivering medical services to those who, for economic or geographical reasons, cannot get medical advice as quickly and easily as they would like.

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