Can e-overall health technologies be applied to answer to the health care requirements of vulnerable populations?

Digital and communications technologies are more and more reworking health care types. The Entire world Health and fitness Firm defines e-wellness as “the expense-successful and protected use of facts and communications technologies in assistance of health and health-connected fields, which includes healthcare services, overall health surveillance, health and fitness literature, and wellness training, expertise and research”. The European Commission elaborates on the idea by concentrating on how e-wellbeing satisfies the requirements of citizens, patients, wellness pros, healthcare companies and policymakers.

The Covid-19 pandemic prompted a worldwide change to distant functions, from doing the job to interacting with public administration to attending doctor appointments. “The pandemic has certainly accelerated a broad variety of options that were previously getting created more than the very last decade, but which expected a main cultural shift for both equally experts and people to adopt them,” points out Dr. Sandra García Armesto, govt director of the Aragón Wellbeing Sciences Institute (IACS) in Spain.

“If we imagine of healthcare procedures as a continuum concentrated on informing and empowering clients, the crucial is to provide the ideal combination of in-human being and remote (synchronous and asynchronous) services, two-way information and facts and aid channels that enable people to get and present suitable information for their possess treatment,” García Armesto carries on.

‘Liquid centres’ and daily life-improving improvements

The enhancement of the Online of Factors (IoT), joined equally to equipment distinct to health-related technological innovation (telediagnosis, telemonitoring, etcetera.) as very well as to more and more ubiquitous apps in everyday units (from smartphones and tablets to wearable know-how), capable of gathering physiological and behavioural parameters, allows us to rethink the logic of health care and bridge the hole between healthcare centres and sufferers.

“In Aragón, we refer to this as ‘liquid centres’, the virtuous hybridisation of elements that need in-human being encounters concerning health care staff and sufferers, and these factors for which the use of digital and communications systems can be extra successful, together with abide by-up and monitoring,” points out García Armesto. “I believe that we are about to witness the blossoming of a selection of digital overall health solutions that will eventually be normalised and built-in into the portfolio of every health and fitness system,” she provides.

García Armesto highlights two extra probably constructive effects of this transformation. On the just one hand, it will exponentially multiply exploitable and integrable data that can be converted into pertinent medical facts for specific affected individual treatment. On the other hand, it will improve the ability to deliver new scientific understanding and promote innovation and new techniques to condition management, which will boost the efficiency and quality of treatment, as perfectly as the performance and fairness of the healthcare process.

Europe’s Remote Rehabilitation Services for Isolated Spots (ROSIA) is a job centered on building a telerehabilitation model for people who have suffered from strokes, coronary heart attacks, long-term obstructive pulmonary illness, joint alternative and Covid-19, among the other circumstances, and who reside in remote, often rural regions, exactly where distances to specialised referral centres represent a barrier to abide by-up treatment and therapy. These kinds of clients stand to profit from extensive personalised rehabilitation plans, which technology has created a lot more available.

“One of the most fascinating factors of the undertaking is that in the 6 web pages selected for its enhancement, as effectively as in Aragón (Spain), Coimbra (Portugal) and Dublin (Ireland) the place it was piloted, these new telerehabilitation companies have become a connection between regional well being services and neighborhood assets on the just one hand, and extremely specialised referral hospitals on the other, making sure that these individuals profit from a excellent built-in treatment program,” states García Armesto.

Such companies also boost patient rehabilitation by providing regional assist that retains them determined and will allow them to intently keep an eye on results.

Against a backdrop of promptly evolving technological know-how, an additional essential aspect of ROSIA, which will be introduced in 2024, is the continual integration of new options (such as gadgets, systems and applications). When tested, they will be involved in the available catalogue so that healthcare pros can advocate them to their sufferers.

Working with mobile apps to increase health and fitness in the midst of humanitarian crises

In accordance to the Earth Migration Report, the flagship publication of the International Corporation for Migration, there ended up all-around 281 million international migrants in the earth in 2020, equating to 3.6 for every cent of the world population. But what happens when sufferers do not know their legal rights or communicate the language of their host country? Can technology enable take out barriers and help save life?

“We know that when you flee from your residence without anything at all to a overseas region wherever you really don’t have a job and do not converse the language, it is hard to prioritise health care. But vaccinations are a cornerstone of health care and should always come initially,” suggests Aral Sürmeli, a health care medical professional specialising in digital and cell well being remedies in the context of humanitarian crises, and a PhD candidate in general public health at the Johns Hopkins Bloomberg College of Public Health in the United States.

Subsequent the Syrian refugee disaster, the greatest of its form due to the fact the Next Earth War, Sürmeli turned associated in providing health care in Istanbul and other Turkish cities in the vicinity of the Syrian border by nearby non-income Health care Rescue Affiliation (MEDAK). “We realised that refugees use their cell telephones as their primary implies of acquiring information. Cellular telephones are not a luxury but a requirement for them to keep connected with their households and good friends close to the entire world.” Sürmeli saw the exclusive potential of cellular phones for sharing well being data, accumulating data and conducting interventions. Consequently, HERA was born.

HERA is a mobile telephone software created to hook up refugees, precisely women of all ages and small children, to overall health products and services accessible in Turkey. Although Turkey supplies health care no cost of demand, the 4 million refugees it has taken in have strained the capability of all services delivered, especially healthcare.

How does it operate? The person downloads the application and registers her aspects. If the person is expecting, she is asked issues about earlier and present pregnancies, as perfectly as her past day of menstruation. Making use of this facts, the app instantly calculates the dates of her prenatal check out-ups (the Turkish Ministry of Health and fitness suggests four for the duration of pregnancy). The application then reminds the person about her appointments. Equally, people enter their children’s date of beginning into the software, which instantly calculates irrespective of whether and when the little one is eligible for vaccination according to Turkey’s vaccination agenda.

“The motive we aim on gals and children is for the reason that with top quality healthcare, the challenges they facial area are generally preventable. In the place of public wellness, vaccination and prenatal care are two of the most powerful and lifesaving interventions we have,” states Sürmeli, who is also the co-founder and CEO of HERA Inc.

In addition to behavioural interventions these as reminders, the software supplies other features created with the particular desires of refugees in brain. For illustration, consumers can simply call an ambulance or obtain their way to the closest clinic. They can also use the application to keep their health care data so they never have to have them about on paper.

“They can read about their health rights and topics of worry [such as breastfeeding]. In addition, we designed HERA to be modular so we can include new capabilities incredibly immediately if necessary. For illustration, all through the Covid-19 [pandemic], we applied a symptom surveillance attribute that asks the user every single two weeks whether they have any signs of Covid-19,” states Sürmeli.

HERA was designed as a resource for organisations to use in humanitarian crises and is thus open up resource and totally free to use and replicate. In Turkey, in addition to various grassroots organisations, international organisations these as Health professionals With out Borders have previously expressed fascination in replicating it.

“We are also in talks with other nations, Greece, Iraq and Nigeria getting the most promising. We are functioning to adapt HERA’s features to the precise requires of their populations. It does not have to have to be Syrian refugees, any migrant inhabitants can gain from HERA,” states Ayse Kasikirik, HERA coordinator since March 2021 and a specialist in gender equality, women’s legal rights and social coverage.

“This is also correct for high money nations this kind of as the United States. We have been doing the job with quite a few hospitals that get care of Mexican seasonal migrant farm personnel to see how HERA can be employed there,” claims Kasikirik.