Artificial intelligence meets Medicine: Telemedicine
As in most fields, there are some steps such as validation and integration that need to undergo a significant change in the field of health. As Bahçeşehir University, Faculty of Medicine, Brain and Spine Surgery team, we are among the pioneers of telemedicine in our country with the telemedicine application called I will heal, which we started to implement in our own clinic. and had to get used to it.
In this article, we would like to share our experiences with the patients of our Brain and Spine Surgery clinic and discuss the future of telemedicine applications in our country and in the world.
According to HHS data, while the share of telemedicine calls in primary health care visits in the USA was less than 1% in February 2020, it increased to 43.5% in April 2020. This extraordinary rate of prevalence and adoption clearly demonstrates the potential to completely change the way health systems work, provide and manage care.
We have made the following sentence many times about Artificial Intelligence, which was heavily on the agenda before the pandemic; Physicians will not be unemployed because of Artificial Intelligence, but physicians who have not learned to use Artificial Intelligence and are not adapted to this change will most likely be the exception to this proposition. Today, we can use the same sentence for telemedicine, and we can say that this transformation will be simultaneous with Artificial Intelligence, or even much faster.
Of course, this change will require an adaptation and learning process for all stakeholders. For example, physicians who are not very accustomed to using computers will need to learn how to communicate with their patients via mobile phones or computers, how to use the camera and microphone for the best image and sound, how to direct the interview differently from the clinic, and how to manage the patient’s expectations.
Is physical examination important? Is there a virtual inspection?
From the point of view of patients, the first prejudice to be overcome is the thought that the physician cannot make an accurate and sufficient diagnosis without touching himself. So why is this not true?
First of all, the importance of physical examination for physicians to make a diagnosis is much less than is often thought. The most important component of the diagnostic process is not the physical examination, but the patient’s story. Information such as what the complaint is, how long it has been going on, what it does to alleviate it, and what it does to increase it constitutes the most important part of the diagnosis process.
Seeing the patient in his own environment, such as his home or workplace, also allows us to see some environmental factors that may affect his complaint and that the patient does not share with us in the clinic most of the time. Besides the story and environmental factors, almost all smartphones and computers today have cameras that are more than enough for us to observe the patient.
What about the physical exam ? As we mentioned, the most important part of the diagnosis process is the story the patient will tell. The physical examination consists of four basic components.
These are: inspection (observation ), palpation (hand-feeling examination), percussion (tapping with fingers) and auscultation (stethoscope) .
Inspection , that is, observation, which has the greatest importance among these four , can be easily performed with telemedicine. The general appearance of the patient, whether he is sweating, his breathing, and the physical parameter based on observation, and even a certain amount of palpation and percussion can be applied by directing the patient.
In reality, the only component of physical examination that cannot be accomplished with telemedicine is auscultation using a stethoscope, a component that has minimal impact on most diagnostic processes. To summarize, most of the complaints that cause patients to come to the clinic can be diagnosed and managed with telemedicine , except for situations that require urgent intervention.
Our patients cannot use telemedicine applications; is another bias towards telemedicine applications. In fact, the vast majority of our patients already use much more sophisticated social media or other applications.
The experience we have gained in our clinic shows that patients of all age groups can communicate with us through our application without any problems, and they are extremely satisfied with the meetings we have made with this method.
Medicine in the Future
The possibility of remote monitoring of patients with developing smart and wearable devices, the fact that we can do this in almost real time with increasing communication speeds, and of course the diversity and consistency of the results obtained by artificial intelligence from this real-time data is increasing day by day . It causes us to think that it will take its place among standard medical practices beyond discussions .
A report by Forrester predicts that there will be more than 1 billion telemedicine calls in 2020 in the USA alone. Telemedicine has already become an irreversible and unstoppable trend.
In the years to come, we will see telemedicine applications continually expand and change our perception of healthcare. From the point of view of patients, telemedicine offers many advantages together. Patients have the opportunity to easily reach the most suitable physician or clinic for them and to manage their appointments effortlessly.
At the same time, waiting times are eliminated and time and place dependency is minimized. Telemedicine started a process in which healthcare was redefined for patients. While this transformation process will make it easier for physicians and clinics, who have adapted to telemedicine applications and provide their patients with services in accordance with this new model, to reach more patients, it will naturally cause a decrease in the number of patients of physicians and clinics who cannot adapt to change.