Family doctors believe that primary care needs to be modernized and that investments in new technologies are needed to be able to implement good patient telecare and move towards algorithmic medicine.
“We can’t just talk about new technologies as something that exists, but within a larger concept that is to modernize care,” Lorenzo Armenteros, spokesperson for the Spanish Society of General and Family Physicians (SEMG), tells THE OBJECTIVE. An issue that, as discussed at the National Congress of General and Family Medicine, worries doctors, who believe that greater investment in this area is necessary.
Its objective, explains Armenteros, is to implement over a few years an algorithmic medicine, with “algorithms created by and for professionals, so that integrated into the clinical history we have the certainty that we follow the appropriate, homogeneous and equitable path so that there is no difference in care”.
Specifically, what they propose is that there be an algorithm that makes it easier for doctors to to know what steps should be taken at each moment for diagnosis or treatment of a patient. “Having marked steps based on certain symptoms or signs is going to help us to have a better medicine, because the capacity for small forgetfulness or delay in diagnosis, since everything is reflected in a process algorithm, is going to be reduced” , says the SEMG spokesman.
Algorithmic medicine, but not automated
That yes, Armenteros insists that this type of medicine would help reduce human errors but does not mean that processes are automated or left entirely in the hands of technology. “First, the algorithm is not made by a machine, and second, it leaves room for the ability of each doctor to decide at any time what to apply,” he says. “What would not remain in the air is the possibility of not doing it because you have forgotten.”
Thus, it would be have a standardized guide that is updated with the steps to follow according to the characteristics of the patient and the disease, so that the doctor does not skip steps when ordering diagnostic tests or drugs or guidelines during treatment.
“It would allow us to have greater homogeneity in the type of assistance, always with the greatest evidence and the highest quality,” says Armenteros, who insists that “does not become a robotic medicine and automated, it becomes a medicine in which the latest developments in science are reflected in a diagnostic and therapeutic process integrated into the clinical history».
‘Apps’ to implement telecare
Another aspect that the SEMG considers important, Armenteros points out, is to improve patient remote monitoring and reach a point where it can be part of the monitoring of their disease through new technologies.
The idea is to have “integrated platforms where the patient can manage his disease and at the same time we manage it in the same way and at the same time”, explains the specialist.
Thus, “we would give self management from the disease to the patient, the concept that it is not only in the hands of the doctors and the drugs, but that they can also see its evolution”, he adds.
For example, it could be the case of a patient with heart failure who had to measure blood pressure and weight every day. These data, thanks to the Wi-Fi of the scale or the blood pressure monitor, would go directly to be recorded in the application and both he and his family doctor and his specialists could follow his evolution and receive alerts if something is not going well.
With this, what they propose is “a change of assistance, of the consultation model” and that the family doctor becomes “the unifying element”. This, says Armenteros, would mean a savings in time management, moneyoy of the displacements.
Investment to make it accessible
The risk of this, Armenteros points out, is that “it can become an inequitable medicine that only the rich have within their reach.” For this reason, from the SEMG they insist that this has to be accessible to the entire population, for which “the health system” has to change and “the doctor has to have the capacity to prescribe certain devices in the same way that a drug is prescribed”.
The spokesman for the medical society assures that “investment in this type of device and its proper use represents savings for the system, by avoiding worsening and outbreaks in some pathologies.”
However, he regrets that “what we propose is far ahead of what the health authorities have in mind” and denounces that these “are based on theoretical concepts that are increasingly far from reality.” “That’s why we have so many problems, because the role of the doctor has been forgotten and what the doctor needs.