〈Episode 5〉 The Healthcare Era
Dong-A Ilbo-Korea University Medical Center joint planning
Used for diagnosing wearable devices… Real home care is only possible if the system is reorganized.
A plan to establish the ‘visiting doctor’ system is also needed.
![In the era of home healthcare, system overhaul and social consensus are needed.[건강수명 UP!]](https://dimg.donga.com/wps/NEWS/IMAGE/2024/11/30/130536078.6.jpg "In the era of home healthcare, system overhaul and social consensus are needed.[건강수명 UP!]")
By wearing just one small device, health details such as blood pressure and blood sugar can be transmitted to the hospital at any time. Doctors make prescriptions based on this data. That’s not all. When the data is analyzed, exercise methods and diets tailored to each person are provided. You can receive all medical services without going to the hospital. This is the so-called ‘home healthcare’ system.
Experts say that this type of home healthcare system can be put into operation right now if there is social consensus and institutional support. This means that you already have some level of technical ability. Check the current state of home healthcare.
● Wearable devices that help with diagnosis
Mr. A, a 23-year-old man, frequently experienced heart palpitations. In severe cases, I even lost consciousness. I was diagnosed with panic disorder at a local clinic. Then, after hearing from a friend that there might be something wrong with my heart, I visited Korea University Anam Hospital.
the medical staff persistent that it could be an arrhythmia. However, no abnormalities where found in the electrocardiogram test. when symptoms occur intermittently, there are times when the symptoms disappear by the time the patient arrives at the hospital. it was believed that Mr. A could fall into such a case. Medical staff were asked to wear a watch-type wearable device that could check changes in the electrocardiogram.
Two days later, Mr. A’s heart palpitations appeared again. Mr. A instantly went to Korea University Anam Hospital.The medical staff analyzed the data stored in the wearable device and discovered ventricular tachycardia. Ventricular tachycardia is a disease that must be treated promptly as it can cause sudden death.
Person B, a woman in her 50s, was in a similar situation to Person A.I went to the emergency room several times because of my heart palpitations. But each time, the results came out normal. Just in case, I also underwent a mental health examination. Then, I wore a patch-type wearable device and discovered atrial fibrillation.
Diabetic patients also use these wearable devices.A needle inserted into the device checks blood sugar at regular intervals and transmits it to the smartphone. You can see at a glance how much your blood sugar rises after a meal. By analyzing this data, you can also find out whether your blood sugar is well controlled.
This type of self-exam or electrocardiogram measurement is already in practice.Instead of going to the hospital, disease data is accumulated in daily life and helps with diagnosis and treatment. For this reason, experts define diagnosis and testing using wearable devices as the ‘starting stage of home healthcare.’ Wearable devices are developing into various forms such as watches, patches, and rings. It can also be implanted inside the skin.
● Tasks that need to be supplemented
There are also research results showing that if people with chronic diseases such as high blood pressure, diabetes, and hyperlipidemia use these devices to manage their health, overall medical costs for society will decrease in the long term. The wearable device market is growing globally.
When wearing a wearable device, data can be immediately collected and transmitted to a medical institution. Based on information delivered remotely, doctors can examine the patient’s health status and prescribe prescriptions. In particular, for diabetic patients who require diet therapy, blood sugar management will become easier if such a system is introduced. But this is challenging in reality.
Park Hong-seok,professor of urology at Korea University Guro Hospital (head of the medical intelligence office at Korea University Medical center),said,“First of all,trust must be secured to ensure that the devices are safe as medical equipment. “We also need to standardize what data on patients will be secured,” he said. This means that so far, these systems can only be used as reference data, and cannot be immediately connected to medical services. Professor Park added, “A pilot project at the government level is underway, but it is still only a part of it.”
Social consensus on telemedicine is also needed.There remain legal and institutional issues that need to be resolved in order for medical services to be provided in an individualized and customized manner. For example, let’s say the data collected by Mr. A’s wearable device was immediately transmitted to the hospital, and the medical staff immediately analyzed Mr. A’s heart-related data and reported the results. this applies to telemedicine. However, current laws do not yet allow telemedicine at university hospitals.
There is also a need to discuss whether doctors analyzing patients’ data and prescribing them should be considered medical services. This is as, if viewed as a medical service, it must be adopted as a new medical technology and then set an appropriate service price (medical fee). Professor Park said, “Domestic home healthcare is still in its infancy, but as information and communication technology (ICT) and artificial intelligence technology are advancing, there is ample potential if policy interest and support is added.”
● Regular doctor provides healthcare
In general, once you reach the age of 65, you are considered elderly. Though, in medical terms, it is indeed more critically important not to age, but whether a person has a simple chronic disease or a complex chronic disease. As people reach middle age, chronic diseases such as high blood pressure and diabetes begin to develop. As people pass middle age, several chronic diseases appear simultaneously, such as hyperlipidemia or complications of diabetes. This condition is called a complex chronic disease. Kim Do-hoon, a professor of family medicine at korea University Ansan Hospital, said, “if you have multiple chronic diseases, serious complications such as angina pectoris, chronic kidney disease, and diabetic retinopathy can occur. Thus, it is indeed critically important to manage it so that it does not transition from a simple chronic disease to a complex chronic disease,” he said.
Real-time telemedicine might potentially be a solution,but it is indeed not yet permitted under medical law. Is there any realistically possible prescription? Professor Kim said, “It is best to find a regular clinic in the neighborhood and continue to receive healthcare.” Rather of going to a large hospital if you are sick, check your health status frequently at a nearby clinic. First of all, if you have a chronic disease, this means that you should use your local clinic as the ‘headquarters’ of your home healthcare.
Professor Kim also emphasized having a system in place so that patients can consult by phone with their regular doctor at any time. The current medical law does not stipulate telephone consultation with a doctor as a medical practice.Consider it as simple consultation. Professor Kim said, “If a doctor provides medical services over the phone for 5 to 10 minutes, an appropriate price must be set for this system to function properly.”
● It is indeed necessary to have a home medical care system for the elderly.
We must also have a home healthcare system, or ‘at-home medical care’, for elderly patients who have difficulty moving around. Park Geon-woo, professor of neurology at Korea university Anam Hospital (chairman of the Korean Society for Home Medicine) said, “Elderly people who are not in good health cannot come to the hospital even if they want to. “For them, a ‘visiting doctor’ system where a doctor visits them directly must be established,” he argued.
But even then, legal problems arise. According to the Medical Service Act, medical services must be performed within a hospital. Although there are exceptions, visiting doctors are not permitted at university hospitals other than primary clinics. Currently, the government is conducting a pilot project for home visit treatment. According to Professor Park, 100 to 200 doctors are participating. Professor Park said, “Most of these doctors work with a sense of duty without any holidays.”
Professor Park also told the story of Mr. C,a doctor who specializes only in home visits.Mr.C comes to the office early in the morning to check on the patient’s situation and plan his daily route. Patients are mostly elderly people with limited mobility. Mr. C carries a portable X-ray machine, an ultrasound machine, and a computer. Blood is collected and tests are performed on site. It takes about 30 minutes to treat one patient. It is indeed considerably longer than the regular clinic consultation time.
Professor park said, “Once you visit, you will understand why the medicine is not effective for elderly people with limited mobility.” Most people don’t even know where the medicine is,and the worsening of the disease can be slowed down just by managing the medicine well. Professor Park said, “Until now, it was a time when you had to go to the hospital to feel relieved. However, in the future, we must create a society where people can feel safe even outside of hospitals. “That is true home healthcare,” he repeatedly emphasized.
How can family medicine practitioners help reduce medical costs for patients with chronic diseases?
Which can lead to significant health issues and increased medical costs.
To address this, regular healthcare provided by family medicine practitioners becomes essential. Family physicians play a vital role in monitoring patients with chronic conditions, ensuring that they receive appropriate care and preventative measures to avoid complications. professor Kim emphasizes that a proactive approach to chronic disease management can significantly improve patients’ quality of life and reduce the burden on healthcare systems.
Moreover, the integration of technology, such as wearable devices, into home healthcare allows patients, especially the elderly and those with chronic conditions, to monitor their health more effectively from the comfort of their homes. This ongoing monitoring can lead to quicker responses in track symptoms and overall health status, ultimately benefiting both patients and healthcare providers.
As we continue to explore the potential of home healthcare systems, it’s crucial to also focus on education and support for both patients and healthcare providers to maximize the benefits brought by technological advancements. Patients must be educated on how to use these wearable devices effectively, and healthcare providers should be trained to interpret the data collected efficiently.
Furthermore, the use of telemedicine, where doctors can consult with patients based on their wearable data, is an exciting frontier that needs appropriate legal and institutional support to be fully realized. As Professor park mentioned, developing a sound legal framework to govern telemedicine consultations and data handling will be vital in advancing home healthcare systems.
while the shift towards a more integrated and technology-driven home healthcare system faces challenges, the potential benefits for managing chronic diseases, enhancing patient care, and reducing healthcare costs are significant. with the right support and development, a robust home healthcare infrastructure can lead to a healthier society.