Patients being monitored remotely, sensors and smartphones transmitting data via Bluetooth, Artificial Intelligence analysing ECGs and providing risk assessments: eHealth is the future.

But what does that mean? Are machines taking over healthcare? Do patients never have to visit the hospital again? And what happens to our data that’s being collected, is it safe?

eHealth Interview Dr Arif Elvan CEO Diagram Research

To find our answers and to understand more about this shift from face to face to digital healthcare, we’re talking to Dr. Arif Elvan, CEO at Diagram Research.

He’s on a mission to get eHealth widely recognised, by clearly demonstrating the added value through clinical trials and studies.

What is eHealth?

eHealth uses information and communication technology (ICT) to improve or enable health care.

Dr. Elvan explains: “eHealth is a container concept, it details a large spectrum from remote care to telemonitoring (the possibility to monitor patients at home from a distance) to assessing images of patients, like a MRI or ultrasound.

Dedicated platforms are used to receive, process and analyse data from a patient in their home situation (outside the hospital). When sufficient data is gathered certain trends can be detected that you cannot see based on individual assessments.”

As a great eHealth example, dr. Elvan refers to the saturation meter (saturation is the oxygen level in the blood) that was widely used during the COVID period. He elaborates: “With the saturation sensor, patients were closely monitored at home from a distance. In this way, many patients could be safely treated at home, preventing unnecessary hospital admissions, which is ideal when the capacity is under pressure.”

Benefits of eHealth

eHealth is rapidly gaining in popularity, why is that?

“Because there is much to gain in efficiency from eHealth,” dr. Elvan explains. He continues: “It allows you to detect diseases earlier and better, to provide more effective, tailored treatment thus making health care cheaper and more manageable.”  

Dr. Elvan gives us several examples to illustrate these benefits. Being a heart research organisation, Diagram Research approaches eHealth from the patient’s perspective. The patient is the centre of the medical universe.

Dr. Elvan shares: “There are certain patients who have an increased risk of certain arrhythmias, they occur only occasionally, not every day. So when that patient comes to the outpatient clinic for monitoring, it’s likely the arrhythmia will not be detected.

However, when you follow that patient remotely via sensors, you can better detect that arrhythmia and other health parameters. This integrated holistic approach allows the physicians to make an adequate diagnosis and better risk stratification than based on a single hospital visit.”

For atrial fibrillation

You can initiate treatment earlier thus minimizing the risk of stroke.

An important cohort that could benefit from eHealth, is people who suffer from atrial fibrillation. This arrhythmia often goes unnoticed and only becomes evident when patients are admitted with a stroke, a common complication.   

“I strongly believe prevention is better than cure,” dr. Elvan says. “So if you detect those patients in time through telemonitoring, you can initiate treatment earlier thus minimizing the risk of stroke.”

For hypertension

Tailoring the therapy to the patient in a smart and cost-effective way.

eHealth can be effective for people with hypertension as well. Also known as the silent killer, majority of the patients are asymptomatic, i.e. don’t feel they have high blood pressure, but it puts them at increased risk for heart disease, heart failure and stroke.

Apart from patients being unaware, it can be problematic to get a trustworthy blood pressure reading in the hospital. “This is called White coat hypertension and is caused by the alert-response,” dr. Elvan explains.

He continues: “Someone comes to the hospital, becomes alert, gets a stress reaction and the blood pressure shoots up. As a result, it is difficult to get a reliable measurement. High office blood pressure does not necessarily mean that person’s blood pressure is also too high when at home.”

According to dr. Elvan, eHealth is a smart solution for these patients: “You follow that person at home with sensors, including a blood pressure monitor and a smartphone that is connected via Bluetooth. You can read it remotely multiple times a day which provides a reliable reading of trends. And if it is too high, the treating physician can set up treatment and continue to monitor the effects of the treatment via eHealth. In a very smart way, you can tailor the treatment to the patient, adequately and cost-effectively.”

For heart failure

We have to deal with the aging of the population in a smarter way.

A third group that could benefit from eHealth, are patients with heart failure. They frequently visit the hospital for treatment and consume a lot of health care resources.

Dr. Elvan clarifies: “The need for hospital care and associated costs are increasing rapidly, but unfortunately you can’t increase the number of hospital beds in line with the ageing population, that would be unaffordable. We have to deal with the aging of the population in a smarter way.”

This brings us to another key benefit: making health care more manageable.  

“You want to keep patients at home as long as possible and adjust the treatment to that home situation,” dr. Elvan says. To do this, eHealth uses sensors like ECGs and saturation meters in combination with other equipment like a scale and step counter.

“This allows you to closely and adequately monitor patients from a distance. When you notice saturation is decreasing, weight is increasing and the patient is moving less, then you know things are not going well. This allows the treating physician or allied professionals to adjust the medication in time to prevent escalation. To this end, remote care is incredibly important.”

For developing countries

Dr. Elvan was involved in medical missions in Indonesia and other developing countries, bringing complex care to poor patients.

He strongly believes that eHealth could make a strong impact in Africa and Asia, since it allows you to reach poor people in remote areas, to provide proper treatment, without having to make large investments.

Establishing its added value

We want to facilitate studies to demonstrate this added value and to further optimise the entire process.

When it comes to adapting to trends and new developments, Diagram Research has been playing a leading role in eHealth projects.

Dr. Elvan shares: “Everyone is experimenting with eHealth, but the added value has not yet been clearly established. As a research organisation, we want to play a role in this; we want to facilitate studies to demonstrate this added value and to further optimise the entire process. By following patients, safely collecting data and professionally analysing the data. And that is our core business”.

One of the projects Diagram Research is currently working on, is the development of an application with AI and ECG.

“It’s an application that analyses ECGs based on deep learning, on artificial intelligence, to predict certain diseases,” dr. Elvan says. “It collects data in a smart way, analyses it and presents trends. In many cases, you can make accurate predictions, avoiding expensive procedures.

The most important thing is to keep healthcare accessible and affordable, and to organise healthcare in a smarter way. And if we as research organisation can contribute, that’s fantastic.”

Approaching it in a patient-centred way

We are all going to benefit.

eHealth is rapidly evolving, where will we be five years from now?

Dr. Elvan answers: “I truly hope that eHealth has become a standard part of health care, fully incorporated into the routine.

I also hope we all look at eHealth in a patient-centred way, instead of focusing on the financial aspect of ‘who’s going to pay’. Because eHealth is about making the care for the patient better and smarter, and in doing so, it automatically becomes more cost-effective and advanced health care remains accessible to the society.

And in the end, we are all going to benefit.”

eHealth is the future

So, it is clear. eHealth is not a sci-fi scenario with machines taking over the healthcare system and no doctors or nurses in sight.

On the contrary, it’s a way towards more personal and tailored care.

Using ICT to improve outcomes in patients, eHealth makes health care more effective, affordable and more manageable.  

So yes, we do think eHealth is the future.

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