Remote care: looking after your health using digital tools

Developments in digital technology are changing the way healthcare is delivered. Digital technology refers to electronic devices and systems that work online.

Online platforms, video calls, devices that you wear (wearables) and apps are all becoming familiar tools to look after our health. In the medical field, this is often referred to as ‘telemedicine’ or ‘telehealth’. In practice, this means healthcare that is delivered remotely. This is where the health professional and the patient connect by digital technology.

The COVID-19 pandemic made it necessary to greatly speed up this change. During this time, care was often provided digitally. The aim was to reduce the spread of the pandemic while continuing to provide support to people who needed it.

During the COVID-19 pandemic, both healthcare providers and members of the public had to adapt to changes in healthcare. In many settings, this meant speaking with healthcare professionals via telephone and video calls.

As the pandemic eases and services are returning to normal, digital tools remain available to use. This could mean that over the coming years you will have a choice of face-to-face healthcare and some remote management of health. As more research looks at how effective these services are and the best way to deliver them, there could be further changes in the future.

Digital tools are having an impact across all areas of healthcare. This includes remote consultation and home monitoring as well as wearable devices and health apps. Here are some examples of the way technology is being used in healthcare:

Video calls for consultations

You will receive an email or text message from your healthcare provider if you have a video appointment scheduled. This will confirm a date and time for the appointment and how you can access the video call. You may access your appointment on your smart phone, tablet or computer. You will only be offered a remote appointment if your healthcare provider does not need to do a physical examination at this stage. See the section below on how you can prepare for these meetings.

Sharing photos or videos

You may be asked to share a photo or video of your condition or specific symptoms before you speak with a healthcare professional. You will be sent an overview of how to do this by your healthcare provider. Photos and videos are usually sent through text messages, emails or secure uploads to an online platform. This will help your healthcare professional to understand more about your condition. Your healthcare professional can also share files or videos with you. This could include information leaflets or videos with instructions for how to use a medical device, for example.

Virtual wards and home monitoring

In some circumstances, people can be discharged from hospital and monitored at home. A good example of this was during the COVID-19 pandemic. As hospital beds were in high demand, people who had more stable symptoms were able to go home. They continued receiving oxygen, and their symptoms and oxygen levels were monitored remotely by consultants.

Online rehabilitation and activity sessions

If you have been advised to take part in activity sessions or rehabilitation to help manage your symptoms or recovery from illness, this could be via an online class or tutorial. Classes may be delivered via video sessions where many people join and take part live. Or you may be sent recorded videos to follow in your own time.

Online diaries, journals or questionnaires

You can choose to log your symptoms in an online diary or journal to help track how you feel over time. It can be helpful to have a personal record to take with you to your next consultation.

Online questionnaires can build up a picture of your condition over a period of time. Your healthcare professional may ask you to do this before you come to your appointment. You might be sent a questionnaire to complete via email or text message before a visit.

Wearable devices

Devices that you can wear, such as smart watches, can help track a range of measurements about your body. This includes heart rate, stress levels, sleep patterns, oxygen levels and activity levels. These devices are usually connected to an app on your smart phone or tablet. An app – short for ‘application’ – is a program that you can install on your smart phone or tablet. This collects information and builds up a picture of health over time.

These systems are not usually directly connected to your healthcare provider. But it can be useful information for you to have during a consultation with your healthcare professional.

Health apps

There are many apps available to help track your health. Some include information on how to manage your condition. Others remind you to take your medication or let you track recordings from a medical device.

Most apps are available to download and use yourself if you choose to. If your healthcare provider wants to receive readings from your medical device, they will discuss this with you. They can tell you which app or platform you need to use as it will need to be connected to a hospital system.

There are many benefits to using digital technologies in healthcare. Here are a few examples of how digital tools can benefit individuals:

Reducing the need to travel

If you can attend a consultation remotely then you do not need to travel. This can save time and money and it is better for the environment.

Improving access to professionals

Remote video and telephone calls can make it easier to access all healthcare professionals without needing to travel to appointments.

In some cases, it can be also difficult to see a specialist in your condition who may work at a specialist hospital, rather than your local hospital. Remote consultations make it easier to access this level of care, despite where you live.

Improving collaboration and empowerment

Taking actions to check your health at home can give you a new sense of understanding about your condition. This may help you feel more in control and able to input into discussions about your health. It can also help with remembering to take your medication. This is particularly useful if you are someone who struggles to follow your recommended treatment routine.

A choice of setting

Some people may also find hospital or clinic settings uncomfortable and prefer to be in their own home for consultations. Some people may find it useful to give their healthcare provider an idea of what it is like to live with their condition at home.

Remote video calls give the option of being at home, which some people may prefer particularly if they receive upsetting news.

Infection control

Remote consultations reduce the spread of infections. If you have any contagious symptoms then it is safer for you to be at home than travel to a healthcare setting where you could infect others. This also means that you are protected from anyone else in a waiting room or on public transport who may have infectious symptoms.

As digital platforms become more widely used, there are many shifts that are still needed within healthcare. Here are a few of the challenges that healthcare systems and members of the public are facing:

Changes to structures in healthcare settings

New systems and changes in working patterns are needed within healthcare settings. For example, if whole groups of patients are given apps to log their symptoms, there needs to be desk-based healthcare professionals who check this information. They would need to be able to act on information received if any ‘red flag’ symptoms need following up. There may also be a need for members of staff to undergo new training to be able to teach people how to use new digital tools and answer any questions remotely.

Access and education

Many of these tools need a smart phone, tablet or laptop and a reliable internet connection to be used at home. Not everyone will have access to these devices or know how to use them. Some people may also not be able to physically use them. As technology changes, it will be important to ensure that all people can continue to access healthcare. Face-to-face services should remain available if they are needed or preferred.

Data security

Proper systems are needed to manage personal information securely. For example, if you have shared a photo with your doctor, this needs to be stored properly, according to the data security laws in your country. For more information on this, read the ELF factsheet on data sharing.

Medical ethics and relationships

There are ethical standards that exist within medicine. These determine how healthcare professionals must act. There are concerns about whether these standards can be kept to with these changes. For example, will remote consultations affect the relationship between a patient and their care giver? The healthcare world works to high standards in maintaining privacy – can this continue on digital platforms?

As the world adapts to new ways of working after the COVID-19 pandemic, these challenges are being addressed by governments and healthcare systems.

If you have been invited for an online appointment or consultation, you can use the following tips to help you prepare:

Before the call

• Decide which device (computer, tablet or smartphone) you will use for your consultation. You will need a stable internet connection for whichever device you choose. Make sure you know how to turn on your microphone, your camera for the video and also the sound.
• Is it worth having a practice and picking a spot where you will sit for the call? Check if your lighting is correct and practice getting your face in the middle of the screen looking straight at the camera. If you are unsure – do you have friends, family or neighbours who could talk you through it? You could also search online for how-to videos.
• Find the appointment invitation, which will include details of how to connect to the call. Make sure you read through this and are familiar with the steps you need to take.
• Prepare a list of things to discuss – you can make some quick bullet points about what you want to discuss so that you do not forget anything during the call.

During the call

• If your video does not connect, your healthcare provider is likely to try you on the phone number they have on your record. If they cannot reach you on the phone, they will usually rebook your appointment for another time.
• Have a notepad ready or a document open on your computer to write down any notes during the call. Your healthcare provider will make notes on your online record at the same time.
• If you are unsure about the discussion, you can recap what you have heard as the call comes to an end. Your healthcare provider can then say if you have misunderstood any points.
• Your healthcare provider can give you an online prescription or refer you on for further treatment during a video call as normal. If you are unsure about how to access a prescription, or how you will hear about further appointments, then make sure you ask before the call ends.

Patient information:

• European Lung Foundation factsheet on data sharing
• Read personal stories of using digital health on the World Health Organization website

Scientific research on digital tools in lung health:

• This article reviews digital care offered during the pandemic: ‘Telemedicine and virtual respiratory care in the era of COVID-19’ 

• This article looks at how home monitoring supported people with COVID-19 during the pandemic: ‘Home-monitoring reduces hospital stay for COVID-19 patients’

This factsheet was compiled with the help of Dr Hilary Pinnock, Jellien Makonga-Braaksma, Dr Carme Hernández, Kjeld Hansen and Joyce Norwell.

It was produced by the European Lung Foundation for the DRAGON project. Find out more about this project. 

This work has received support from the EU/EFPIA Innovative Medicines Initiative 2 Joint Undertaking – DRAGON grant n° 101005122. Further information at: https://www.imi.europa.eu/

The communication reflects the author’s view and neither IMI nor the European Union, EFPIA, or any Associated Partners are responsible for any use that may be made of the information contained therein.