The emergency we are experiencing is to a large extent a “new” situation, something unprecedented not so much from a clinical point of view (of epidemics and pandemics humanity has experienced abundantly over the centuries) but rather from the point of view of what we might call “how to manage”.
The speed at which news spreads now far exceeds the speed at which a virus spreads, and that is the real difference from the past: compared with our ancestors, we learn that there is an epidemic before it even materially arrives.
This can also be devastating on a psychological level, because the anticipation of something we are unable to see generates a great deal of anxiety. But it can also be positive since it gives us a way to prepare for situations with a minimum of anticipation.
The management of the Covid-19 emergency, from the point of view of health facilities close to collapse, especially in Lombardy, is posing – among others – the problem of how to ensure continuity of service in a context where common sense even before legislation requires and imposes the use of mobility only in conditions of real need. And that’s not all: the need to free beds to be dedicated to intensive and semi-intensive care for the acclaimed Covid-19 is causing other patients to move to decentralised structures: patients far from their attending physicians with the need for continuous consultations.
We can hear the word “telemedicine” these days in the news and talk shows that bombard us with news, it is becoming common in the debate. We talk about it above all evoking it as a tool that can help the management of the emergency situation: telemedicine to guarantee citizens/patients the possibility of interacting with their general practitioners and health facilities during pre-triage or other moments where a communication channel is needed.
There is a lot of talk about it and little is done: the everyday life of decision-makers is rightly consumed by countless decisions to make, masks and respirators to buy, ICU beds to set up.
It would be necessary, however, to find half an hour of time, on the part of the NHS managers and politicians, to think about how much telemedicine could represent a nice piece of solution, not so much – obviously – to the epidemiological problem but rather to the corollary of the secondary problems.
Tele-consultation, tele-visit and telerehabilitation, if seriously and capillarily introduced, could not only help the management of the emergency, but rather trigger a process of real evolutionary transformation of the way of managing and treating even in times – which we all sincerely hope – of return to normality.
The problem of lack of resources, in these weeks, seems certainly secondary: even the EU is understanding the need to activate extraordinary sources of funding to be allocated to the health systems of the Member States in derogation from the current rules.
It is a question of really wanting it, the transformation in an innovative sense.
We all hope that the current emergency will end before these proposals can possibly be considered. Independently of this, we hope that the highlighting of the current critical issues will provide the cue for a courageous initiative of extraordinary funding for the digital transformation of the NHS.
If not now, when?
Paolo Colli Franzone
IMIS Istituto per il Management dell’Innovazione in Sanità