In a world where wellbeing and mindfulness are gaining momentum for millennials and generation Z, the aging population is a significant group who are at risk of being forgotten in the rush of yoga mats, water bottles and avocado on toast.
Countries such as Qatar, Kuwait and United Arab Emirates (UAE) should anticipate a minimum of five times increase in the proportion of their geriatric population between 2000 and 2050. In Dubai, cardiovascular diseases and cancer were the main causes of death in 2016, which accounted for over 51% of all deaths – this is three times higher than the UK or Australia . This coupled with a high number of overweight adults (34.5%) spells trouble, and sooner than you might think.
Our ability to handle the challenges of this aging, ailing population depends on the preparedness of society, specifically the healthcare and social security infrastructure. Despite the increase in these chronic diseases, these older people want to remain in their homes. Consequently, there is a demand for home-based care, yet this service remains underdeveloped.
Personally, I am unsure that the Dubai Health strategy 2013 – 2025 of building 3 new major hospitals and 40 new Healthcare centres is aggressive enough to meet this growing demand whilst also attracting Medical tourism. This situation calls for new provisions in health care and social security systems. And in the field of telemedicine, there is untapped opportunity.
Still in its infancy in the Gulf, but with growing acceptance, telemedicine or virtual care, can service many of these elderly patients in their own homes - telemedicine literally means “healing at a distance.” And in fact, according to the American Medical Association, 70% of primary care visits can be handled without a visit to the physician’s office.
Telehealth, which is often used interchangeably with telemedicine, covers a broader range of health-related services, including patient and professional education.
At Herman Miller, we define telemedicine as direct patient care delivered remotely. eHealth, mHealth, and connected health, along with telehealth and telemedicine, all express forms of healthcare delivery via technology.
Telemedicine can be broken down into five separate areas, which need to then be supported by good design to ensure they are successful and provide the appropriate level of care for the patients.
1. Messaging – this can be via telephone or email
- Order and refill prescriptions
- Respond to emails from patients
- Telephone a nurse
2. Data exchange involves the electronic sharing of data for the specific purpose of care provision, diagnosis, and treatment.
- High-quality, inexpensive cameras enable accurate sharing of wound, dermatology, and ophthalmology diagnosis and care
- PACS (Picture Archiving Communications Systems) allow radiologists to read images anytime and anywhere
3. Real-time consultations are video exchanges between patient and care provider or between two care providers.
- Widely used in behavioural health, dermatology, paediatrics, and stroke care.
- Enabled by digital equipment, such as otoscopes, stethoscopes, and ultrasound spirometers.
- Anaesthesiologists consult remotely with other anaesthesiologists in an operating room; a remote-control camera allows the consultant to pan and tilt to observe
4. Remote monitoring means care providers work from their homes, in offices at hospitals, or in a stand-alone facility that may or may not be owned by a hospital.
- On a daily basis, patients with chronic diseases use digital scales and digital blood pressure cuffs and transmit data to a care manager, who analyses and contacts patient as needed
5. Real time interventions include surgeries performed remotely via robotic surgical systems.
- A surgeon in Canada has carried out 20+ robotic operations, from colonoscopy to hernia repair, on patients 400 km away
Some of these activities are already underway in the region. Organisations such as Mobile Doctors 24/7 accommodate for messaging, data exchange and real time consultation. However, I am not aware of any applications of Real Time Interventions in the Gulf but that doesn’t mean they haven’t occurred.
As a Psychologist working on behalf of Herman Miller I am interested in the Caregiver and Patient experience whilst engaging in these services. Good telemedicine room design will accomplish two major functions:
1) it will create the visual and audio clarity and accuracy that is necessary to support clinical examination and diagnosis from a distance, and
2) it will create a connection between the patient and the remote care provider sites where the patient/clinician interaction, not the technology, is the focal point.
What do exam rooms look like that balance technology with effective care and foster communication and relationship building?
What do command centre spaces look like? The eICU command centre (located within a hospital or at a stand-alone building anywhere) is a facility in which a critical-care team monitors ICU patients and exchanges information with the onsite ICU staff through real-time audio, visual, and electronic means.
What do care-provider spaces look like?
While there are a number of similarities between 'Exam-Room Space Design Principles' and the 'Care-Provider Space Design Principles' these should remain separate as the Care-Provider Space is catering for the digital patient and the Exam-Room Space for the physical one.
When telemedicine and thoughtful space design are combined, it becomes possible to better manage chronic conditions in the aging populations. This will reduce emergency department admissions, which in turn reduces the cost of care, as well as providing better care coordination overall. The furniture within all of these settings should be as flexible as possible to cater for further Virtual Care demands.
If you would like to further information on Virtual Care then please email firstname.lastname@example.org and arrange an inhouse seminar at your convenience.
1. Economic and Social Affairs of the United Nations Secretariat. World Population Prospects: the 2006 Revision. http://www.un.org/esa/population/unpop.htm (1 August 2012, date last accessed)
2. Chronic Disease and aging in Eastern Mediterranean region: From Research to Policy and Practice, Center for Studies on Aging-Lebanon. 2010. http://csa.org.Lb
4. Telemedicine Room Design, California Telemedicine and eHealth Center (CTEC), 2011
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