Digital health: difficulties and triumphs from the first astronaut missions to the COVID-19 pandemic

This article was exclusively written for The European Sting by Ms. Ananda Ciabotti Candido, a 4th-year medical student from São Paulo enthusiastic about innovation and research. She is affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

NASA was one of the first institutions to value telemedicine and understand that it goes beyond monitoring patients. The agency was keen to ensure the health of their spacecraft crew even before departing, in their pre-flight training with doctors and other professionals from the health. NASA’s flight suits had data such as blood pressure, pulse, ventilation, and an electrocardiogram. In addition, they even developed the “Gemini Project” to simulate the health standards of the crew in orbit before traveling in a small capsule with two passengers.

NASA’s investments in digital health demonstrate that telemedicine everywhere in the world is a tool to reduce distances between doctor and patient, reduce healthcare costs and expand the care capacity of healthcare services. Hence, it evades the medicine performed by Hippocrates in the fifth century, bringing distrust and strangeness to those used to having closer contact with the patient, holding hands, observing movements beyond a face on a canvas, making a good physical examination. Therefore, the main challenge of telemedicine is to prove its effectiveness and quality to its consumers, in this case, health professionals.

Digital health is not just consultations but issuing reports, medical prescriptions, exchanging information between professionals, teleconferencing in surgeries, among others. Regardless of the modality, all require knowledge of the technology, ethics, and studies for using the data received and provided. That also is considered a difficulty for E-health, being necessary to be careful with errors in telemedicine, requiring adequate training with employees of these technologies.

E-health has grown a lot in the last year, its main growth driver being the need to stay safe from the COVID-19 pandemic. The telehealth platform of the Brazilian university UFRGS, for example, grew by about 802% in 6 days, right after the first death in the country, which reached the mark of having the highest number of daily deaths by COVID-19.

However, it is notable to consider possibilities beyond well-established socioeconomic realities and good financial potential to afford telemedicine tools, such as cell phones and computers. There is no data on these populations because, in addition to having access to telemedicine, they are made invisible, even by professionals who should provide care for them. In addition to considering only patients out of vulnerable situations, it is crucial to plan strategies to aggregate this other percentage of people since digital health tends to dominate a large part of health care and may exclude those who don’t have access to the basics.

References

1. Cipolat C, Geiges M. The history of telemedicine. Curr Probl Dermatol. 2003;32:6-11. doi: 10.1159/000067346. PMID: 12471983.
2. Montelongo A, Becker JL, Roman R, de Oliveira EB, Umpierre RN, Gonçalves MR, Silva R, Doniec K, Yetisen AK. The management of COVID-19 cases through telemedicine in Brazil. PLoS One. 2021 Jul 14;16(7):e0254339. doi: 10.1371/journal.pone.0254339. PMID: 34260644; PMCID: PMC8279372.

About the author

Ananda Ciabotti Candido is a 4th-year medical student from São Paulo enthusiastic about innovation and research. She believes in a humanized medicine, in which its members believe and fight for One Health. She is currently part of the Scientific Team at IFMSA Brazil