e-Health is the cost-effective and secure use of information and communication technologies (ICT) in support of health and health-related fields. It encompasses interventions like telehealth, telemedicine, mobile health (mHealth), electronic medical or health records (eMR/eHR), big data, wearables, and artificial intelligence. These components work together to enhance healthcare delivery and improve patient outcomes.
e-Health plays a pivotal role in achieving universal health coverage (UHC) and the Sustainable Development Goals (SDGs). By improving access, efficiency, and equity in healthcare, e-Health advances global health priorities and promotes well-being for all.
CLAUDE BOSCHER, Former Surgeon of the Pôle Tête et Cou, Hôpital Américain de Paris, Neuilly sur Seine, France
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“Today I share my experience with a database for chronic diseases.
Age Macular Degeneration and Alzheimer’s are chronic diseases with growing and associated epidemiologies carrying a heavy cost on GDP, like for example the central-vision impairment in AMD, which increases also the risks of falls, depression, and dementia. Of note, very recently, the European Medical Agency has taken 2 decisions, significant regarding economic concerns: not to allow reimbursement of an expensive medicine with a poor cost-benefit ratio, and to allow it, for an off-label, cost-effective one.
We know that diseases develop along with aging and that there are potentially modifiable aging-accelerating factors. Therefore, there is a window for timely intervention, that actually may last for years.
The retina is the only organ observable not invasively, and therefore it is a unique opportunity for Preventive Medicine. For around 15 years, optical coherent tomography (OCT) technology has allowed us to switch visualization from the organ level to the tissue level. Being at the crossroads of aging theories, physiopathology, and disease development models, the retina is indicative of the condition and monitoring of non-directly observable organs, as the brain, as much as research OCT devices are getting closer to the cellular and infra-cellular levels.
However, there is no current reciprocal prevention policy. For example, it has been recently shown that around 100000 cases of dementia in the US might have been better prevented via eye care, and in the case of AMD, routine accelerating factors screening is limited to the long-known cardio-vascular and metabolic associations.
Databases are well-established as essential tools for storing, organizing, and tracking medical data. The issues regarding the web access ability have been solved. EUMEDA is a physician-to-physician-oriented platform, that covers all fields of medicine, is implemented by very advanced technology, and can be consulted on the web anywhere, anytime.
Building a database is not easy, especially when the physician is completely ignorant of the field, as I was, and demanding unusual items in one specific field. Collaboration with EUMEDA’s computer team allowed for fulfilling achievements.
Here is how our database is built: for each patient, all known aging accelerating factors are recorded and classified, in addition to complete retinal screening. The team achieved the unique capacity to upload heavy videos of two minutes duration in one click. Hopefully, innovative therapies evaluated with follow-ups and statistics will allow to evidence key factors for both prevention and care. Also, a software allows measures and comparisons of alterations, along with time and potential treatments, like here, the progression of retinal atrophy.
Physicians' reluctance-skepticism in Preventive Medicine is due to a lack of scientific culture, itself mainly due to the lack of time, especially in the retinal field, overwhelmed by the AMD burden. I was already able to notice that the existence of such a database has a positive effect: it reduces learning times drastically, as years of studies and publications are delivered quickly in a friendly manner that stimulates teamwork. Most patients react very positively as well, to a holistic approach to their condition. However, the cost of additional non-reimbursed investigations remains an obstacle. Besides it is time-consuming to implement a database, and funding for Preventive Medicine is scarce.
But I am confident that the UN initiatives to support the growing of e-health will help to overcome residual barriers.”
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