View archived news

Junior Member News - September 2016

The terms “eHealth” and “telemedicine” are currently used as synonyms to define the utilization of telecommunication and information technology (IT) in the management of health and clinical care. eHealth represents a promising, yet to refine, disrupting method of healthcare delivery, and allergy is a field that due to its broad spectrum of diseases which comprises is suitable and ideal for developing specific tools which would facilitate both patients and doctors an improved means of communication.  M-Health, which stands for mobile health, has proven to save both money and time, providing not only health information via mobile devices, but also facilitating communication in a bidirectional way (doctor-patient).

Notwithstanding, the quality and quantity of evidence of its utility is yet scarce and to be improved. Potential utilities of eHealth include implementing self-management plans, improve treatment adherence using gamification techniques, follow-up to assess treatment response; tutorials for patients of how to use specific devices (bronchodilators, adrenaline auto injectors, etc.). Moreover, a cost-efficacy study deemed a 1 billion euros savings out of the use of eHealth just in Europe. Interestingly, the use of m-health could reduce the per capita cost in Europe up to an 18%, and even to a 35% in the case of the patients who are suffering chronic conditions.

As any new technology, several issues shall be taken into account, such as the learning period, both for physicians, allied health professionals and patients, to better reach the required goals for which these tools have been or are being designed. One of the main objectives of eHealth in allergy shall be reducing the important knowledge gap in allergy management, and gathering real-life reports from patients when suffering the reaction.

Hitherto, two distinct modalities of eHealth have been defined:

  1. Store & Forward: remotely delivered. The patient may not be present at the moment of the physician evaluation, and the management instructions can be given at any time so as to be convenient for both the patient and the doctor.

  2. Real-time interactive services: The patient may be present or not. It depends on the availability of suitable technology to the specialists and patients.

Moreover, the information shall be provided by the patient, both directly (actively) or indirectly (passively) in both cases.

A tailored intervention delivered on a mobile phone platform, integrating low literacy design strategies and basic principles of behavior change, may be a powerful way to promote increased adherence and asthma control among underserved minority adolescents. Moreover, e-health via the use of specific mobile apps may help allergist to predict an asthmatic exacerbation, or even shall be useful to advice the patient to look for urgent consultation given the data stored either actively of passively at home with the simple use of a mobile phone or of a computer. E-Health shall give information so as to develop effective personalized strategies to better cope with difficulties in the utilization of a bronchodilator device in asthma, or improve the adherence of immunotherapy.

The scientific evidence gathered to date corresponds mainly from technology which is considered somewhat outdated, such as asthma management plans via SMS between patients and respiratory diseases specialists. We are talking about evidence, based on 2.0 technology, living in a 4.0-technology world. Besides, there are currently over 40.000 new mobile Applications (App) created per month in all sectors; regretfully, just a small percentage are considered suitable and usable.

Reimbursement policies, privacy issues and confidentiality/security concerns represent challenges to the e-health implementation and growth. In brief, patient empowerment, habit modification (improve healthy way of living), change in the doctor-patient relationship, monitoring of an specific allergy condition or even achieving relevant clinical data storage could be some of the outstanding possibilities of e-health in allergy.

Darío Antolin-Amerigo
WAO Junior Member Group Steering Committee Member

Servicio de Enfermedades del Sistema Inmune - Alergia
Hospital Universitario Príncipe de Asturias
Alcalá de Henares
Madrid, Spain

References:

  1. Socio-economic impact of eHealth. An assessment report for the European Union. PWC. June 2013

  2. Dimov V, Gonzalez-Estrada A, Eidelman F. Social media and the allergy practice. Ann Allergy Asthma Immunol. 2016 Jun;116(6):484-90

  3. Dimov V, Eidelman F. Utilizing social networks, blogging and YouTube in allergy and immunology practices. Expert Rev Clin Immunol. 2015;11(10):1065-8.

  4. Foster JM, Usherwood T, Smith L, Sawyer SM, Xuan W, Rand CS, Reddel HK. Inhaler reminders improve adherence with controller treatment in primary care patients with asthma. J Allergy Clin Immunol. 2014 Dec;134(6):1260-1268.e3

  5. de Jongh T, Gurol-Urganci I, Vodopivec-Jamsek V, Car J, Atun R. Mobile phone messaging for facilitating self- management of long-term illnesses. Cochrane Database of Systematic Reviews 2012, Issue 12.

  6. Charles T, Quinn D, Weatherall M, Aldington S, Beasley R, Holt S. An audiovisual reminder function improves adherence with inhaled corticosteroid therapy in asthma. J Allergy Clin Immunol. 2007 Apr;119(4):811-6.