Telemedicine consists in the provision of distance medical services using electronic and telecommunications media.
In its origins, its use has been to facilitate this access to health services from remote and isolated places.With the passage of time the potential of its practical applications that make it desirable for users and health professionals are observed.
Thanks to telemedicine, the quality and speed of responses to certain pathologies have been increased.Although the costs of establishing the systems is being high, in the long term, the savings in visits to the office, the hospital and the response time will be minimized.A slightly differentiated systems are being applied, from the information that centralizes in a large database to the information that specialists can receive, the rural zone doctor and the urban area doctor.This centralized information will serve, with care of data protection, as an epidemiological basis of a basic health area, a province, an autonomous community,….
different variants
With telemedicine professionals can exchange data to make diagnoses, propose treatments and prevent diseases and in research and evaluation activities, in order to improve health.
Within telemedicine, several terms can be differentiated, such as teleconsultation is the one that facilitates access to the knowledge and advice of the remote expert;Cooperative work, which is a network of groups of professionals who share resources, databases and information to help decisions;Telepressure, when attending a remote healthcare professional to a patient, such as the case of telepedicism through real -time videoconference systems;Telemonitorization, is the remote surveillance of a patient's physiological and biometric parameters;Telecare, when health care is offered to patients in daily living conditions, as in the case of elderly living at home;Telecirugía, with an important use of Telerrobotic, Artificial Vision and Virtual Reality;patient and administration management;Management of administrative processes in the health environment, such as asking for time, access to patient history;training and information at a distance of health professional, and health information to the population with prevention campaigns.
The advances in the treatment of diabetes in the last ten years have contributed to the improvement of patients in their pathology and in their quality of life.In oral treatment is the appearance of IDDP-4 (Sitagliptin, vildagliptin, saxagliptin, linagiptine and alogliptin) that has been a turning point with the almost disappearance of side effects such as hypoglycemia, with the best control of HBA1C,Possibility of being used in patient with renal failure.
Subsequently, the SGLT2 (PAUPA, DAPA and CANAGLITAZON) have appeared that act exclusively on the kidney, decrease glycosylated hemoglobin (HBA1C) around 0.66%, produce decrease in blood pressure and weight loss of approximately 1.8kg.As for side effects, they have a low risk of hypoglycemia, but with their use there is an increase in genitourinary infections.
Measurement systems
But where an important advance for diabetics has appeared has been the appearance of the glycemia meter, without the need to puncture and with a control that allows the monitoring of glycemia more accurately, it is the free free style.It is a device consisting of a sensor (a fine and flexible filament (5mnm) is inserted below the skin, which remains for 14 days in the back of the arm, automatically collecting glucose values day and night and a sensor that isAble to readThe data.
There are also the glucometers that measure glycemia in capillary blood.Most have similar benefits: it takes 5 seconds, blood samples are small, they don't have to be calibrated.There are others who are blood cetone meters, who measure blood ketone bodies next to glycemia.The future is determined by reducing the number of punctures and even none, as with the Free Style free.Also thanks to the appearance of smartphone, it is possible to transfer the information to office systems with which to bring better glycemia control.
As for electronic cards, there is disparity in its implementation.Among its advantages is to know the habits of completion and efficacy of the treatments that the sick have established.In addition, treatment could be modified more quickly and efficiently, which is a time saving of health professionals, when making these measures.
The useful thing is the take at home so as not to saturate health systems, in this case it is sufficient if the patient with his device has a daily take control, as his doctor teaches him in the consultation.
Among the inconveniences is to provide a system that was common for all patients and uniformly assess all these measures.The economic one should also take into account.
It is increasingly frequent that patients use chat and forums where they exchange information with other patients.Among the advantages of this phenomenon is the simplicity of the information, which must be affordable to any degree of educational level, avoiding terms that cause abandonment;The capacity for channeling aid, since these are usually unknown to a high non -patient;Greater impact on the citizen, the patient feels more integrated in his process of healing and evolution of his pathology.
Veraz information
Among the risks that may appear is not to ask for information from the patients, those associated with the monitoring of inappropriate itineraries of the information, such as, for example, access under deception of non -accredited therapies, and the distortion of the information.
With respect to interconsultations, the main objective is to improve communication between primary assistance doctors and specialists, using information technologies to optimize resources and quality of care.The main problem of these interconsultations is that communication between specialists and primary assistance doctors is usually unidirectional and inappropriate.They are more due to the patient's desire than due to the primary doctor to be complemented in certain pathologies, to request report clarification and usually use more to see the results of the requested tests but in order to have before having the results of said tests
In rural areas of small population these interconsultations are often used due to the advantages of not having to move to specialized centers.However, in urban areas or close to the Specialties Center, what is requested is the derivation.Thus, interconsultations are a very useful tool, where the information available in the central systems can be used in different ways, as a means of obtaining faster, more effective, and economical results, both for the administration and for the patient, or as a collaboration between two professionals, where it would be interesting to produce a feedback between them.
For the elaboration of this article, the collaboration of the doctors specialized in General Medicine Juan Barón Carrillo, of the Las Marinas Health Center has been available;Valentín Moraleda Líndez, El Alquian Health Center;José Antonio García Ramos,Albox Health Center;Julián Gomez Ojeda, La Gangososa Health Center;Alberto Soria Bonillo, from the Almería Centro Health Center;María Soledad Manrique Nebreda, of the Health Center Las Norias de Daza;Cristóbal Aparicio Esteban, from the Virgen del Mar health center;Diego Rodríguez Cañada, from the Cruz de Caravaca Health Center;Miguel Aguirre Ferrite, of the Dalias Office;Emilio Melero Rodríguez, from the Aguadulce Sur Health Center;Francisco Javier Guerrero Camacho, from the Torrecárdenas Hospital;Antonio López Nieto, from the Oliveros Health Center, Cayetano Galera Moreno, Casa del Mar Health Center, and Sebastián José Pérez Martínez, from the Plaza de Toro Health Center.
