Prof David Segal

Telemedicine,
digitalisation and technology as a whole have huge potential to improve the
care of people living with diabetes.

“The first
steps to utilising telemedicine in the private sector have been made, but
obstacles remain in building upon that and expanding use, particularly in the
public sector,” Dr Bruno Pauli, from the Department of Diabetes and Endocrinology
at the Chris Hani Baragwanath Academic Hospital, observed during a virtual media event
reviewing The Economist’s “Enabling
Telemedicine for People Living with Diabetes: Focus on South Africa” report*
released this week.

“Telemedicine in South Africa” he said, “will become more and more important but is still
in its infancy compared with higher income countries”.

Among the
challenges, he added, was a resistance to recognise the potential of
telemedicine and provide funding and other resources for the development and
implemetations of systems that will allow for more effective and higher quality
management of people living with a chronic condition”.

“Before
COVID-19, telemedicine, in terms of remote consultations with patients,” he
continued, “essentially did not exist in South Africa. There was no
infrastructure, no legal framework and the Medical Aids schemes, which cover
the 15% of the population under the private health system, would not pay for
such consultations, until March 2020.”

Acknowledging
that telemedicine and diabetes technology have been able to demonstrate their
role in diabetes management during the COVID-19 crisis, Prof David Segal
(pictured), Paediatric Endocrinologist, reminded his audience that telemedicine
offers solutions to deliver healthcare services at scale, at the right time and
at any location: “Especially in this time of the pandemic, we need to use
technology to create ‘health care with no address’. We cannot build enough
hospitals, or spend enough money, to treat everyone with legacy hospital-based
systems of care.

“The mobile
phone is a disruptive technology,” he continued, “and that is where the
hospital will move to. Telemedicine can take healthcare to the people rather
than the other way around. It has potential to improve outcomes, reduce costs,
increase convenience and customer satisfaction.”

As far Prof
Joel Dave, of the Groote Schuur Hospital Division of Endocrinology was
concerned, telemedicine was now “essential”. As most patients had a mobile
phone, telemedicine could act as “gap cover” after discharge from hospital or
between clinic visits
 by, for
example, facilitating daily, weekly or monthly phone calls/reminders, detecting
medication errors and other problems early, offering motivation through team
work, help with access for any problems, and help with titration of medication.”

Earlier in the
presentations it was noted that doctors were already starting to see the use of
new innovations in diabetes care which can complement telemedicine services, innovations
such as smart glucose monitors which have made continuous glucose monitoring
available to people living with diabetes in the private sector. These devices
collect data on glucose levels, per the consent of the user, which is shared
with healthcare professionals in real-time.

With this
technology individuals, it was explained, can view and share their continuous
glucose monitoring data with their doctor via the cloud and the practitioner,
in turn, can analyse the data and then discuss the treatment plan with the
patient.

*The report is
available at: 
https://eiuperspectives.economist.com/healthcare/enablingtelemedicine-people-living-diabetes-focus-south-africa