Telemedicine – the only solution for beneficiaries with heart diseases, who live in rural areas

Data from the Health Ministry, made by the National Institute for Public Health and by the National Center for Public Health Statistics and Informatics show that heart diseases are among the leading diseases in Romania like in other developed countries.

From the statistical data it appears a number of 2.127.480 people with hypertension (hypertensive disease). To this it is added the number of patients who are living with the consequences of hypertension, such as chronic ischemic heart disease with a number of 1.047.177 patients, patients with cerebrovascular accidents(for example stroke) with a number of 289.028 patients just to name a few of the most common cardiovascular diseases.

Cardiovascular disease is ranked as nr.1 as a cause of mortality in Europe in both women and men. It is responsible for about ½ of all deaths in Europe causing over 4.35 million deaths each year in the 53 member states of the World Health Organization -European Region and more than 1.9 million deaths each year in the European Union. Cardiovascular disease is also a major cause of disability and loss of quality of life.

WHO estimates that reductions in blood pressure, obesity, smoking and cholesterol will decrease by more than half the incidence of cardiovascular disease.

While the mortality and incidence of cardiovascular disease in countries from northern, southern and western Europe are declining, in central and eastern countries are not only not declining, but in some cases they are even growing.

Although the mortality rate in the EU caused by cardiovascular diseases is declining, currently the number of patients (men and women) with cardiovascular disease is increasing. This paradox is caused by increasing longevity and improved survival at people with cardiovascular disease.

Cardiovascular disease kills more people than all cancers together, with a higher percentage among women (55% of deaths) than among men (43% of deaths) and there is an increased mortality among patients with a low socio-economic position.

Hypertension is always caused by another disease, such as atherosclerosis, chronic kidney disease, thyroid disease, etc., which has to be detected and treated in order to prevent serious complications. High levels of cholesterol and triglyceride causes generalized atherosclerosis, which leads directly to high blood pressure, which if it is not treated in time, will be responsible for other serious and irreversible disease.

Neglected diabetes causes serious complications such as diseases of the blood microcirculation, kidney failure, loss of vision, hypertension, etc. The problem is that in most cases patients do not know about their disease and with time their body gets used to high levels of glucose, and the disease is detected when the body decompensates and the patient falls into a coma and it is transported to hospital. The problem is that until then the complications of the basic disease are already appeared.

All these things have at least two aspects: at the level of the person – diminishing seriously the health of the person, until to total dependence in case of strokes, and at the level of health system- the costs are much higher.

Today telemedicine is recognized and accepted worldwide and it is rapidly developing. It can be the remote monitoring, in real-time of medical parameters, storage and transmission of medical data (“store and forward”) which are then analyzed off-line or it can also be real-time interaction between the doctor and patient, including remote online consultations, medical televisits, electronic communication. Medical information is transferred quickly via phone or internet, with the aim to provide advice, diagnosis and treatment from distance or even to conduct examinations and medical procedures.

Romania has the advantage of extensive infrastructure of fixed and mobile telecommunications, but it has also increased access to the Internet, including broadband too. It is among the most advanced countries in the remote connection in terms of emergency medicine, providing transmission imaging systems, computerized tomography, X-rays or other medical records from ambulances to hospitals or from smaller hospitals to emergency hospitals in the university centers. This model of connected hospitals with the ambulance service can and should be completed now with the introduction of telemedicine to the primary medicine, in the present practice of the family doctor.

Telemedicine is one of the best solutions available today for both the health system and for the final beneficiaries who require care and medical attention. Telemedicine has the potential to accelerate health reform in Romania and it can bring benefits for patients from Romania, especially for the approximately 46% who live in rural areas.