– I can call planned patients and explain that in our hospital they will be safer than shopping at a discount store, not for acute ones. They sit at home with chest pain and are afraid to call for help or wait for an ambulance for hours, says cardiologist Dr. Paweł Balsam. How is cardiology defrosting in Poland during a pandemic?
- How do cardiologists rate teleporces? – Telemedicine turned out to be a solution that allowed for maintaining contact with the patient, maintaining continuity of treatment – says Dr. Balsam
- Unfortunately, the number of diagnostic tests and treatments has decreased during the coronavirus pandemic. Doctors say that patients are afraid of visiting hospitals, they do not want to get infected
- Cardiologist: – I call and explain to patients that they are safer in our hospital than when shopping at a discount store
- You can find more such stories on the TvoiLokony home page
Zuzanna Opolska, MedTvoiLokony: Mr. Docent, when the Ministry of Health praised the “Report on the satisfaction of patients using teleportation at a primary care physician during the COVID-19 epidemic”, the Patient Ombudsman received complaints about teleporces. Has telemedicine turned out to be a fiction in the era of a pandemic?
Dr hab. Paweł Balsam, cardiologist: No, quite the opposite. I think that it turned out to be a solution that allowed for maintaining contact with the patient, maintaining continuity of treatment and, above all, issuing prescriptions. Just to remind you that we are one of the dozen or so countries in Europe that have e-prescriptions. For example, in Germany, prescriptions were sent to pharmacies by fax.
However, we have reached the stage where normal visits have to be ‘defrosted’, and many clinics continue to provide tele-services. And this is the third, fourth or fifth e-visit that does not contribute much to the patient’s therapy. Teleporting should complement the care system, not be its only element. In our hospital, you can make an early post-hospitalization visit, for which TV visits are perfect. In the normal course, the patient came to see me only three months after hospitalization, and as part of the National Health Fund, within 30 days I can teleport and find out if everything is okay, if the patient has urgent needs and if it is worth rushing the normal visit.
What are the risks of telemedicine from the point of view of cardiac patients?
In both the primary care office and the specialist clinic, the lack of real contact with the patient means that we may overlook an exacerbation of the disease or a condition that may lead to its exacerbation. Which, in turn, is associated with the risk that the patient will go to the intensive care unit with exacerbation of heart failure or with acute coronary syndrome.
Is the risk of error in collecting telephone interviews high?
It is difficult to estimate, but if the person is not experienced in telemedicine and does not have access to remote research, the risk of error is several times higher than during a standard visit.
In teleporadach, I have the comfort that I order tests – the patient can come for a Holter EKG or blood test and I have it in the system. In fact, the only thing I don’t have is a physical exam, but it’s based on something nonetheless.
However, in POZ we have nothing but a telephone … Therefore, the risk of error is really huge. In August, the story of a 35-year-old mother orphaned three children circulated in the media. She came to the hospital in Ostrzeszów twice, the second time she was consulted through a closed door and intercom. It turned out that she had acute kidney failure. It was too late for help …
If you have cardiological problems, make an appointment with a doctor and seek advice. On the haloDoctor.pl platform, your doctor can see you within 10 minutes
Unofficially, it is said that the number of diagnostic tests has dropped by 40%. – what could this mean for cardiac patients?
The risk of not controlling the medications taken. In cardiology – the vast majority of them require laboratory control – drugs for hypertension: angiotensin converting enzyme inhibitors (ACE inhibitors) or angiotensin receptor antagonists (sartans) require kidney function control every three months, while drugs for cholesterol, after switching on or after dose modification, require control after 8 – 12 weeks. Given that the number of diagnostic tests has dropped drastically, patients are actually treated “blind”. This poses the risk of side effects of drugs resulting from a lack of proper control. First of all, there is a risk of stopping medications and replacing them with supplements.
How does cardiology frostbite work?
Slowly … – patients are still afraid to come to the hospital. For several years, our secretary has been appointing patients for scheduled procedures, and since May I have dealt with it myself …
- Also read: Prof. Adam Witkowski: Coronavirus is a much stronger threat for heart patients
Was it so hard to convince them?
Yes, that’s why I call now and explain to patients that they are safer in our hospital than when shopping at a discount store. Each patient for the planned surgery is marked with the coronavirus, and therefore has a guarantee that he is lying in the room with negative patients. All staff wear masks, we disinfect our hands on a regular basis. We are not a one-name hospital, so we do not have COVID-19 patients, unless the patient is admitted acutely with a heart attack, but we have yellow rooms for this until the test result and a COVID department for positive patients.
Only we are talking about elective patients, with whom I have time to talk, and yet there are also sharp patients. At the last Congress of the European Society of Cardiology (ESC), the current president, prof. Barbara Casadei said that no European health system was ready for the situation we are facing. And it’s not really the coronavirus that kills, it’s the paralysis of healthcare systems, just look at the statistics. Across Europe, the number of patients presenting for a heart attack fell by 40%, which of course does not mean that the heart attacks have disappeared. Poles simply sit at home with chest pain and are afraid to go to the hospital or wait for hours for an ambulance …
This may interest you:
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- How are heart diseases detected? Leading Polish experts answer patients’ questions
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