Galicia, a Spanish region situated in the Northwest of the country, with a population of 2.8 million, is one of the regions with the highest percentage of elderly in the European Union, with an increasing rate of chronic diseases. Currently, the 23% of Galician population is aged 65 or over, therefore ageing is a major challenge for the region and to improve quality of life of elderly people is a priority for health authorities. Besides, Galicia shows high demographic dispersion throughout the region, especially in rural areas. Interestingly, it is in this rural and island areas, where ageing rates are the highest. These two factors mean that there are specific conditions regarding care services for citizens and precisely these conditions have been considered when drawing-up the priorities of the region.
GALICIAN HEALTH SERVICE SEEKS FOR INNOVATION
Galician Health Service (SERGAS) has made great efforts in identifying and developing technologies with the aim of becoming a reference in the implementation of new technologies in the field of active ageing and healthy living and in the promotion of personal autonomy and to support the development of new ITC products and services was strengthened in the last years.
The expected outcomes of PERSIST clinical study are perfectly aligned with the general strategy of SERGAS. In this prospective study, SERGAS, specifically the University Hospital Complex of Ourense, as a partner, is going to assess the usefulness of a synchronized bracelet and mobile phone connected with clinicians to carry out continuous and real-time monitoring of patients operated on and treated for early-stage breast or colon cancer. The bracelet is intended to monitor certain variables that influence the general health of patients such as daily exercise, blood pressure, heart rate, calorie consumption, etc. The mobile phone will be used for patients to report their discomforts or concerns on a daily basis and to periodically fill out validated quality of life and health status surveys.
SERGAS IN PERSIST
The role of SERGAS in the clinical study consists of recruitment and follow-up of 20 patients diagnosed with breast cancer and 20 with colon / rectal cancer.
As it was commented above, Galician health area is characterized by having an aging population, predominantly rural and with a significant geographic dispersion. Keeping in mind this situation,
in addition to the monitoring of our patients that allows us the early detection of symptoms that may be suspected of tumour recurrence and an adequate control of the quality of life, this project might potentially have other advantages. Among them, some can be cited, such as the implication and empowerment of patients in the process of monitoring their disease, a reduction of the number of trips to the hospital while maintaining adequate patient control, a reduction of the number of consultations, with the consequent reduction of the care burden, and, last but not least, a guarantee of the control of certain warning symptoms that may be indicating the development of serious pathologies such as depressive syndrome.
ARE THESE NEW TECHNOLOGIES A REAL OPTION TO IMPROVE THE MANAGEMENT OF CHRONIC DISESASES IN THIS KIND OF REGIONS?
Although the use of these technologies aims to improve the monitoring and control of our patients, there are some external factors that may interfere in obtaining the expected results.
First, purely technical issues such as a good and proper internet connection. To get a good connection in rural areas of our province (Ourense) is considered a necessity to try to stop the great abandonment of residents that the rural environment has suffered in recent decades. Although in recent years a great improvement in this aspect has been achieved, some efforts are necessary to achieve high-speed connection in all rural areas. On the other hand, the capacity of use and the familiarity of older patients with the new technologies can be a handicap for the success of the project.
Secondly, regarding the professionals, it is important to overcome resistance to change in order to adapt to these new approaches, which provide more ongoing care and permanent contact with the patient. Lastly, it is advisable that Galician and Spanish health system promote the evolution to the introduction of structural or organizational changes that make it possible to implement this type of tools in the follow-up and control of cancer patients.
It seems obvious that new e-health technologies offer opportunities for using remote care, but a number of challenges have been identified concerning their right implementation – for instance, the limited access to internet in rural areas, the lack of digital infrastructure or the need for alignment to make a successful digital transformation. Consequently, in order to promote the development and implementation of these new tools created to make our day-to-day life easier, not only the effort of scientists is required, but also the effort of professional administrations to facilitate the way.
Keywords: ageing, dispersion, challenges, new technologies, cancer patients
Author: Jesús García Mata, Head of Oncology Department of University Hospital Complex of Ourense (SERGAS).