Health tourism and genetic screening were among topics tackled at the International Healthcare Conference in Seville, report Carl Carter and Hannah Langfield
Telemedicine
Roles, advantages and benefits of telemedicine across global boundaries - Lawrence Jones, director of telemedicine at the University of Texas.
Describing the onset of telemedicine, Jones said technology is the easy part, but the business force driving it into the mainstream has been held back by human factors.
Telemedicine, Jones said, is taking care of patients at a distance, with video conferencing a vital aspect of the process.
After an initial face-to-face meeting, video conferencing allows doctors to treat patients in different places.
The technology of telemedicine includes distance learning, research collaboration and administrative meetings, as well as electronic medical records and internet services.
Email can help treat patients in a different place and also at a different time, as information can be stored, forwarded, and a second opinion obtained.
Often, the opportunity for interaction is limited as there are only a few available working hours across the world's time zones.
Jones declared telemedicine a multi-disciplinarian approach to medicine, effective in bringing together groups of different doctors.
This allows for second opinions, as information can be digitally scanned.
However, Jones warned of more possibilities for failure using this method, for example in the gathering of information and transferral process. This means it is vital that it is carried out with the utmost care and new technology is harnessed safely.
Jones said: "The electronic medical record is the glue that holds this process together.
"Patients are receiving services they wouldn't otherwise receive.
"Moreover, there is no pressure to carry out such medicine. If a patient doesn't like this process they can simply opt out."
Initial concerns about telemedicine is the cost.
"Consumers expect good customer service from providers and highly functional e-applications that give access to their local providers," Jones added.
What is more, to deploy telemedicine units to remote areas, as well as care and assistance to go with them, will cause increased costs.
However, if done well, it should also save money. Assuming patients can be kept in regular attendance, follow-up care is also carried out more efficiently, which reduces costs, while managing chronic conditions.
According to Jones there is an air of optimism around telemedicine, with doctors encouraging its expansion.
RECENT EU ENTRANTS
Key developments in healthcare systems in new EU member states - Professor Ray Robinson, teacher of health policy at London School of Economics and Political Science.
Professor Ray Robinson, from the London School of Economics, examined key developments in healthcare systems in new EU member states, which are expected to develop rapidly in the future.
He emphasised health finance reforms, the development of purchasing arrangements and new approaches to hospital management.
In his analysis of the trends and prospects for healthcare systems in new EU member states, Robinson drew upon work recently undertaken at the European Observatory on healthcare systems, a resource centre which collects information for the public and private sector.
Examining the reform of health finance systems, Robinson emphasised the change in recent years through the rejection of centralised, state-funded schemes that applied under former communist regimes in favour of a German-style social health insurance scheme, with competing sickness funds and a compensation scheme to cover for risk structure. The Dutch system, with slight variations, is also popular.
He concluded that new EU countries appear to want to move away from a tax-funded government system and there is likely to be a private healthcare supplement first and foremost rather than a substitute for healthcare.
HEALTH TOURISM
Health visitors to South Africa - Aims' managing director, Bernadette Breton.
Medical tourism is when people leave their home country for medical and relaxation needs.
South Africa is a hugely popular tourist destination and in recent years has diversified into an area well equipped for health holidays.
Breton spoke about two types of medical tourist - the family visitor, in South Africa to see the family and take advantage of readily available cheap healthcare and the scalpel-surgeon-safari visitor who visits the county for operations along with a luxury holiday organised by tour operators.
Breton said between them main tour operators had been receiving four to six such tourists a week.
GENETIC SCREENING
Ethical and insurance implications of gene testing - Richard Walsh, head of health, Association of British Insurers.
Walsh tackled the rise of genetic testing and considered possible future scenarios, as well as the ethics that accompany this potential challenge to the current position.
Medical science has moved from an art form to a science form, with our reality becoming ever more complicated, Walsh said.
Using work by Accenture, the first factor to be considered was the socio-political environment that surrounds such a contentious issue.
How will people feel and how well will data be protected? If genetic screening becomes mainstream and creates an underclass that will not be eligible for insurance, what implications will this have?
The first obstacle that has to be overcome, he continued, is the negative public perception of genetics. According to the Government and opinion formers it is likely that there will be comprehensive advances over the next three to five years and selected but dramatic breakthroughs.
In terms of insurance, many countries say you cannot buy critical illness cover because you cannot price it - genetics may change this.
When considering the UK moratorium (extended to 1 November 2011), it was made very clear that there would be no use of predictive genetic test results to underwrite travel insurance, private medical insurance or any other one-off or annual policy, or for long-term care policies.
Moreover, customers will not have to undergo any specific genetic testing in order to obtain insurance.
Walsh said: "Predictive tests will prevail, not diagnostic ones and disclosure of another person's predictive tests is forbidden.
"Thus the potential challenge for the current position with genetics is highlighted as full risk assessment and is said to be fairer than selective risk assessment.
"Currently, however, any potential genetic risk does not have to be disclosed - as opposed to similar potential risks that are not genetic," explained Walsh.
He believes that insurance implications will not deter people from taking tests (cholesterol tests are a proven sign), as they can identify problems that can then be treated or reduced through diet and drugs.
Walsh concluded by saying that the moratorium is seen as a compromise resulting from public perception of genetics and that, in ethical terms, full risk assessment may eventually be seen as better than partial risk assessment.
