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Remember the last time you went for a medical check-up? The chances are you waited a week for an appointment, had a long wait to see the doctor, and nervously wondered which of the people around you in the waiting room were the most infectious.
As governments cut public spending in the aftermath of the financial crisis, health services across Europe and the US have come under enormous pressure to cope with the basic medical needs of ageing populations.
Waiting times have increased, satisfaction has fallen and the quality of healthcare has come under strain. Even simple things, such as updating a prescription or requesting a routine appointment, have added to the burden for overworked doctors and nurses.
This is despite the fact that basic technologies, such as videoconferencing and online chat, have simplified communication in most other parts of life and business.
“We are really, really strained and we need to look at ways to do things more efficiently,” says Dawn Harper, a doctor with the UK’s National Health Service.
Dr Harper increasingly offers email and telephone consultations to reduce the workload generated by patients with routine requests. But she says video consultations and other technology could help cover even more ground.
“What you get from [video consultations] is much more than from email or the telephone,” she says. “If we could take away lots of the problems that could be dealt with online, that would free up NHS time and keep doctors working.”
Over the past year a number of start-ups have raised funding to provide and test technological solutions — known as telemedicine — for pressured public health systems.
Last June, two Swedish health authorities agreed for the first time to compensate telemedicine providers with public funds for consultations. In the UK, the NHS is trialling a partnership with UK start-up Babylon to offer patients in London online consultations.
Kry, based in Stockholm, is one of the Swedish start-ups providing the technology. Founded in 2014, the app-based video consultation service employs about 200 doctors and serves 2 per cent of all primary healthcare patients in Sweden, as well as people in Norway and Spain.
The group has raised just over $29m from venture capital groups including Accel, Index and Project A and set its sights on other European countries, including Germany, where it has just launched a pilot. In a demonstration of how fast the technology is moving, until Germany’s E-Health reforms of 2016, it would have been illegal to provide video consultations in that country.
Kry is also seeking to expand in France, where President Macron pledged before last year’s elections to invest in telemedicine.
The implications are significant for older patients. Johannes Schildt, co-founder and chief executive of Kry, says 5 per cent of the app’s customers are over the age of 60. “You have early adopters first and they are more inner-city tech-savvy people,” he says. “But our app is very very easy to use — our oldest patient just turned 100.”
The company has just launched specialist consultations with psychologists and psychiatrists to make it easier for older or less able patients to receive proper mental healthcare.
“My grandmother has such a hard time to reach the healthcare system, for her to travel it’s such a difficulty and cost,” Mr Schildt says.
Critics argue that such apps raise security concerns about the accreditation of doctors and will not gain traction among older users, many of whom may be “digitally disenfranchised”.
Research from Deloitte shows that in the UK, more than three in five people between the ages of 55 and 75 use a smartphone, although only 8 per cent of the group used their phones for video calls each week. The figure is higher in other countries, including the Nordics, where more than three-quarters of 55-75 per olds have access to smartphones.
Telemedicine start-ups have also added services beyond virtual consultations that raise fresh questions about accountability in healthcare. Babylon for example, offers artificially intelligent symptom checkers that enables patients to identify the best treatment options through their phones.
Seth Pierrepont, investor at Accel, says new technologies offer the last glimmer of hope for creaking public health systems. “My view is that these tools are going to be critical if public health is to survive,” he says. “A lot of burn time in hospitals happens from patients that don’t necessarily need to be there. You can treat a lot of people remotely through triaging, or treating them through telemedicine.”
In the UK, where NHS trusts are battling with funding deficits that have reached record levels, Dr Harper says it is time to act.
“The NHS is like mum. She’s always been around, and it’s very easy to take her for granted, but we’re in a position where we may lose her. If we don’t do something fast, we’re going to miss her when she’s gone.”
Aliya Ram is the FT’s European technology correspondent; Twitter: @aliya__ram
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