bringing healthcare to the patient

Erik Brühlmann



New technologies also benefit older people with eye diseases – for example, in the treatment and monitoring of disease progression.

Digitalization is progressing – but relatively slowly in the medical sector. Although the technology for projects such as electronic health records or telemedical solutions is available, implementation in clinical routines is slow. «The lack of innovation is due, among other things, to the influence of various special interests and systemic peculiarities,» says Lucas Bachmann, founder and president of medignition, a team of researchers, doctors, engineers, designers, business analysts and investors that initiates start-ups in the field of digital health.

«But that will have to change.» The physician and epidemiologist points to the predicted demographic development. According to the Federal Statistical Office, by 2040 a quarter of the Swiss population will be older than 65 – and that will lead to a substantial increase in patients with age-related diseases.

In the field of ophthalmology, the focus is on chronic retinal diseases such as diabetic macular oedema and age-related macular degeneration. Both diseases lead to severe visual impairment if left untreated. Already today, about 30,000 people in Switzerland are being treated for these diseases - and the number is rising rapidly. Worldwide, the number of patients with age-related macular degeneration, the most common cause of blindness in old age, is expected to increase by almost fifty percent to 288 million by 2040.

«One way to reduce the increasing pressure on treating physicians is to bring medicine closer to the patients and use medicines with a longer duration of action,» says Lucas Bachmann. The pandemic has helped the ball rolling at a greater speed than expected. In many countries, outpatient ophthalmology services were largely disrupted, either because staff were needed elsewhere or because patients were reluctant to make the trip to the specialist due to a risk of infection. Suddenly, care had to reach the patients. In many places, initiatives developed to ensure at least a minimum: Patient measurements at home, telephone consultations and, last but not least, telemedicine services. «It is necessary to further promote this development so as not to take action only when the pressure on the medical care system in Switzerland becomes too great at some point,» Lucas Bachmann is convinced.

The physician sees two ways in which this development could take place. «On the one hand, consultations will have to become more meaningful and efficient,» he says. That means: patients only go to the doctor when it is really indicated and they bring the preliminary information with them. Smartphone apps like Alleye from Oculocare medical, a subsidiary of medignition, can become an important tool here. The eye measurements are simple, the data is transmitted to the attending physicians. And if this data indicates an eye disease or a deterioration of the monitored condition, contact is made.

But can senior citizens do the groundwork at all? «People underestimate the elderly,» says Lucas Bachmann. «Many are now perfectly capable and willing to use a smartphone and apps.» Any inhibitions will be further reduced in the future as digital natives reach retirement age and beyond. A second important pillar is the use of modern therapy concepts that need to be administered less frequently and thus relieve patients and the healthcare system.

The mobility of elderly patients is often limited; going to the ophthalmologist is a tedious affair for them. It would be an advantage for them if they only had to make these trips when it is really necessary. This is where the involvement of non-medical actors in ophthalmological care could pay off.

A mobile eye clinic for old people's homes.

Providers of home care services could be trained as well as nursing staff in retirement homes. In this way, patients would receive easily accessible medical care and the referring services would have information for the treating physicians, so that the actual specialist visit can be organised efficiently.

«The technical possibilities for this are there,» says Lucas Bachmann. With medignition, he has developed the mobile eye clinic «Augenmobil», which follows this thrust. «This also helps to prevent eye diseases from not being recognised and people losing their sight as a result.»