"Telemedicine eases the burden, but does not replace GPs"

Silke Schmitt Oggier is Medical Director at santé24, SWICA's telemedicine service. The trained pediatrician with a master's degree in public health is medically responsible for everything that is triaged, diagnosed and treated at santé24. In this interview, she looks to the future of telemedicine and explains why telemedicine will not replace GPs.

Ms Schmit Oggier, can you explain what santé24 is as simply as possible?
Santé24 is SWICA's telemedicine provider and a subsidiary of SWICA. We work like a virtual doctor's surgery and are available around the clock for all SWICA policyholders. There are insurance models where we have to be used as the first point of contact. This applies to around half of all calls. However, everyone else can of course also benefit from our service.

What does telemedicine include?
It's not that precisely defined, our range of services is very broad. We advise insured persons in the traditional way when they are ill, can order further laboratory or X-ray examinations and carry out drug treatments. We can also prescribe external therapies such as physiotherapy or psychotherapy or refer patients to specialists. We also have a psychological and psychiatric team and specialists from a wide range of fields, such as nutritional counseling, exercise science, pharmacy and coaching, and can offer interventions and support in these areas. We can also launch new programs on an agile basis. At the beginning of the year, for example, we very quickly set up a telemedical long Covid support program to accompany affected patients for six months.

Silke Schmitt Oggier has been the medical director of SWICA's telemedicine center, santé24, for nine years.

To what extent does telemedicine replace GPs?
Telemedicine relieves the burden on GPs rather than replacing them. Personal contact will continue to be needed in the future, especially for very acute or chronic patients who really need a physical examination or care from a GP.

How does telemedicine benefit patients?
Telemedicine is the easiest way for patients today to get competent and fast help with health problems. Of course, we are talking about patients who do not need a physical consultation or any further investigations or operations apart from routine laboratory or imaging diagnostics. The fact that we are available 24 hours a day is of course also a big plus for our patients.

Has the coronavirus pandemic driven developments in this area?
At least the awareness and acceptance of telemedicine has increased in recent years, not only among patients but also among our medical profession.

The strong digitalization in the healthcare sector also requires a lot of data. To what extent do these huge amounts of data also open up new areas of business?
I would say that digitalization creates data. If used sensibly, this data can help to better diagnose or treat illnesses. However, collecting and evaluating this data and making the results available naturally opens up new areas of business. The whole thing can also be used negatively by selling patients drugs, additives or devices that they do not need. It is therefore important to think carefully about which fitness or health data you make available to which providers of trackers or electronic recording devices.

How does Switzerland compare internationally in terms of telemedicine/digitalization in the healthcare sector?
There are countries that are much further ahead than Switzerland. Either because their geography or limited resources meant that they had to consider earlier how they could bring medical care to sparsely populated or remote areas. Australia or Israel could be mentioned here. Then there are countries that have a different relationship to data protection. Not that they don't take data protection very seriously. In these countries, such as Estonia, it is clear that all data is collected and shared electronically. However, it can be checked at any time whether someone has accessed it without authorization. However, it has to be said that our direct neighbors are no better off. So far, there has been too little pressure in Switzerland to promote telemedicine even more.

With devices such as the TytoHome , patients can carry out simple examinations themselves at home.

What else could be new in the future?
I could name many new models and strategies, but I'll limit myself to one: there will be more and more devices like the TytoHome, which we sell, that patients can use to carry out their own examinations. With such a device, a layperson can listen to their heart and lungs, examine their ears and throat, take their temperature and pulse or record a short video of themselves. The doctor can view the whole thing at a different location and decide what needs to be done by talking to the patient. This means that patients can also "go to the doctor" from home.

To what extent is Winterthur a good location for this?
The location is actually much less relevant today than it used to be. Today, in order to recruit good healthcare professionals and doctors, it is an advantage to be present at different locations and to be able to offer home office work. However, since SWICA's head office and general management are in Winterthur, our head office is of course also here.

Do you have a connection to Winterthur, and if so, what is it?
Winterthur has been my professional home for almost nine years, so even when I work from home, I still have the feeling of being in Winterthur.

Interview: Linda Stratacò, December 2022