The Covid-19 crisis and the confinement imposed by the government have forced the French to reassess their relationship to distance and massively adopt new technologies to overcome the hazards of physical distancing. Teleworking, e-commerce, videoconferencing, online culture… Whole sections of our daily life have had to adapt to distance, and health has not escaped it. This technological enthusiasm should be used to overcome the health crisis and then, in addition to the enhancement of “people”, be fully integrated into the reflection on modernization of the hospital world.
Indeed, the surgery, which necessarily involves the presence of the patient in the hospital, experienced some downtime during confinement. The implementation of the Blanc plan focused all the efforts of the hospital world on Covid-19 patients and in the organization of adaptive measures to this unprecedented risk of contamination. So-called “non-urgent” surgeries were the first to be impacted, and the shutdown of the entire chain of care caused significant delays in treatment, including the diagnostic phase. For example, at the Bordeaux University Hospital, in urology, more than 300 surgical procedures had to be deprogrammed in the space of nine weeks.
The time to resume activity has now come and the capacity for surgical reprogramming must be supported. The “second wave”, very real, is undoubtedly that of patients put on hold and diagnostic catch-ups. This forces us to reconcile limited professional resources (often even before the epidemic crisis), tired staff and secure care circuits to reorganize. More than ever, this situation makes it essential to optimize the care pathways. This must benefit from technological innovations and awareness of the importance of careful, professional and benevolent human coordination.
Technological innovations have a key role to play in the development of innovative and optimized care pathways. First, on the surgical technique itself: robotic assistance, for example, has made it possible to transform complex open surgeries into minimally invasive surgeries reducing post-operative pain and complications and thus facilitating the implementation. practices of improved rehabilitation after surgery (RAAC), even outpatient. Then, on the very management of these courses, requiring the transfer of paramedical skills to the coordination of the intra and extra-hospital stages. Perioperative tele-monitoring, by adding digital to nursing coordination, makes it more efficient, streamlined and makes the patient the central player in his care. Patient support is secured despite the reduction in length of stay.
All in all, technological progress should be seen as a catalyst for optimizing the sometimes limited resources available to our hospitals, which have been hit by health and existential crises. In this post-epidemic period where the availability of hospital beds remains limited, innovative short-stay treatments are becoming essential to reduce waiting lists in the best conditions.
If there is one positive thing to take away from the crisis that our health system has just experienced, it is indeed the demonstration of the importance of human qualities in our health professions. Technology, through robotics and digital, allows us to complement these qualities for an improved surgical experience. While the responses to the demands of nursing staff remain insufficient for the moment and that consultation begins on the reorganization of the hospital world of tomorrow, it is to be hoped that the quality of care, by optimizing resources reconciling human and technology, will be set up as a priority.
The “second wave”, very real, is that of patients put on hold due to the epidemic
Jean-Christophe Bernhard is a professor at the Bordeaux University Hospital, Department of Urology and Renal Transplantation.