The evolution of ehealth

Growing up I remember when computers were still bulky, heavy and noisy. I will never forget one of my favourite computer games - Vette!

I don’t exactly know how I got the game. My father developed software programs as a hobby so I think it came with the PC magazines he collected every month. Vette! was launched in 1989. It was a racing game set in San Fransisco. There were 4 cars to choose from and I always chose the red one.

I would insert the floppy disc into the slot and the computer would make 'click click clack clack' sounds. After a while a screen would show a red corvette in a car shop. A man would be standing there, obviously performing my commands when I hit spacebar. Just above the corvette, was a screen with a list of statistics like gear, top speed, transmission and so on. I remember I chose the red corvette because it had the best statistics and was the fastest of the other corvette cars which were green, yellow and blue. A few taps of the spacebar and I would see my opponents. I'm not sure why that screen was there. I think it was to buy time as the computer clickly clackly churned away.

When I pressed spacebar yet again, I would be taken to the next screen. There I could choose which part of San Fransisco I wanted to race in. There was not much choice, I think the game only had 3 parcours. Finally my last tap of the spacebar would take me to my favourite part of the game. The screen of the the driver's view. Hitting the arrow buttons on the keyboard I could control my red corvette. It would go left, right, passing trucks and cruising over the golden gate bridge. The up and down arrows would increase or decrease the speed of my car. I would be clicking and tapping on the keyboard and the computer would be clackling and churning away trying to keep up.

It was the most fun game I played and I would play Vette! everyday after school and in the weekends. Till today, I remember the music. I can hum it in a heart beat. After mastering the game, always beating my opponents, I made it my mission to upset the police. I would get speeding tickets and that felt great. One of the best games I have ever played came in a floppy disc. I cannot imagine having to insert a disc let alone a floppy one in the computer I own today.

Much has changed in the past 30 years.

Computer stored data in floppy disc in the 70’s, then came CD’s in the early 80’s. In the mid 1990’s DVD's were a breakthrough because they could store so much more than floppy discs. Fast forward 10 years USB and SD cards made DVD’s extinct. Now, who actually owns an SD card or USB stick? I mean everything is now in the cloud. Technology has made it possible to access, and insert vast amount of information anywhere provided you have internet connection.

It seems fair to say that there has been little to no resistance towards moving away from floppy discs to virtual cloud storage. Yet for some reason, Telehealth has had poor uptake by various stakeholders.

Most likely, the reason being that many ehealth tools have been developed without involving end-users (patients and healthcare professionals). Plus even when something is developed, there is not enough effort put towards training This contributes to the relative poor response by health professionals.

I remember being in Bristol a few years ago. I was working in the emergency department and prior to starting my shift, I was asked to attend a full day training on their newest and most advanced computer software. For 8 hours I was told to click here, click there, scroll around everywhere. The instructor was proud to announce the launch of this amazing software that would revolutionise the way doctors and nurses kept patient records, inserted vital signs and so on. Furthermore it would serve as a flexible mobile unit that could be taken from patient to patient without ever having to sit behind a desk again.

I left that course overwhelmed by the amount of clicks I had ahead of me on my first day at work. The next day was my night shift, I had barely started to type the patient history into the allocated ‘insert patient history here’ box when the A&E consultant said to me ‘you did the training yesterday?’ to which I replied 'yes'. I was feeling a sense of having done something awful to this state of the art software. And then he said to me. 'Well whatever you were taught yesterday forget all of it. I want you to write down everything in this box down here, all of it, everything and then click save.’

He continued to mumble how terrible the software system was. It was utterly expensive and cumbersome to use. "Doctors do not have the time to click here, click there and click everywhere to get things done."

I immediately thought to myself "unless they are playing Vette!" as I wrote the patient history in the box that was allocated for 'insert other here'.