Modern medicine is a scientifically verified system for prevention, diagnosis, and treatment; modern healthcare is a network that can continuously implement and improve this knowledge. The lecture stresses that technology by itself is not enough—it must be underpinned by evidence, quality, and sensible financing. In Slovakia, however, it runs up against old barriers.
Obstacles: politics, quality, data, and laws
Slovak healthcare suffers from the long-term disinterest of political elites and a lack of continuity of change; the entrenched notion that "healthcare is a black hole" holds back investment. The result is lagging even behind the V4 countries and weak management of primary care, which became fully apparent during COVID—Slovakia was among the countries with the highest mortality. Without control over the primary care sphere, it is difficult to implement swift and effective interventions.
There is a lack of meaningful quality control and cost-effectiveness at all levels, big data is poorly structured and information systems are not interconnected. We do not have robust registries that would automatically pull data from hospital systems and enable comparable evaluation. Archaic legislation on medical records hinders effective work and keeps nurses in administration instead of caring for the patient. What is needed is a unified data concept, pressure to measure quality, and competent evaluation of outcomes.
Digital that helps: from ECG to risk prediction
In primary care, there is potential in algorithm-supported clinical decision-making, work with documentation, integration of sensors (watches, rings), population health management, risk prediction, and also patient education. An example of rationalization is the so-called right bundle branch block on the ECG, which about 8 % of people have; if we send all of them unnecessarily to a cardiologist, it costs about 3 million euros annually. An app that takes a photo of an ECG and uses artificial intelligence to interpret it accurately can help, but it requires large training datasets—we do not have them domestically, so foreign data were used. The adoption of such tools here runs into distrust rather than the real limits of the technology.
In acute myocardial infarction, the occluded coronary artery needs to be opened within two hours; traditional ECG correctly identifies only about half of patients, and delay doubles one-year mortality. Digital tools can "clean up" poor-quality recordings from the field, explain why they reach a particular conclusion, and from a 12-lead ECG estimate the rate of progression of aortic stenosis, thus reducing unnecessary echocardiography visits. To make sense, they must be linked to reimbursement and quality control: today a modern operating room stands empty in the afternoon because insurers do not pay for procedures above the limit, even though waiting times stretch to 18 months. Technology is an opportunity, but only when accompanied by evidence, transparent measurement of outcomes, and fair financing.
