Consulting "Doctor Google" for any minor or major health problem has been a habit for Marija Pavlović from Belgrade for years.
"If there's a quick way to help me with something right away, then I try that, and if it doesn't help, I Google something new."
"For more serious things, of course, I go to the doctor, but with such problems it's really stressful to read on the Internet what can happen to you," this 31-year-old describes her long-term experience for the BBC in Serbian.
However, informing and searching for medical services on the Internet has started to change in the Balkans as more websites and applications with this purpose have appeared over the past few years.
Now it is possible to perform a neurological examination of newborns by sending a video to experts via the Internet, to consult with doctors via the application, and there are also platforms where clinics can be selected and rated, such as accommodation on tourist sites.
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Telemedicine, that is, the application of modern communication technologies in health care, can help with "simpler health problems", but it cannot completely replace the traditional "clinical examination, without which medicine loses its meaning", according to infectious disease expert Moša Marković.
"It is inevitable that in the future everything will be done indirectly, over the phone or the Internet, but until I see the patient, I cannot draw any conclusions - direct contact between the patient and the doctor is crucial.
"Any information that goes indirectly from one person to another loses quality - when you conclude indirectly, and not directly, the possibility of error is greater," this retired doctor explains to the BBC in Serbian.
The Medical Chamber of Serbia (LKS), as well as the Croatian Association of Hospital Doctors (HUBOL), did not respond to the BBC's inquiry about the practice of telemedicine in these countries, as well as the advantages and disadvantages of this approach.
'Booking' for medical services in Serbia
Scheduling a doctor's appointment through clinic websites is not new for many residents of Serbia for a long time, as well as information about doctors and institutions through social networks, forums and other sources on the Internet.
That inspired the authors Hippocracy applications to create a platform on which people in Serbia will be able to perform each of these actions, as well as to share the experience they had with clinics and doctors.
Before embarking on the detailed development of technological solutions, the creators of this platform conducted research into the habits of patients in Serbia.
It showed that as many as 81 percent of them search for comments and ratings of other users on the Internet before going to a private clinic for an examination, and the pandemic has influenced that number to be higher, says Saša Stanojević, one of the founders, for the BBC in Serbian.
If the impressions of others were not positive, 40 percent of those who were thinking about going to a certain clinic will give it up, he adds.
That's why they decided to create a platform that would be "like Booking in tourism" in the field of healthcare, says Stanojević.
"Each polyclinic, like accommodation on those sites, has its own profile with location, working hours and doctors who work for them, you can directly schedule an examination through our site, and there are also reviews and user experiences for each individual clinic, which are divided and according to specializations," he describes.
Marija Pavlović, a Belgrade native who works in the customer support sector, mostly gets information about diseases and institutions from Google.
But, this often means that they will spend several hours on different websites and forums during the search, as well as a lot of unverified and sometimes conflicting claims, she says.
That's why he "always has reservations about everything he reads on the Internet," he adds.
Using applications like Hippocracy could solve part of the problem, but only to a certain extent.
"I believe that it can be a better system - instead of Googling here and there, looking at this, that forum or social networks, you can find everything in one place," says Pavlović.
However, as she says, trust in what she would read on such a platform "depends on the nature of what she is looking for".
"With things like this, you need a layman's opinion - you want to find out if something helped someone, even though you don't know if it would be helpful for you, so there are both advantages and disadvantages," said the suspicious woman from Belgrade.
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Doctor's advice at a click, but not 'doctor Google'
While in Serbia it is possible to make a decision about which doctor the patients will see through the application, in Croatia they do not have to leave their homes to get to the doctor.
On the website Little dot Little Dot and the application of the same name, they can choose some of dozens of pediatricians, neurologists, psychologists, surgeons and other doctors with whom they can communicate after registration.
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Dario Šimović, Croatian engineer and creator of the application, describes it as "a tool for counseling, not diagnosis and treatment", which was initially dedicated to children, and later became available to adults as well.
"The application is not like 'doctor Google' where you often cannot see the authors of the texts, but with us you can get information and advice from real doctors whose names and surnames are clearly stated.
"We also have 500 professional articles on the website, the authors are doctors whose first and last names are listed, and they are written in a language that can be understood by an ordinary person," explains Šimović for the BBC in Serbian.
One registered account can contain multiple digital medical records for all family members, which doctors have access to before and during counseling via correspondence, phone call or video link.
"We followed what different generations like - mine, the middle generation, likes phone calls, generation Z likes to write, and millennials prefer video communication, which is often used in neurological counseling, so we made all three ways possible," explains Dario Šimović.
Dr. Moša Marković, a retired infectious disease specialist, believes that this kind of technology could help and speed up the treatment process, but only for simpler health problems of patients.
"That's why there are counseling centers, which you can call and get some kind of help, because there are a lot of things that don't even need to get to the doctor and examination or are not urgent," he explains.
But he also finds a number of flaws in this approach, which he believes will not be able to replace direct contact between doctors and patients in the future either.
"I would never do my job completely that way - even when friends call me on the phone, I can give them advice, but I tell them to bring their child or come for an examination themselves," describes the retired infectious disease specialist who spent his working life in General hospital in Pancevo.
Doctor Marković also emphasizes that lay people, ie patients or parents, transmit information to doctors through modern technologies, which can lead to wrong conclusions.
"For example, sometimes the skin should not only be seen, but also felt and concluded how it looks - that's called a clinical examination," he adds.
How do recordings of baby movements help in neurological examinations?
Recently, parents in Croatia can check their children's neurological development using modern technologies, recording their movements at home.
She contributed to that application SENDD (System for early detection of neurodevelopmental deviations), which uses a combination of artificial intelligence and the expertise of neuropediatricians, who review the recordings, to provide an assessment of children's neurological development.
"This medical method is 30 years old, neuropediatricians know it very well and are aware that by studying the movements of children, you can see if everything is fine with the child's brain," Tomislav Strugar, head of the artificial intelligence department and leader, told the BBC in Serbian of this project in the TIS group, which developed the application.
Until now, doctors have observed children's movements live in surgeries, and technology allows them to get the sample on the basis of which the diagnosis is made more easily and to make it better, adds Strugar.
"These movements must be spontaneous, they must not be stimulated by sounds or the voice of the parents, the child must lie on his back, he must be full and he must not be nervous.
"When this examination is done in institutions, the question is whether they will show sufficient movements in front of the doctor for such an assessment - that's why we decided to move it all to home conditions," he describes.
What can be a shortcoming for some other forms of telemedicine, namely the lack of direct contact between doctor and patient, is not a problem with this model, Strugar claims.
"The child does not have to go to the hospital, there are no sensors and scanners that would irritate them, it is easier for doctors, because now they can do this type of examination anywhere and they only need a few video recordings in the period between the second and third month," argues this expert in artificial intelligence.
Through models that recognize the position of key points on the child's body and heat maps that illustrate the movement of babies over a certain period of time, this technology helps neuropediatricians in establishing a diagnosis.
"Currently, doctors first examine the images, then artificial intelligence is trained with those images, and the final goal is for artificial intelligence to enable doctors not to have to examine the images of healthy children, which are the majority, but to warn them only of those where there are deviations.
"In this way, polyclinics would achieve savings, and parents would remain confident that neuropediatricians will continue to assess children's neurological development," explains Strugar.
What does innovation mean for doctors and what for patients?
When he created the Little dot application, Dario Šimović wanted to provide users with advice from "experienced and expert doctors, with a good status in society".
That group includes mostly older doctors, he says.
"That's where we had a problem at the start, because they generationally don't believe in new technologies.
"They themselves doubted whether they could work in this way, but we conducted a survey and found that 87 percent of them had already used new communication technologies with patients - Viber, Vocap, smartphones or emails," says Šimović.
Saša Stanojević, one of the founders of the website Hipokratija, got a similar impression during the conversation with doctors and heads of clinics.
"Digitalization of healthcare is not at a high level in our country, we are only at the beginning of that process and we have seen that it takes a lot of time for them to accept it.
"It's much easier with those who have younger management, and it takes more time to get closer to older people," adds Stanojević.
Doctor Moša Marković is one of the doctors who see the limitations of telemedicine, although he believes that it can be useful for "simpler things".
"Modern technologies can be used when asking parents whether children should be vaccinated or what to do when a child has a fever, you can give some minor advice," he states as some examples.
"But in cases where life is at risk or where things are more serious - there is nothing without an examination", assesses the infectious disease expert.
Belgrade resident Marija Pavlović says that for milder health problems, she would try to consult a doctor through modern communication technologies.
One of the main advantages of telemedicine is the "avoidance of an unpleasant atmosphere" in hospital waiting rooms.
"I like to try new things, it sounds fine to me for minor problems, it would somewhat avoid the appearance of stress and anxiety before an examination or check-up with a doctor.
"But for some councils, you need a doctor to examine you and perform tests - that can't be done through the application," concludes Pavlović.
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