This generation is constantly identifying the relevance and role of the digital technology for its professional usage and establishing its applicability to cope with the current life style requirements. The telehealth is one such newer paradigm, which is based on IT technology and its tools, having the potential to inculcate a change in some of the traditional norms of healthcare management. Telehealth, having a broader scope than its prime core component ‘telemedicine’, offers more than a mere communicative outreach. With an overarching applicability, it serves to provide a patient centered privacy, brisk professional response, patient health data security, and aims to minimize economic burdens both for the individuals as well as the healthcare systems. Due to its broad spectrum of utility, for the last one decade, telehealth is being adopted by the general practitioners as an entrepreneurial maneuver at one end while it is also being incorporated in health policies by the governments for cost benefits and to strengthen their health strategies.
According to the technology pundits with a compound annual growth rate of 26.5%, the Global telehealth market revenue is expected to reach USD 475.50 billion by 2026, which was USD 62.45 billion in the year 2020. Pakistan is also aware of the uses of telehealth paradigm and is moving in the right direction. The Ministry of National Health Services Regulations and Coordination is working on the policy draft for telemedicine and the final form is around the corner. With this back drop and support of the government, all the stakeholders have clear path ahead regarding the integration of telehealth within the existing healthcare system to enhance the health outcomes.
Post-COVID scenario is more conducive for the incorporation of telehealth and its components into the existing health care systems. Maintaining good health standards while maintaining the doctor-patient distance is the need of the hour. Certain private sector companies claim to have a growth of more than 900% in Pakistan as an aftermath of the pandemic and its implications. Such a steep growth elicits the potential and acceptance of this digital tool.
The entire range of the usability of telemedicine is broad. While the general physicians are incorporating the telehealth tools into their practice to increase their patient numbers, the tertiary care hospitals are aiming at maintaining health outcomes for the chronic patients by delivering their health advice and meds at their doorstep. This is ensuring lesser burden on the hospital resources due to decrease in the footfall, reserving the tertiary care facilities for the critically ill and emergency patients. With such a technology backed ‘triage’ the quality of healthcare outcome improves for all the categories of patients, the remotely placed, the chronically ill and the ones who are being rushed to the emergency wards and filter clinics.
Post-COVID scenario is more conducive for the incorporation of telehealth and its components into the existing health care systems.
While all these global perspectives for the use of effective models of telehealth exist, a few pertaining to our local context are paramount advocates for our adoption of telehealth as a healthcare tool. One is self-employment of the underutilized fully trained healthcare workforce who has opted out of active medical practice/career. The majority of this underutilized health professionals is of female professionals. In certain orthodox settings of our country, the telehealth platforms can provide ideal environment of privacy to a remotely lodged lady patient in rural areas holding a smart phone, to consult a qualified lady doctor extending professional medical advice from her own laptop within her own domestic confines. Second advocating point, is to ensure the equity of medical resources for different factions of the community. A challenge to health care strategy is ensuring health equity, which can be minimized by providing better access and early diagnosis for a broader range of patients, through telehealth apps.
The limitations and usability have to be balanced out before deciding the model to be adopted in different scenarios. The interrelation of the cost feasibility, outcome to be achieved, digital infrastructure required and training of the health professionals as well as the care givers to operate the systems has to be defined and calculated to achieve better outcomes. For subsequent success of the telehealth models, a lot of efforts need to go into capacity development in terms of training of the practitioners, acceptance of the technology at both ends and access of the masses utilizing these services and apps.
A focused and structured training for different tiers of telehealth users has to be laboriously undertaken at this stage so as to utilize all the facets of telehealth and to develop a cadre of licensed telehealth practitioners. The tiers of telehealth users, which require training, include the doctors, nurses and caregivers. Even some element of training and marketing is required for the end users for using the telehealth apps and telehealth centers. Our planning and capacity development drives should entail the digital infrastructure available in remote areas.
The IT professional and application developers should design befitting collaboration tools, cloud based support and define medical related peripherals. Tertiary care hospitals should incorporate telehealth platforms in their health care strategy, to enhance their service through existing digital and conventional healthcare delivery systems for better patient access to equitable, affordable and standardized health service. The hospitals should envision the digitization and automation to create ‘central health databases’.
For quality digital healthcare provision, leaders should ensure training of their teams and analyse global best practices so as to optimize our outcomes. The diaspora of the medical fraternity of Pakistan is a huge asset in terms of globally accepted professional excellence and their educational potential. With the right telehealth model in place, this diaspora can be of worth in terms of professional training for telemedicine and to develop a model, which identifies the same diaspora as the hub for the telehealth activities.
Telehealth is a launching pad for the artificial intelligence (AI) applications, which are rapidly evolving for the health sector. A good telehealth framework has to be in place to enable our health systems to embed the AI when the time comes. The day when the AI will be tending to a good range of our health needs would be arriving sooner than our expectations. As these lines are being written, the AI experts are studying patterns to develop radiology algorithms to assist radiology workflow and for quantitative imaging for better imaging outcomes. Our preparedness for the day and our contribution for the global focus of digitizing the health industry need a collaborated approach.
For a standardized uplift in the private sector and infrastructure development, there will be a need to accredit digital health service providers, and train and license the telehealth practitioners. Guidelines, licensing pre-requisites, training syllabi, protocols and interoperability standards have to be defined and periodically revisited.
If, at this juncture, all the identified stakeholders collaborate and contribute, we can have our footprint in the evolution of digitization and AI in the health sector. With a telehealth integration strategy conforming to our own specific needs, addressing our local scope, having a network of trained professional resource and a methodical capacity development, our evolved telehealth infrastructure would be sustainable, cost effective and have an exponential usability curve.
The writer is director of Medical Education & International Linkages, at the University of Health Sciences, Lahore. He can be reached at [email protected]