Health and Healthcare Systems

Telemedicine can be a COVID-19 game-changer. Here's how

Dr Greg Gulbransen takes part in a telemedicine call with a patient while maintaining visits with both his regular patients and those confirmed to have the coronavirus disease (COVID-19) at his pediatric practice in Oyster Bay, New York, U.S., April 13, 2020.  Picture taken April 13, 2020.

Delivering services remotely could change healthcare for the better - but governments must act now Image: REUTERS/Lucas Jackson

Cornelius Kalenzi
Postdoctoral Researcher, KAIST-Korea Policy Center for the Fourth Industrial Revolution
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Healthcare Delivery

  • Governments must reimagine healthcare delivery in the face of COVID-19.
  • Telemedicine could be a big part of the answer - both now, and in a post-pandemic world.
  • Here are 5 barriers to its implementation - and how to overcome them.

Our hospitals - the trenches where the COVID-19 battle is raging - have become risky places for both patients and healthcare workers. Governments must take unprecedented steps to mobilize resources in order to give hospitals and healthcare workers the tools to combat this deadly pandemic. As of May, more than 100 countries are resorting to varying measures of lockdowns, social distancing, and the production of personal protective equipment (PPE) to limit transmission. But these measures are insufficient to stop the overstretching of healthcare systems that were already overwhelmed before COVID-19.

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Government leaders and other stakeholders, therefore, need to reimagine how healthcare services are delivered. Already, some countries like the US and China are ramping up production of ventilators, PPE and testing kits to supplement the existing model of healthcare delivery, while countries including Australia, Singapore and a few others are quietly encouraging the use of telehealth services. However, we aren't seeing equivalent efforts across the board to mobilise digital innovations, especially telemedicine - the ability to deliver healthcare services remotely, using computing devices and customer-facing AI-powered apps.

This approach could be a game-changer for the healthcare industry - but scaling its implementation will require well-coordinated action between governments, tech firms and healthcare providers to overcome existing barriers.

Hospital beds per 1,000 people in the G7 countries
Hospital beds per 1,000 people in the G7 countries Image: OECD

Here are five of those barriers that are common to all countries - and how to overcome them:

1. Technology inertia — a resistance to innovation

At a basic level, scaling telemedicine depends on providers' abilities to alter, streamline and simplify the patient journey. Instead of all COVID-19 patients rushing to a hospital ICU, 'some' can alternatively receive the same services from e-testing (performed by artificial intelligence (AI) symptom checkers), e-diagnosis, e-consent, e-prescription and remote monitoring - all from the comfort of their own homes. Advances in and availability of mobile computing, AI chatbots and telemedicine platforms mean that these capabilities are readily available to deploy in any country with a 3G or 4G network. Moreover, cloud-based healthcare platforms don't require additional software development and the installation of expensive new hardware.

Today we are witnessing a surge in demand for telemedicine in different countries - but the majority of governments are still largely silent on the subject digital health technology. Some - such as South Korea, Japan, and some European countries - are stuck in a state of technology inertia and regulatory limbo, despite their well-developed communication infrastructures and capable human resources. Many developing countries in Asia, Africa and Latin America, meanwhile, cannot leverage existing mobile and cloud services to fast track telemedicine; they need leadership and guidance to do so, especially from coordinated efforts of government and regulators, major tech firms and start-ups to get started.

2. How to fix reimbursement issues

While this should be relatively easy in places with full healthcare coverage, it becomes complicated for millions of uninsured patients in the rest of the world. Therefore, making it easy for the uninsured to register - and for governments to pick up the bill for COVID-19 patients - could be a starting point. The US has recently moved in this direction, and other countries could take a leaf from their book. Being agile enough to relax the rules on telemedicine reimbursement - such as whether a doctor can diagnose, treat, and prescribe from anywhere and still be reimbursed, for example - can help. While some countries such as the US and Germany are moving to ease these rules quickly, in many others these stumbling blocks are limiting the adoption of telemedicine.

3. The regulatory and data-sharing environment

The healthcare industry is very rigid - and rightly so, given the importance of the safety and privacy of patients and healthcare providers. However, in times of deadly pandemics, this rigidity can endanger the very people it seeks to protect. Regulators need to act fast to update laws, especially those related to patient information protection and privacy - for example, the EU's General Data Protection Regulation (GDPR) - to reduce compliance costs. Similarly, the web of safety and technology standards have created a complex environment for start-ups and telemedicine providers to navigate. Indeed, Asia's early success in combating the pandemic is partly attributed to its agility in navigating the delicate balance between laws, standards, privacy and public health. One starting place is to relax data-sharing laws with sufficient care to ensure that the core of personal information protection is preserved - through easing registration of patients and doctors and sharing of patient data, for example.


4. How to integrate AI technology into hospitals and clinical practice

In the majority of countries, hospitals have been slow in adopting telemedicine technologies thanks to low IT budgets, complicated legacy systems, and a lack of human resources. On the other hand, telemedicine is today increasingly run by start-ups - such as MDLIVE in the US, Babylon Health in the UK and Doktor24 in Sweden, among hundreds of others - which have until now faced significant challenges in overcoming resistance from doctors and established healthcare systems. However, these are times of crisis. Hospitals need quick help to be able to integrate telemedicine within their healthcare delivery systems. The support can come in the form of executive directives or hospitals quickly mobilizing healthcare workers to use existing new cloud-based technologies, including availing healthcare workers with tablets, mobile computing, license resources, as well as training to launch such services.

5. Patient empowerment and public engagement

Figuring out how to encourage patients to receive treatment in the comfort of their homes will be critical. The viral videos of doctors begging the public to stay at home show the pain and challenges ahead for hospitals and doctors. Similar to social distances campaigns strategies, governments could use political pulpits, public health campaigns, and online education programs to drive telemedicine adoption and ensure that the public can still receive healthcare services.

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