Considerations for the effective implementation of telemedicine in developing countries
Maritza Reategui Valdiviezo
Partner at Rodrigo, Elias & Medrano Abogados, Lima
Daniela Supo Calderon
Associate at Rodrigo, Elias & Medrano Abogados, Lima
In accordance with the definition provided by the World Health Organization (WHO), telemedicine entails the provision of healthcare services by means of information and communication technologies (ICT), facilitating the remote delivery of medical services encompassing consultations, diagnoses, treatments, patient monitoring, and ongoing health education. The distinguishing feature of this discipline is the secure transmission of medical and health data via digital platforms, thereby enabling interaction between healthcare professionals and patients without requiring their physical presence. The focal point of telemedicine lies in its pursuit to enhance healthcare accessibility and efficacy, thus facilitating seamless communication between healthcare providers and patients.
Although telemedicine has existed for several years, it is the onset of the Covid-19 pandemic which stimulated a remarkable surge in telemedicine. Consequently, the rapid proliferation and adoption of this service has highlighted its potential as an effective and accessible tool for dispensing healthcare. As emphasised by the WHO, telemedicine is deemed among the principal innovations in healthcare services, not merely from a technological standpoint, but also within cultural and social contexts, as it extends access to healthcare services, improves quality of care, and enhances organisational efficiency.
Telemedicine has demonstrated itself as a transformative instrument, particularly within developing nations, where access to medical services is curtailed due to geographical obstacles, substandard infrastructure, and lack of resources. In such settings, telemedicine has ushered in novel ways of improving healthcare and overcoming various challenges within the healthcare environment.
Within developing nations, notwithstanding the conspicuous increase in telemedicine integration within healthcare services, there remains a trajectory to traverse before this method of providing healthcare can be embedded within medical protocols. In essence, telemedicine harbours substantial potential for providing healthcare services within developing nations; yet, it is confronted by an array of challenges which may encumber its general integration and widespread acceptance. It is therefore imperative to undertake a comprehensive analysis of the obstacles, duly considering requisites, circumstances, and salient resources relevant to the assimilation of telemedicine services within the healthcare sector.
Therefore, some of the key factors which should be taken into account by healthcare providers in developing countries, aiming to achieve a comprehensive and secure implementation of telemedicine services, include the following:
Regulation
The careful consideration of telemedicine regulatory matters is of great importance, necessitating a primary analysis of current regulations during its implementation and development.
As explained earlier, telemedicine involves the transfer and utilisation of medical information using ICT. Therefore, owing to its nature, regulatory considerations which generally must be taken into account include the safeguarding of personal data, privacy, and confidentiality of information, as well as aspects relating to suitable management and administration of medical records. Ensuring the security and confidentiality of sensitive data involved in telemedicine services is key for instilling trust in the system. Indeed, the security, confidentiality, and appropriate handling of sensitive data represent a principal focal point when implementing telemedicine services.
To this end, adherence to current data protection legislation in the jurisdiction is imperative. In acknowledging the distinct particulars of each country, this regulatory framework shall outline the security policies to be followed in the storage, transfer, and processing of sensitive information. The implementation of a procedure for informed consent for the use of clinical data in the context of telemedicine is also essential.
It is crucial that healthcare establishments adhere to security and confidentiality standards consistent with pertinent regulations. Often, the lack of legal clarity and fragmentation of the legal framework pose impediments to the implementation of disruptive practices. Therefore, ensuring a coordinated and comprehensive orientation across the organisation becomes necessary, ensuring all parties involved in the provision of telemedicine within the healthcare establishment are adequately trained and acquainted with security standards and sensitive data handling protocols to be observed during service delivery.
Ensuring interoperability
A pivotal point to be considered in appropriate implementation of a telemedicine system lies in interoperability, which is the ability of computer systems or software to exchange and make use of information.
According to the WHO, interoperability stands as one of the most significant and necessary challenges to the transformation of public health. The WHO defines interoperability as the capacity of two or more applications and the procedures they support, to share data and enable the exchange of information and knowledge among them, and to provide a service to all those involved in the proposed telemedicine service.
As shown by its definition, interoperability assumes a fundamental role within the telemedicine context, facilitating the effective and seamless exchange of information among diverse systems and devices. In essence, interoperability involves the capacity of systems and platforms used to share clinical data efficiently. This flow of information is essential for healthcare professionals to access a patient’s clinical information in real-time, regardless of whether the patient’s medical history is housed in another information system.
Consequently, ensuring the interoperability of the telemedicine service becomes essential in achieving suitable system functionality, as well as in reducing implementation costs.
Healthcare professionals’ training
A foundation for the adequate implementation of telemedicine lies with the calibre of the professionals who practice it. It therefore becomes imperative to implement ongoing training for healthcare professionals, as this constitutes a crucial element in enhancing the delivery of telemedicine-related activities.
Continuous training ensures healthcare professionals remain well-informed about the latest innovations and clinical practices pertaining to telemedicine, a factor that significantly contributes to improving the quality of care provided.
Similarly, proper training equips healthcare professionals with the requisite tools and skills to address effectively the specific challenges associated with telemedicine. These challenges encompass, among others, remote communication, skilled handling of the computer systems required for service implementation, interpretation of digital data, and suitable management of sensitive data within a virtual environment.
Conclusion
Undoubtedly, the gradual adoption of telemedicine has profoundly affected factors which measure competitiveness within the healthcare sector. The integration of telemedicine has triggered a process of innovation, redefining the ways in which medical services are delivered. As a consequence, the most competitive medical institutions have embraced continuous innovation as a fundamental strategic pillar, centring their efforts on developing advanced technological capabilities and persistently improving the quality of services offered.
This innovative approach has proved a distinguishing characteristic for private healthcare providers, positioning them in an advantaged position against their counterparts. By prioritising the adoption of new technologies and the ongoing optimisation of their processes and clinical practices, these institutions have succeeded in improving the efficiency of their medical services. Telemedicine has played a pivotal role in this endeavour, facilitating more accessible, timely, and higher-quality healthcare.
This drive towards innovation and continuous improvement has enabled healthcare establishments to set new benchmarks in the delivery of medical services, engendering heightened levels of trust and patient satisfaction. Consequently, telemedicine has become a decisive factor in achieving competitive advantages, reshaping the practices and outlook of the sector towards a future-oriented to excellence in healthcare provision. Therefore, among others, it is imperative to consider the three aforementioned factors in order to harness the comprehensive potential of telemedicine and, most importantly, to practice it appropriately within the corresponding regulatory and ethical framework.