The George Institute recommends: Leveraging telehealth for efficient delivery of primary health care in the WHO South-East Asia Region

NEW DELHI, FEB 25. The WHO Policy brief on scale-up telehealth supported primary health care delivery has been supported by new research conducted by the George Institute for Global Health. The George Institute led a policy brief titled “Leveraging telehealth for efficient delivery of primary health care (PHC) in the WHO South-East Asia region” focuses on comprehensive national digital health strategies to maximize the potential of telehealth, especially in the context of the contemporary Covid-19 pandemic. This was recently published by the WHO.

Telehealth interventions can address primary health care delivery challenges by boosting efficiency, availability, quality, utilization, and accountability. It will accelerate progress towards universal health coverage (UHC). These are its key policy strengths. There are further benefits: Telehealth holds promising opportunities to strengthen health systems by building the capacity of the existing healthcare workforce, enhancing competencies and speeding up referrals. The overall effect will be a continuum of care.

Further, telehealth generates health data to support artificial intelligence (AI)- based clinical decision support systems, cutting-edge diagnostic tools, and measuring clinical outcomes. It will also help in the adherence to evidence-based interventions such as rational use of antibiotics. Patients are important: user acceptance and satisfaction are critical for realigning and expanding telehealth to boost this delivery of health services for all.

There is an international precedent for this. In 1978, the Alma Ata Declaration placed cost-effective PHC at the centre in achieving “Health for All”. The 2018 Astana declaration revitalised PHC as a cost-effective strategy to achieve UHC. Rising inequalities in access to health care persist in South-East Asia. “Competing priorities, rapidly evolving demographic and epidemiological shifts, rising burden of noncommunicable diseases (NCDs) and aging populations further challenge the effective delivery of primary health care”, states Dr Oommen John, lead author of the George Institute's research team.

Further, technical issues matter: Data governance, standardization, interoperability, data privacy and security warrant the embracing of comprehensive digital architecture and frameworks to ensure trust, reliability and scalability of telehealth in the SEA Region, Dr John adds. Key takeaways can be summarised as follows:

  • During the COVID-19 pandemic, countries leveraged telemedicine technology and are well on their way to scaling it up. Public and private sector actors are active in developing various healthcare service delivery platforms.
  • The WHO identifies digital interventions, including telehealth, as one of the operational levers to augment PHC delivery. By empowering individuals and communities, the digital revolution provides a unique opportunity to improve people’s health.
  • The use of technology in healthcare delivery is expanding. In reality, barriers remain at the policy, organizational, technology and individual levels. At the level of technology, poor Internet connectivity, data standards, interoperability, lack of data integration, and lack of data privacy and security hinder widespread diffusion of telehealth.
  • A strong digital health ecosystem is non-negotiable. Thus, the organization of digital infrastructure for the seamless flow of the appropriate information is vital for networked organizations
  • People also matter: Countries must engage in developing a skilled and competent workforce with specific training for health services delivery through telehealth interventions. In this context, a stronger digital health ecosystem can help ensure the sustainability of telehealth initiatives.
  • On the negative side, there are perceptions of poor quality of care, understaffing, low level of competencies, and lack of community engagement causing the underutilization of PHC systems. Therefore, the appropriate use of digital health interventions, including telehealth, can effectively help overcome such challenges.
  • Governments must incentivize technology penetration as evenly as possible. To begin with, states must address and overcome technology infrastructure gaps, and ensure interoperability between multiple-segmented systems. Long-standing issues relating to “the digital divide” also must not be neglected.
  • Finally, at the individual level, for both healthcare providers and patients, perceptions related to usefulness, ease of use, liability, and security concerns should be addressed.

To read the full paper, click here