Digital health today: starring roles for telemedicine

Ian MatthewsArticle

Telemedicine tech is improving the lives of patients and healthcare providers—especially where needs are most acute

Digital health innovation offers a unique opportunity to improve healthcare delivery in places where resources are scarce. In communities around the world with limited medical infrastructure, digital technologies can significantly improve access, efficiency and decision-making, making life better for patients and healthcare workers alike.

  • Access to care: By going digital, healthcare can move beyond traditional brick-and-mortar service points, erasing distance to enable more people to access care, even where infrastructure is limited.
  • Efficiency: In the hands of providers, digital tools provide quick answers, speed up diagnosis and help make the right treatment decisions; in a glance they can reveal a patient’s progress over months or years, and in a click, send a prescription or reminder.
  • Data & decision-making: Just as having all aspects of a patient’s health in one place can improve treatment and reduce medical errors, rolling up service delivery data helps epidemiologists know and respond to where infectious diseases are spiking.

The global health community has come together to support low and middle-income country (LMIC) governments in their efforts to introduce digital health in coherent, strategically sound ways. In March of this year, World Health Organization Director-General Dr. Tedros Ghebreyesus unveiled a new Department of Digital Health to enhance WHO’s support to countries in prioritizing, integrating and regulating digital health technology. Then, last month, WHO released its first-ever Guideline on digital interventions to improve health outcomes and access to care.

Companies can also take these guidelines to heart as they plan new offerings and go-to-market strategies for LMIC markets.

Telemedicine earned a thumbs-up based on WHO’s critical review of the evidence. Provider-to-provider telemedicine, WHO concludes, can shorten the time for patients to receive appropriate care, and in some cases decrease length of stay. For healthcare workers it can improve performance and reduce the professional isolation of providers working in remote settings. Primary care workers in particular noted how telemedicine services allowed them to access advice from more experienced health workers, which they believe enabled better quality of care and patient satisfaction. One area where more evidence is needed is in linking this type of telemedicine to ultimate outcomes.

The most exciting telemedicine innovations are connected devices that capitalize on IoMT—the Internet of Medical Things. One such device being made available in Africa and India by the social impact company Tech Care for All is ReMeDi. ReMeDi integrates multiple point-of-care tests into a compact briefcase or backpack—from blood pressure, digital stethoscope, ECG and pulse oximeter to a wide range of blood and urine tests, including HIV, malaria and spirometer for TB screening, along with other noncommunicable diseases and maternal/newborn diagnostics. ReMeDi is lightweight and small, making it well suited for frontline health workers in remote, rugged settings. The unit uses Bluetooth Low Energy (BLE) technology to automatically send test results into the patient’s electronic medical record that the system creates. A built-in telemedicine function allows a higher-level (or more specialized) practitioner to join the consultation via video and instantly view and discuss test results. With rechargeable battery power, ReMeDi also works off-grid and offline, syncing data once connectivity is available.

Telementoring, a telemedicine outgrowth that extends the reach of best-practice care by building the skills of providers who aren’t necessarily specialists, is also winning ardent advocates across Africa and India. The Bristol-Myers Squibb Foundation, a leader in developing provider capacity in oncology, is supporting Project ECHO, a telementoring movement to increase the availability of cancer care in sub-Saharan Africa, where specialists are few and far between. ECHO uses case-based learning via video “classrooms” to connect cancer specialists to lower-level providers in a “hub and spoke” model, developing the ability of the local centers to offer what ECHO pioneer Dr. Sanjeev Arora calls “the right care in the right place.”

The good news for governments looking to digital technologies to help increase health equity among their populations is that they have choices. Along with offerings generated by the donor-funded global health community, a wealth of entrepreneurs across Africa and Asia are developing digital innovations for all aspects of healthcare delivery, using better technologies and more intuitive designs than ever before.

Ian MatthewsDigital health today: starring roles for telemedicine