Pakistan is the densely populated country with the major rural-urban disparity in the delivery of healthcare services. Even though the population of Pakistan is concentrated in the villages and small towns, the medical services in those areas are far from sufficient. The telecommunication industry in Pakistan is undergoing a rapid development, as a result of which the communication connectivity all over the country has improved remarkably. Many developing countries have started to realize the importance of eHealth/telemedicine and are pioneering the implementation of telemedicine projects. Telemedicine/eHealth projects in developing countries offer an opportunity for people living in underserved and rural areas to obtain improved primary healthcare services.
The field of telemedicine has changed drastically from its inception. It was only about fifty years ago that a few hospitals started experimenting with telemedicine to reach patients in remote locations. But with the rapid changes in technology over the last few decades, telemedicine has transformed into a complexly integrated service used in hospitals, homes, private physician offices, and other healthcare facilities.
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Today the telemedicine field is changing faster than ever before. As technology advances at exponential levels so does the widespread affordability and accessibility to basic telemedicine tools. Pakistan is not an exception and has started several eHealth/telemedicine projects to resuscitate primary health care. Various private and government organizations have participated in the implementation of telemedicine in Pakistan. Pak-US collaboration in telemedicine led to the establishment of first telemedicine/E-health training center for capacity building in Pakistan. It has trained 45 doctors and nurses in telemedicine. These trained personals are helping other hospitals, like Pakistan Atomic Energy Commission Hospital, to establish their telemedicine facilities. Moreover, during the 2005 earthquake of Pakistan, this center established telemedicine centers in affected areas. The need for telemedicine and eHealth was greatly realized in 2005 earthquake of Pakistan. The Government of Pakistan is now considering eHealth as a modality for the rebuilding of quake-hit areas. Pakistan space organization (SUPARCO) has also established Pakistan’s first satellite-based telemedicine network. In collaboration with Ministry of IT, SUPARCO is establishing three satellite-based telemedicine centers in big cities. The Government of Pakistan, in consultation with Telemedicine/E-Health training center, is also working on establishing nationwide telemedicine network by connecting all medical college hospitals with district hospitals.
We have also initiated one of the first online telemedicine clinics in Pakistan under the name of SehatYab. Pakistan urgently needs to revive and boost the neglected primary health care department, and we at SehatYab identified that this big chasm can only be bridged through the introduction of telemedicine technology thus bringing the doctor to the patients’ doorstep.
With the interrelated fields of mobile health, digital health, health IT, telemedicine all constantly changing with new developments, it’s sometimes difficult to pin down a definition for these terms. In much of the healthcare industry, the terms “telehealth” and “telemedicine” are often used interchangeably. In fact, even the ATA considers them to be interchangeable terms. This isn’t surprising since the telehealth and telemedicine definitions encompass very similar services, including medical education, e-health patient monitoring, and patient consultation via video conferencing, health wireless applications, transmission of image medical reports, and many more.
However, if you want to get technical, telemedicine is really a subset of telehealth. Whereas telehealth is a broad term that includes all health services provided using telecommunications technology, telemedicine refers specifically to clinical services. There’s how the California Telehealth Resource Center defines telehealth:
“Telehealth is a collection of means or methods for enhancing health care, public health, and health education delivery and support using telecommunications technologies.”
Telehealth may involve more general health services, like public health services, whereas telemedicine is a specific kind of telehealth that involves a clinician providing some kind of medical services.
In most cases, telemedicine is a net benefit. It expands access to quality patient care, especially to regions and underserved populations that need it the most. It provides a way to cut down on healthcare spending and engage today’s connected patient. I believe that it has the potential to change the healthcare delivery model for the better. One of the most important uses of telemedicine is to provide timely specialized medical assistance to people living in far, rural areas. Telehealth has great potential to expand access and improve the quality of rural healthcare. It can reduce burdens for patients, such as travel to receive specialty care, and improve monitoring, timeliness, and communications within the healthcare system. In Pakistan, about 70 percent of the population is living in rural setups, and are deprived of basic healthcare facilities which have led an outburst in the mortality rate. I hope that Sehatyab and other online clinics will rescue and revolutionize the primary healthcare system in our country.
Another major use of telemedicine is for the mental health. Telepsychiatry, a subset of telemedicine, can involve providing a range of services including psychiatric evaluations, therapy (individual therapy, group therapy, family therapy), patient education and medication management. Telepsychiatry can involve direct interaction between a psychiatrist and the patient. It also encompasses psychiatrists supporting primary care providers with mental health care consultation and expertise. Mental health care can be delivered in a live, interactive communication. It can also involve recording medical information (images, videos, etc.) and sending this to a distant site for later review.
However, telemedicine also has a few downsides — by nature of its virtual interaction, and because of societal and technological barriers that could change in the future. The good news is, with the growing popularity and widespread acceptance of telemedicine, we’re likely to see the cons of telemedicine resolve themselves. With new technological advancements and shifting policy that increasingly supports telemedicine, we’re continuously finding ways to improve telemedicine and make it a viable, even advantageous form of healthcare delivery for many medical scenarios.
Here’s a quick overview of the top pros and cons of telemedicine:
- More convenient, accessible care for patients
More accessible, convenient healthcare for patients is the driving force behind the telemedicine field. I believe it will revive the healthcare system in the country, especially in remote rural areas. Now telemedicine is used around the world, whether it’s to provide basic healthcare in third-world countries or allow an elderly patient with mobility issues to see the doctor from home. Telemedicine has the power not only to break down typical geographical barriers to care access but to make the entire healthcare delivery model more convenient to patients.
- Saves on Healthcare Costs
Telemedicine has the power to cut our healthcare spending by reducing problems like medication non-adherence and unnecessary ER visits and making typical doctor visits more efficient. Image source: propakistani.com
- Extends access to consults from specialists
With telemedicine, a medical practice or hospital system can immediately expand access to niche medical specialists. This makes it easy for primary care doctors to consult medical specialists on a patient case, and for patients to see a needed specialist on a rare form of cancer, no matter their location. As another example, small hospitals without adequate radiology specialist on-staff can outsource evaluation of x-rays via telemedicine.
- Increasing patient engagement
Today’s patient lives in an increasingly connected world and expects a different kind of care experience. Telemedicine engages patients by allowing them to connect with their doctor more frequently, in a convenient way. That means more questions asked and answered a stronger doctor-patient relationship and patients who feel empowered to manage their care.
- Better quality patient care
Telemedicine makes it easier for providers to follow-up with patients and makes sure everything is going well. Whether they’re using a more extensive remote patient monitoring system to watch the patient’s heart or doing a video-chat to answer medication questions after a hospital discharge – telemedicine leads to better care outcomes.
Cons
- Requires technical training and equipment
- Some telemedicine models may reduce care continuity
Telemedicine companies that are consumer-facing offer the huge benefit of on-demand care for patients. A sick patient can simply log in online and request a visit with one of the company’s doctors and get treatment. But this model, similar to the retail health movement, leads to a breakdown in care continuity. A random doctor who doesn’t know the patient doesn’t know their whole medical history.
- May reduce in-person interactions with doctors
Some critics of telemedicine argue that online interactions are impersonal, and physical exams are often necessary to make a full diagnosis. If more patients are resorting to online interactions in place of in-person visits, what effects will that have? In-person patient-doctor visits are clearly valuable and necessary in many circumstances. Telemedicine is best used to supplement these visits – to do simple check-ins with patients and make sure everything is going well. For minor acute conditions (like infections), an in-person visit with an established patient is often not needed. In those cases, telemedicine can save the patient, the doctor, and the healthcare system time and money.
Telemedicine will surely resuscitate primary healthcare in Pakistan. However, it is still unpopular or new in Pakistan but where it is applied, it’s being applied effectively. It does add benefits and convenience to lives of people living in remote areas as well as to those living in urban cities. In future telemedicine is predicted to grow and provide healthcare facilities to areas of Pakistan that are still deprived of them.
REFERENCES:
https://publications.muet.edu.pk/index.php/muetrj/article/view/25/17
https://chironhealth.com/telemedicine/providers/primary-care/
https://tech4lifeenterprises.com/2017/07/20/mdconsults-pioneering-telemedicine-in-pakistan/
https://telecompk.net/2008/10/10/telemedicine-in-pakistan-a-story-from-american-press/
https://www.researchgate.net/publication/4258427_Telemedicine_Country_Report-Pakistan
https://evisit.com/what-is-the-difference-between-telemedicine-telecare-and-telehealth/
https://www.psychiatry.org/patients-families/what-is-telepsychiatry
https://www.mobihealthnews.com/content/health-affairs-telemedicine-mental-health-fast-growing-inconsistent
https://www.healthitoutcomes.com/doc/the-role-of-telemedicine-in-mental-health-0001
https://www.ruralhealthinfo.org/topics/telehealth
https://www.beckershospitalreview.com/healthcare-information-technology/how-telemedicine-is-transforming-treatment-in-rural-communities.html