Telemedicine: Healthcare for the Developing World
Giving those in remote and rural areas the access to quality care
The clock ticks persistently as you watch fish swimming aimlessly around the aquarium. There are eight minutes until 12:30. Sigh. You’re going to be late for chemistry class again, except this time it isn’t your fault. You checked into the walk-in clinic half an hour ago, but a nurse still hasn’t called your name. And to make matters worse, the baby next to you has started crying.
Paying a visit to your doctor’s office can be a dull experience. Whether it be flu shots, a check-up, or something more severe like a broken leg, we all wish that we didn’t have to go through the tedious process of seeing a doctor. But what if I told you that in some countries, you’d have to walk for days to get to a decent clinic or hospital?
According to the World Health Organization, the average number of physicians in developing countries is 0.7–1.0 per 1000 population. Not only are practitioners scarce and under-trained, such areas are also lacking in adequate healthcare infrastructure. Access to care, cost-effective delivery, and distribution of limited providers have all been major concerns. However, many these issues are now being addressed with an innovative solution: telemedicine.
The term was first coined by Thomas Bird in the 1970s. Technology wasn’t as sophisticated then, so telemedicine referred to the use of the telephone as the mainstay for sharing medical information. This was the impetus for remote healthcare that did not involve clinical services. Since then, telemedicine has quickly evolved, and now employs a multitude of modern technologies. All you need is a simple Internet connection! It involves transmitting information via text, video, audio, or still images to a range of specialists. Patients can now video-conference with a health care professional half-way around the world or email MRI scans for medical analysis. More remarkably, without any face-to-face interaction, doctors can distantly monitor the blood pressure or glucose levels of a clinic’s patients through a computer screen. The numerous health care possibilities are not all that make telemedicine a propitious solution for developing countries—basic telemedicine initiatives also have low start-up costs.
Implementing such technology means that local doctors can learn from more experienced ones around the globe. With practice, they will be able to better recognize particular diseases and devise treatment options. The Center for Connected Health is a Boston non-profit that runs Operation Village Health, a project that provides health services in two Cambodian villages using a few cameras and a handful of donated x-ray, ultrasound, and EKG machines. Doctors at Massachusetts General Hospital and Brigham and Women’s Hospital provide remote consultations for these patients at no charge. (Harvard College Global Health Review, 2012) After diagnosing and outlining potential treatments, doctors from the two Cambodian villages send the information to Boston doctors, who revise the proposals where they see fit. Evidently, telemedicine has a substantial impact on health care access: it eliminates the costs associated with transportation and ensures that quality resources and insight are being shared with remote areas.
Albeit the numerous benefits of implementing telemedicine in developing countries, there are still a number of challenges that can stand in the way. Language and cultural barriers are one of them. However, this can be overcome with time, as the two parties grow accustomed to working with one another and those in rural areas gain experience with the unfamiliar technology. Other concerns are equipment breakdowns and impossibly slow Internet connections. Adrian Pacheco, director of the Centro Nacional de Excelencia Tecnológia en Salud, explained, “The biggest challenge is [Internet] connectivity. The diagnostic centers are ready and available to do more than 150 screenings every day and they do not reach even 50.” Furthermore, the lack of an international framework to enable healthcare professionals to deliver medical services outside of their licensed jurisdiction presents another barrier. The transmission of information via the Internet may also pose risks to the patients’ privacy; however, to address this concern, non-profits such as the Center for Connected Health are working toward solutions like making video-conferencing tools compliant with medical codes to ensure confidentiality.
Nevertheless, telemedicine a promising approach that has overcome many existing barriers to care. While there are still many concerns that lie in the way, Dr. Joseph Kvedar, Director of the Center for Connected Health, asserted that telemedicine is exceptionally promising due to “the great value that can be brought […]by the possibility of time and place independence in health care.”
