Telehealth: A Tool to Improve Access, Monitoring, and the Quality of Healthcare

"More than half of people do not receive the healthcare they need, and this is where telehealth plays an absolutely crucial role." With these words, Ferdinando Regalia, Social Sector Manager at the IDB, opened the webinar Telehealth: Connecting Patients and Providers, organized by the IDB, the Pan American Health Organization (PAHO), and the World Bank.

During the seminar, moderated by Jennifer Nelson, Senior Health Specialist at the IDB, case studies and examples from Argentina, Colombia, and Mexico were presented. Experts agreed that telehealth is redefining access to healthcare. While its use surged during the pandemic, it has since declined, underscoring the importance of consolidating its implementation given the significant benefits it provides, from improving healthcare access to enhancing disease management.

Telehealth and Diabetes

One standout case presented was a telehealth pilot project implemented in Mexico City to treat diabetes patients. In a city where Type 2 diabetes prevalence is estimated at 12.6% and is one of the leading causes of death, the project facilitated patient consultations with specialists via video calls managed by general practitioners, eliminating the need for patients to travel to another location.

Dr. Consuelo Stephanie Arellano, Director of Health Information at Mexico City's Ministry of Health (SEDESA), presented the project. She highlighted urban challenges in Mexico City that create barriers to healthcare access, such as heavy traffic, overpopulation, and mobility challenges, which often make even short trips excessively time- or cost-prohibitive. This initiative successfully reduced the gap between patients and specialists.

Focusing on non-communicable diseases, Sebastián Bauhoff, Principal Health Economist at the IDB, shared findings from a qualitative study conducted in Colombia. The research examined barriers to diabetes treatment and explored how telehealth could create opportunities. The study analyzed data from 40 patients and 40 healthcare providers to identify strategies to improve chronic disease management.

Bauhoff explained that the barriers patients face include administrative issues (e.g., three-month wait times for care), habits and misinformation, limited healthcare infrastructure (e.g., difficulty accessing medications), and the need for families to adapt to the patient's dietary requirements.

"Telehealth can enhance efficiency and access by facilitating appointment scheduling or providing educational resources for patients and families. However, some challenges, like behavioral changes, cannot be addressed solely with digital tools but can be supported through their use," Bauhoff noted.

Garrahan Hospital: A Pioneer in Telehealth

In Argentina, Garrahan Pediatric Hospital in Buenos Aires stands out for its 27-year history of telehealth advancements. The high-complexity hospital, with 42 specialties, has built a telehealth model involving 320 public healthcare providers at various levels.

María Celeste Savignano, Head of the Telehealth and Innovation Department at Garrahan, shared that the hospital serves 40% of Argentina's pediatric oncology patients, regardless of insurance coverage. "Between 92% and 93% of teleconsultations are resolved without requiring patients to leave their homes," she explained. Teleconsultations are recorded in patients' medical histories, a critical legal feature.

Savignano also highlighted that the hospital's intensive care unit collaborates with ICUs in five jurisdictions to provide remote consultations for critically ill patients, whose health could deteriorate if transported. She emphasized that telehealth involves all healthcare workers, not just physicians. "Telehealth is a broad field that integrates diverse knowledge and disciplines, enabling us to not only deliver care but also provide ongoing education and training for healthcare workers in remote areas," she said.

Digital Tools to Bridge Gaps in Healthcare Access

In Buenos Aires Province, the local government is advancing digital tools to improve healthcare access. These include teleconsultations for first and second opinions, follow-ups, and remote diagnostic imaging. Santiago Pesci, Director of Statistics and Digital Health for the province, explained that healthcare services and populations are unevenly distributed, creating inequities in access. Digital resources are thus critical for addressing these disparities.

Coordinated Action for Effective Results

Federica Secci, Senior Health Specialist for the World Bank's Latin America and Caribbean Health, Nutrition, and Population Practice, emphasized the importance of collaboration: "The Alliance for Primary Health Care in the Americas [an IDB, PAHO, and World Bank alliance] is strategic for overcoming barriers and accelerating progress toward universal health coverage. In April, the World Bank committed to delivering quality essential health services to 1.5 billion people by 2030. Achieving this goal requires coordinated actions from governments and their partners."

Carlos Martín Otero, telehealth consultant at PAHO, stressed that solutions must be tailored to each country's needs. "If a country benefits from teleconsultations by phone, starting there is perfectly fine. Technology should serve as a tool, not the centerpiece, of this transformation. The real challenge lies in organizational changes that improve access to healthcare," he explained.

The Need for Regulations to Advance Telehealth

To make digital transformation feasible, countries must align and coordinate through regulatory frameworks. According to an IDB report on telemedicine, while technology is a great equalizer, the absence of specific telemedicine legislation discourages its use.

Although many countries adopted telehealth during the pandemic, only 6 of the 26 countries where the IDB operates have established regulatory frameworks for telemedicine. Legal disparities among countries further complicate regional agreements. Therefore, regional norms and agreements are essential to promote telemedicine adoption.

At the end of 2023, the IDB, PAHO, and the World Bank launched the Alliance for Primary Health Care in the Americas. We firmly believe that digital tools like telehealth are crucial to achieving its goals and improving the quality of life in the region.

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