Making telemedicine a success will take much more than good tech

We’ve been given an opportunity by Covid-19. Yes, this is a once-in-a-lifetime struggle, and our country has had to endure unspeakable calamities. But it also gives us the chance to finally provide everyone with appropriate and equitable healthcare. It also provides us with the potential to develop new careers in addition to saving lives.

Telemedicine holds the key to both.

Telemedicine has a number of advantages for expanding healthcare delivery. It has the potential to improve the doctor-to-patient ratio, provide high-quality, specialised treatment even in rural locations, and do so swiftly and cost-effectively.
So, why haven’t we seen any substantial success with telemedicine projects, despite their evident benefits?
A successful telemedicine programme must go beyond the standard healthcare paradigm. It isn’t only a matter of technology facilitating access to a “doctor.” Telemedicine would already be a success if technology was the only missing link, as it has been available for a long time.
Patients, particularly those in remote regions, will require assistance with telemedicine technology, such as where to look, what to say, and so on. For local languages and dialects, doctors may require translation support. Patients will want assistance in comprehending medications as well as post-consultation support in following suggestions. Receiving medical care without the presence of a doctor is a huge change, and patients will require assistance in developing trust in the system.
And this is a lengthy procedure. A procedure that relies on the system producing beneficial results. The telemedicine service coordinator is the key to establishing confidence in telemedicine.
This is where the telemedicine coordinator comes in. It is indisputable that telemedicine can increase access, particularly in rural and distant places. However, in order to realise that potential, we must consider the function of a “telemedicine coordinator.”
A telemedicine coordinator works in the field to mobilise communities through lobbying. They are frequently members of the same social groups. They will speak with village households to see if individuals are reporting diseases and what interventions are needed. They’ll also have to raise awareness about healthy habits that can help prevent diseases and pandemics from spreading. Telemedicine coordinators make telemedicine more acceptable by addressing community concerns.
The coordinator is the initial point of contact at the telemedicine centre; she takes down the patient’s information, interprets the symptoms, and offers the doctor a clear briefing. It will be their obligation to thoroughly explain the treatment and prescription to the patient, as well as to answer any additional questions and arrange follow-up visits. A capable coordinator should be familiar with the patients’ context, medical language, and enough technology to facilitate a consultation.
Patient counsellors are employed by organisations such as the Aravind Eye Hospitals (65 million patients served, 7.8 million procedures). They are crucial in ensuring that therapies are patient-centered and that patients stick to therapy and follow-up appointments. This type of function can help patients adjust to a new system and fill gaps in telemedicine (language, technology, and medication adherence).

What does it take to become a telemedicine coordinator?

Nepal has a substantial community health worker network. The Auxiliary Nurse Midwife (ANM) is a role that connects the community with health services at the village level. They are meant to be multi-purpose health workers who work at the grassroots level. Their work extends beyond maternal/child health and family planning to include health and nutrition education, environmental sanitation, infectious disease immunisation, minor injury care, and first-aid administration.
We need to upskill Nepal’s 200,000-plus ANMs so that they may serve as telemedicine coordinators and serve as the country’s telemedicine backbone.
Even in their current incarnation, however, ANMs confront obstacles such as poor pay, institutional support, and social recognition. The training they receive is neither uniform nor sufficient. There is no efficient supervision or feedback mechanism in place to help them improve their work. We must solve these problems and equip ANMs with a career advancement path if this livelihood is to be promoted.

Accountability and empowerment

ANMs must be given the opportunity to take on a higher-order position that expands their talents and pay. They will need abilities to interface with the community on a deeper level as telemedicine coordinators. They must also be given the ability to work with more autonomy and accountability. Job security, social security, and insurance will provide them with financial stability and assist them in doing their jobs more effectively.
We require immediate measures that can address these problems on a large basis.
Telemedicine has the potential to significantly improve healthcare access, quality, and affordability in the United States. The Covid-19 epidemic has given us the opportunity to make a concerted effort to move it forward. But, in order for it to truly take off, we’ll need innovations that expand the role of community health workers, as well as solutions that strengthen livelihoods and bridge the last-mile gap.

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