Zimbabwe gets set for telemedicine

Dr Spencer T. Mamvura

HEALTHCARE delivery is being transformed by advances in telemedicine which is now recognised as an essential enabler for support of health systems across the world, acting not only as an agent for reforming healthcare systems, but also as an enabling tool to share resources among countries with similar challenges without having to duplicate efforts.

Lack of interoperable health systems and consensus on data standards is one of the major barriers to the use of health information. Mobile phone use has seen tremendous growth across the developing world offering opportunities to engage e-Health applications.
Telemedicine, simply put, is the remote diagnosis and treatment of patients by means of telecommunications technology. Clinicians are now linking up with patients from their desktop or mobile device connecting with patients in their own home or into other places of care such as nursing and residential care homes, secure hospitals and even prisons. Telemedicine has evolved in all disciplines of medicines and its effectiveness has been noted in many countries which include India, Mongolia and Kenya.
Telemedicine in India has grown leaps and bounds reaching most of country’s populace. Several state governments for example Maharashtra and Andhra Pradesh have launched free medical helplines. More than 1,000 phone calls are received each day seeking medical advice, with 33 percent of the calls coming from India’s underdeveloped states.
Mongolia in Asia has noted significant improvement in health delivery after launching telemedicine. Mongolia is one of the largest countries in Asia yet sparsely populated with a population of about 3 million people. It is characterized by harsh winters, poor road networks in rural areas and high transports costs. A journey to seek treatment in the capital city can drain a family’s resources. Because of the demerits mentioned above, the Health ministry, with support from United Nations Population Fund (UNFPA) and funding from the Government of Luxembourg, came up with the intervention of telemedicine in order to save lives of people in rural areas who could not easily access medical services.
Working in Kenya and India, World health Partners (WHP) is a non-profit organization that delivers healthcare services to rural and underserved communities by building branded, telemedicine-enabled healthcare networks called Sky. In Kenya, WHP has launched The Sky Network in Homa Bay, Kisumu, and Siaya counties with support from the respective country ministry of health. WHP’s commitment to Every Woman Every Child has greatly expanded its work in Kenya and is valued at a contribution of 7 million USD. Through the Sky Network, women are offered reproductive health services and children are offered testing and treatment for tuberculosis, pneumonia, and diarrhea. This has resulted in improved quality and accessibility of the maternal and newborn services, including emergency obstetric care in selected areas. Since its launch, project has reached 60 person of pregnant women in rural areas. There has been an improvement in the diagnostic capacity of remote physicians on foetal conditions.
The Zimbabwean health sector has not been spared with the current economic meltdown that has affected the country in the last few years. The public health system is overwhelmed and private healthcare fees are beyond the reach of many. In addition, lack of adequate drugs, and specialist health personnel to service the populace, has impacted negatively on the health status of the country. The government is trying to cover the gap by increasing the capacity to train medical doctors at Midlands State University and at National University of Science and Technology to complement the traditional medical school of the University of Zimbabwe
While the government is making efforts to resuscitate and bring back the situation to normalcy, other alternative solutions to health delivery needs to be adopted. In Manicaland province, the government through POTRAZ and some external funders launched out a pilot study on telemedicine which promised a major breakthrough for Zimbabwe. But the project seems to have died a natural death. Despite all the challenges, it is highly important that the government and the business community come up together to try and find ways which Zimbabwe can strategically leverage on telemedicine and improve the health status of the country which is also used as an indicator to measure the country `s potential for investment especially from the perspective of Foreign Direct Investments.
There are vast advantages of telemedicine which can only be enjoyed by those who have implemented the program. They include but are not limited to the following;
• Access to healthcare 24 hours a day no matter where you are as long as there is internet/telephone connection.
• Doctors attracts new patients generating income to their regular practice from the comfort of their homes or on their own time.
• Practices that were once isolated are now connected by a network of physicians who share information regulated by the codes of ethics and laws applicable to the protection of information and only with the patient’s consent, points of view, diagnoses and knowledge.
• Both the doctors and patients can use computers, smart phones and tablets that will enable them to reach each other even in remote areas.
• It also encourages local healthcare works to remain in rural areas by augmenting (to increase or add something) professional support and allowing them to continue their professional development.
• It cut costs of unnecessary hospital and GPs visit thereby preserving the fund for vulnerable populace.
• Through self-monitoring, chronic diseases complications are picked earlier allowing for timeous interventions

The major concern in adoption of telemedicine has been buy in from the important stakeholders. Concerns have been raised about patient confidentiality and also how cases which cannot be dealt with by telemedicine are going to be handled. Issues involving the confidentiality and protection of a patient’s data can be minimised by restricting access to the identification system. Computerised systems used in telehealth must possess mechanisms that track use of personal information, and access must require personal passwords. The key to preserving confidentiality is to allow only authorized individuals to have access to information. Again, a sound triaging system should be put in place so that cases which needs personal contact with the health professional are referred to the appropriate facility for further management
Implementation of telemedicine in Zimbabwe is very feasible and will go a long way in improving the quality of health care. The already existing infrastructure can be capitalised on to deliver health to the most remote areas and cut on unnecessary hospital visits. The lack of funding and properly documented policy and framework in place for telemedicine practices are the major obstacles in the setting up of telemedicine in Zimbabwe, but if everyone concerned bring their energies and resources together, this insurmountable task will be accomplished and everyone will reap the benefits. Let’s embrace technology today and gain a healthier tomorrow!!!

References
http://www.healthit.gov/topic/health-it-initiatives/telemedicine-and-telehealth
http://www.ehealthresearch.no/files/documents/WHO_CC_Annual_report_2008.pdf
http://www.who.int/goe/publications/atlas/zwe.pdf
https://www.healted.com/blog/Telemedicine-in-India
https://www.dailynews.co.zw/articles/2018/07/12/potraz-in-telemedicine-initiative