Integrating Telehealth for Strengthening Health Systems in the Context of the COVID-19 Pandemic: A Perspective from Peru

Abstract

The COVID-19 pandemic forced the government to rapidly modify its legal framework to adopt telemedicine and promote the implementation of telehealth services to meet the healthcare needs of patients in Peru. In this paper, we aim to review the main changes to the regulatory framework and describe selected initiatives to promote the telehealth framework that emerged in Peru during the COVID-19 pandemic. In addition, we discuss the challenges to integrate telehealth services for strengthening health systems in Peru. The Peruvian telehealth regulatory framework began in 2005, and in subsequent years, laws and regulations were established that sought to progressively implement a national telehealth network. However, mainly local initiatives were deployed. In this sense, significant challenges remain to be addressed, such as infrastructure in healthcare centers, including high-speed Internet connectivity; infostructure of health-information systems, including interoperability with electronic medical records; monitoring and evaluation of the national agenda for the health sector in 2020–2025; expanding the healthcare workforce in terms of digital health; and developing the capacities of healthcare users on health literacy, including digital aspects. In addition, there is enormous potential for telemedicine as a key strategy to deal with the COVID-19 pandemic and to improve access to rural and hard-to-reach areas and populations. There is thus an urgent need to effectively implement an integrated national telehealth system to address sociocultural issues and strengthen the competencies of human resources in telehealth and digital health in Peru.

Evaluation of usability and acceptability of Telemental health service among vulnerable occupational workers: A formative study based on user-centered design (Preprint)

“…Among the main barriers identified were uncertainty in appointment management, non-compliance with scheduled times for these services, lack of clear communication and the absence of a legal framework integrating care outcomes with the healthcare system for a timely referral. Despite on Peru has made significant improvements in the regulatory framework, allowing the development of many of these services, there are still legal and operational gaps to achieve sustainable satisfaction and adherence, which also serves as limitation for the integration of health services [45], especially when telehealth services are not developed with the end user in mind or fail to address digital divides [46]. Rees and Peralta point out that many telehealth services focus on solving operational problems within the healthcare system without considering patient needs, which affects their sustainability and acceptance [47].…”

A review of neurological health disparities in Peru

“…Factors including lack of appropriate disease management guidelines and protocols tailored to a country or region and time-efficient disease reporting systems make it difficult for clinicians to obtain current guidelines that reflect the reality where they practice clinically. Lack of internet access and access to computers makes it almost impossible to implement an electronic health record system for accurate patient record-keeping and telehealth services to improve access to care for patients with neurological conditions in rural areas ( 42 ).…”

Factores que influyen en la aceptación de la telesalud en mujeres peruanas

“…El caso de las mujeres en el Perú ilustra claramente cómo la telesalud no está exenta de reproducir o incluso acentuar disparidades de género preexistente en el ámbito del derecho a la salud (Curioso et al, 2023). Las tasas de alfabetización digital y disponibilidad de teléfonos inteligentes entre mujeres de zonas rurales y urbano-marginales suponen un factor limitante que reduce drásticamente sus posibilidades de beneficiarse de las teleconsultas (Curioso-Vilchez & Coronel-Chucos, 2022).…”

“…Las tasas de alfabetización digital y disponibilidad de teléfonos inteligentes entre mujeres de zonas rurales y urbano-marginales suponen un factor limitante que reduce drásticamente sus posibilidades de beneficiarse de las teleconsultas (Curioso-Vilchez & Coronel-Chucos, 2022). Subsanar tales deficiencias y encaminarse hacia un sistema de salud post-COVID más inclusivo con perspectiva de género requiere de políticas universales orientadas a democratizar el acceso a conectividad, dispositivos móviles y competencias digitales elementales entre las mujeres y otros grupos históricamente relegados (Curioso et al, 2023). Teniendo en cuenta esto, el objetivo de la investigación es identificar los factores de aceptación de telesalud en mujeres peruanas, de modo que se pueda obtener conocimiento a partir de resultados contextualizados a la luz de los componentes conductuales de las mujeres peruanas.…”