Telemedicine Ready or Not? a cross-sectional assessment of telemedicine maturity of federally funded tertiary health institutions in Nigeria

Abstract

Background and Objective Telemedicine (TM) has solidified its place as a means for continuity of healthcare services and a cost-effective approach for improving health equity as demonstrated during the COVID-19 pandemic. Preparedness of health systems for telemedicine is an indicator of the scalability of their services, especially during disasters. We aimed to assess the maturity and preparedness of federally funded tertiary health institutions (FFTHIs) in Nigeria, to deploy and integrate telemedicine Methods We conducted a cross-sectional study of randomly selected FFTHIs in Nigeria using PAHOs tool for assessing the maturity level of health institutions to implement telemedicine services. Descriptive statistics were used for overall maturity levels and non-parametric tests to compare scores for overall maturity and specific PAHO domains per region. The level of significance was set at p value <0.05. Results Twenty-four of thirty randomly polled FFTHIs responded (response rate of 77.4%). Overall, the median TM maturity level was 2.0 (1.75) indicating beginner level. No significant inter-zonal difference in median overall maturity level (p=0.87). The median maturity levels for telemedicine readiness in specific domains were organizational readiness - 2.0 (2.0), processes 1.0 (1.0), digital environment 2.0 (3.0), human resources 2.0 (1.0), regulatory issues- 1.5 (1.0) and expertise 2.0 (2.0); mostly at beginner level, with no inter-zonal differences. Most participating institutions had no initiatives in place for domains of processes and regulatory issues. Conclusions The current status of telemedicine maturity of FFTHIs in Nigeria behoves policy makers to advance the implementation of telemedicine across the country as part of national digital quality healthcare.