Telemedicine supported strengthening of primary care in WHO South East Asia region: lessons from the COVID-19 pandemic experiences

Abstract

The COVID-19 pandemic has exposed the fragmentation of the healthcare delivery systems and highlighted the role of resilient primary healthcare systems for a robust public health response during health emergencies. Primary care while being the first point of contact between the citizens and the health systems has received scant attention or targeted investments over the past several decades. Through this narrative review, we aim to outline the potential role of telehealth in augmenting health systems capacity. While teleconsultations have increased exponentially during the pandemic, evidence suggests that utilisation of primary care for non-emergency and non-COVID-19 conditions such as chronic medical conditions has significantly decreased, suggesting that most telemedicine utilisation has been to address an immediate crisis. In countries with pre-existing national digital health framework and enabling regulatory environments, telehealth interventions while strengthening the public health response to COVID-19 also supported the continuum of care at the primary care level. Even after COVID-19 is controlled, telemedicine has the potential to address persistent obstacles to primary care in the South East Asia region, including scarcity of trained healthcare workers, access challenges and costs associated with in-person care. Telemedicine holds promise in strengthening primary care and has the potential to catalyse achieving universal health coverage.

An evaluation of the introduction of telehealth for remote antenatal and postnatal contacts in Bangladesh and Lao People’s Democratic Republic during the COVID-19 pandemic

“…Furthermore, shifting the community culture from face-to-face care to remote care requires extensive community awareness and campaign (25). Community awareness about the benefits of remote care is critical to the successful implementation of telehealth (23) In our study, both the childbearing women and healthcare providers raised the issue of access to technology as a barrier to successful implementation of telehealth. This is not dissimilar to other findings where health providers were concerned regarding the quality of care and the risk of increasing inequalities in healthcare access due to a lack of available technology (6,26).…”

eHealth, telehealth, and telemedicine in the management of the COVID-19 pandemic and beyond: Lessons learned and future perspectives

“…A model of care based on the use of telemedicine from the first contact between healthcare professionals and patient (in a primary care setting), has been shown to be of fundamental importance. Gudi et al [ 19 ] outlined how telehealth interventions have the potential to address persistent challenges in primary care worldwide, while strengthening the public health response to COVID-19. Further, Monaghesh et al [ 20 ] corroborated this notion in their systematic review of eight studies, which concluded that telehealth interventions are able to improve the overall delivery of care whilst maintaining the safety of patients and healthcare providers during the pandemic.…”

The Pandemic, Infodemic, and People’s Resilience in India: Viewpoint

“…Volunteer-led platforms such as Project StepOne offered tele-triage and teleconsultations for individuals with COVID-19 symptoms and provided self-management support at home through remote monitoring. This platform has over 7000 impaneled doctors and is partnering with 16 state governments to address COVID-19 management through telemedicine solutions [ 23 , 24 ].…”