Telemedicine as a Tool for Social Inclusion

[This text has been written by Patricia Pascau, Project Manager; and Carolina Batista, Latin America and the Caribbean Strategic Focal Point, at ISGlobal]

The COVID-19 pandemic has posed an enormous challenge for the delivery of health care services in every corner of the globe. Telemedicine has emerged as a useful and effective tool for addressing this challenge in places where the existing infrastructure and knowledge have allowed the implementation and development of such an approach.

Unfortunately, not all countries and population centres have been able to develop this option—providing health care to the population via information and communication technologies—to the same degree. In many small towns in Latin America, the medical care available, especially for the most vulnerable members of the population, has deteriorated considerably. These concerns, arising from the experience of the pandemic, have now shifted towards the future, as people have begun to ponder how to improve health coverage and access to health services for the entire population in other similar situations. Given the uncertainty surrounding this issue, telemedicine is seen as a useful and effective means of delivering health care that can be incorporated into local health management.

Unfortunately, not all countries and population centres have been able to develop telemedicine—providing health care to the population via information and communication technologies—to the same degree

Hence the logic behind Telemedicine for Social Inclusion in Times of COVID-19, a triangular cooperation initiative between the Panamanian Ministry of Health, the Brazilian municipality of Bom Jardim, the International Italo-Latin American Organisation (IILA) and ISGlobal. The purpose of the initiative was to share knowledge in order to meet a concrete telemedicine training need in Bom Jardim, a small city of 25,000 inhabitants, while at the same time drawing on the specific experience of this Brazilian municipality to create a local telemedicine implementation model that can be replicated in many similar environments.

The initiative—one of 15 selected to receive financial support from the European Union’s ADELANTE 2 programme—ran from September 2021 to February 2022 and focused on four main issues: regulations, health, science/technology and budget.

The objectives were to create a network for sharing best practices and lessons learned, to train medical and non-medical personnel, and to develop a project guide on how to create scalable telemedicine centres in the region.

The objectives were to create a network for sharing best practices and lessons learned, to train medical and non-medical personnel, and to develop a project guide on how to create scalable telemedicine centres in the region

The main activity of the initiative was a seminar entitled “Training for Transformation: Telemedicine and Inclusion”, which was initially scheduled to take place in person in Bom Jardim last December, but had to be postponed due to the pandemic. The seminar was ultimately held online from 3 to 15 February. It was attended by officials representing the participating institutions, doctors and other health personnel, and administrative, legal and IT staff from the municipality of Bom Jardim and the Panamanian Ministry of Health.

The seminar took a multidisciplinary approach and covered a wide variety of topics, ranging from issues directly related to providing health care via telemedicine systems to legal and administrative issues pertaining to the protection and security of the personal data of individuals who use these remote services. Participants also cultivated skills that will allow them to develop and optimise the necessary organisational and management processes for a telemedicine service, including the legal and technical aspects of developing and launching a pilot project.

During the seminar, ISGlobal reiterated its focus on translating scientific evidence into health policy in order to advance towards the Sustainable Development Goals (SDGs). Our specific contribution provided participants with an overview of how telemedicine use has evolved in Latin America, including the main challenges, international recommendations and guidelines, national strategies in the region, and the acceleration that has taken place during the COVID-19 pandemic. Of the experiences shared, one of the most highly regarded was the Saude das Manas application, which is designed to facilitate access to health care for women living in Brazil’s Marajó Archipelago.

Global Health and Telemedicine

We also presented ISGlobal’s approach to digital health and telemedicine, which we illustrated with an overview of some of our current projects, including initiatives aimed at improving the diagnosis and treatment of infectious diseases, which can improve access to better care for remote or displaced populations. As examples of innovative solutions, we included the online platform Trip Doctor; ArboCat, which uses algorithms to calculate the risk of autochthonous arbovirus outbreaks in Catalonia; and CRIBMI, a software package developed to optimise the health screening of immigrants arriving in Spain according to the epidemiological profile of their country of origin. Our presentation also covered the regulation of telemedicine in Spain and the need to guarantee the application of best practices and strengthen patient protection and data privacy as telemedicine becomes more widespread.

Some examples of innovative solutions: Arbocat, which uses algorithms to calculate the risk of autochthonous arbovirus outbreaks in Catalonia; or CRIBMI, a software package developed to optimise the health screening of immigrants arriving in Spain according to the epidemiological profile of their country of origin

Despite the limitations of the online format, the seminar brought together 40 participants from the various institutions involved in the project and allowed for a debate on the role of cooperation in responding rapidly to challenges—such as those generated by the pandemic—via telemedicine.

Prior to the seminar, the participating institutions conducted a comparative study of telemedicine services in the countries taking part in the initiative. The analysis provided an overview of the regulations governing telemedicine systems in the institutions’ home countries. The aspects covered by the study included the management of telemedicine systems, the state and municipal policies that make up the institutional framework, the responsibilities of service providers and the confidentiality of patient information.