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Infectious Diseases

Updated 04 June 2020

OPINION | Coronavirus intensifies the need to embrace telemedicine

Dr Anna Mokgokong explains how telemedicine, prompted by the coronavirus pandemic, is changing the face of healthcare in South Africa.

  • Because of the coronavirus pandemic, it is safer for medical practitioners to consult their patients remotely
  • Great strides have been made in the efficiency and effectiveness of 'telemedicine'
  • A remote doctor provides you with a diagnosis and sends any prescriptions to the pharmacy of your choice

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When I was a young doctor a few decades ago, my fellow medical practitioners and I debated on how a novel technology known as “telemedicine” could be used to deliver healthcare from a distance to rural populations. 

At the time many of us smirked. We pondered who would willingly give up a personal relationship online? How safe can or could this be? How could anyone believe that the “laying on of hands” could be replaced by a practitioner miles away through a cell or desk phone, laptop or IPAD or just a desktop computer?

For years, I maintained some measure of scepticism. Despite advancements in technology, I did not believe that we could feel the same connection, the same understanding, with our primary care patients through a remote encounter.

Best time to learn new things

And then bang, the novel coronavirus (Covid-19) engulfed the world and I was forced to cancel local and international face-to-face meetings in favour of virtual ones and realised this is the best time to learn new things, which included embracing telemedicine and/or virtual consultations.

During the debate with my fellow medical practitioners at the time, we discovered that telemedicine or telehealth was first introduced during the mid-1900s to 1980s. It was used by astronauts and the navy. 

Telehealth or telemedicine was designed to offer medical help to people even though they were far from the hospital. However, due to various limitations and restrictions, telemedicine is often the last resort of hospitals.

One of the critical things we needed to grasp during the debate was the idea of changing – changing systems, changing ideas, changing protocols.

Now in a crisis like this, a clear context of what to do to cope with change has become valuable. This is quite challenging as we have never dealt with something like this before. Covid-19 is a change that shook the whole world and forced us to adjust to the "new normal".

As a former practising doctor who has now taken the leap to telemedicine, I can attest to how simple and efficient telemedicine truly is. 

With telemedicine, you meet the doctor over the phone or video chat instead of in an in-person consultation. 

You discuss your symptoms and medical history with the doctor, who provides you with a diagnosis and sends any prescriptions to the pharmacy of your choice.

New era of healthcare

Indeed, the coronavirus, which has forced us to embrace physical distancing in the absence of a vaccine, has accelerated this new era of healthcare. Over the past four months, we have moved from almost 100% in-person visits to the majority of our care delivered virtually.

Amid the pandemic, telehealth companies are connecting patients to vital healthcare services through videoconferencing, remote monitoring, electronic consultations, and wireless communications. 

Indeed, because of Covid-19, numbers of virtual doctor visits have surged. Healthcare providers are trying to contain the spread of the virus by giving medical advice to patients remotely. Only the most serious cases receive treatment in person. 

This is also valuable for patients who need routine care for other medical conditions and for medical professionals who must continue to help the sick. Healthcare workers at hospitals, for example, are using iPads to communicate with patients in isolation. Virtual health service is being complemented by the "pick-up and drive-thru" services which were rolled out even before the advent of Covid-19 and "pharmacy on wheels".

Hospitals and doctor’s rooms have become an important focus point during lockdowns, and demand for medical services continues to grow exponentially as the pandemic spreads.

Besides Covid-19, the demand for treatment for medical conditions – like diabetes, heart disease, organ transplant, asthma and advanced age – continues unabated.

Capability, creativity and resilience 

The coronavirus has brought to the fore everyone's capability, creativity, and resilience. We never knew how capable we were of embracing technologies like telemedicine until we were forced to do so. 

Videoconferencing apps are making it easier not only for employees to work remotely to reduce the risk of spreading the coronavirus, but also for the sick to consult a medical practitioner.

It is amazing how, for people isolated by the coronavirus epidemic and others who don’t just want to take any risks, the tech sector has become a new best friend with an array of lifestyle solutions making "physical distancing" easier.

Telemedicine is making gains. Indeed, the technology used in telemedicine or telehealth is helping to reduce the risk and cost of infection to patients and medical staff alike, and has become a wonderful tool during the time of Covid-19.

Examples 

The medical services offered are similar to being at a clinic, hospital or doctor’s rooms, except that the consultation is done virtually. Photos or any other requests to the doctors must be sent online. This supplements other kinds of digital health that have been around for decades. 

Albert Luthuli Hospital, regarded as one of the most successful public-private partnership in healthcare in South Africa, has been running its radiology department digitally with all X-rays, magnetic resonance imaging scans and CT (computed tomography) scans sent digitally between providers and patients. 

We need to do all we can to facilitate the digital healthcare delivery that the recent pandemic requires. 

Adopting a universal standard for telehealth 

Recently I watched one of my associates, a radiologist, analysing the data of a distantly located patient, which made me increasingly convinced that modern technology can help us render quality healthcare even in the most rural of areas. Each and every patient should now be able to enjoy the same level of treatment regardless of their location.

Even as we embrace technology during these unprecedented times, we should not forget how the Covid-19 pandemic has amplified the importance of effective public service. The dedicated health workers who are often unappreciated and targeted by a frustrated public, are redefining the “front lines” and what it means to serve the public good. Their warm smiles, healing touch and careful observance of vital diagnostic signs and other clues, can never be replaced by any technology.

After Covid-19, I believe virtual consultations will become even more widely used, especially by patients with mobility problems. We need to adopt a universal standard for telehealth, which will require transparency and consensus-based practices to better guide developers, providers, and patients.

Covid-19 has demonstrated the vital importance of ongoing and robust investment in technology and the development of digital health. 

*Dr Anna Mokgokong is chairperson of the Afrocentric Group, South Africa’s largest health administration and medical risk management solutions provider, which owns health companies such as Medscheme

Image credit: Getty Images, additional photo supplied