It has been observed that by the time patients come to seek treatment in clinics or hospitals; in many cases their ailment has already multipli to such an extent that it becomes a tough job for the health care professionals to treat the patients and even the healing process takes longer than usual. Furthermore, in recent years, there has been a considerable decrease in the health care professionals in the developing countries which has subsequently increased the demand for quality health care services for patients. The current health sectors reforms focus on the equitable, efficient and effective health interventions which are clearly spelled out in the Millennium Developmental Goals (MDGs) and the major challenge seemed to be faced by the health sector is the slow progress in improving the health related indicators.
In Pakistan, the infrastructure of health services is very strong which consists of Basic Health Units (BHU), Rural Health Centers (RHCs) and the District hospitals. The vast network of health care facilities consists of 5349 Basic Health Units, 4755 dispensaries, 562 Rural Health Centers (RHCs), 945 hospitals, 903 maternal child health centers (MCHs) and 290 TB Centers (Existing Infrastructure of Health care in Pakistan, 2009) but functionally it is being left high and dry due to the lack of resources. Moreover, according to the Health Expenditure Indicators by WHO, in 2009 Pakistan only spent 2 percent of its Gross Domestic Product (GDP) on health. This, also, is attributed to lack of resources. Other explanations for not getting early treatment, in a social setup like ours, are un-awareness regarding the disease process, cost of health care, lack of access to health care services and indolence to go to doctors rather getting it treated at home by home remedies.
In order to handle the unresolved issues in health sector, the emergence of Tele-health, a novel conception, has profoundly been seen as an emerging field and is making extensive contribution on improving curative, promotive, preventive and rehabilitative services of health sector. This includes telecommunication and use of electronic information for the benefit of public health via internet or telephones. Patients can communicate with health care professionals by means of telephone rather scheduling an appointment. This also incorporates video conferencing through which doctors and patients can see each other despite not being present in the same setting.
The World Health Organization (WHO) Regional Office for the Eastern Mediterranean (EMRO), 2005 has defined two modalities of tele-health, one is real time (live) tele-health in which interaction takes place between two persons via audio or video conferencing. The video-conferencing instruments are used along with peripheral instruments which are attached with the computer which assist the interactive examination of the patients. This modality is becoming common these days due to cheaper rates of communication channels. The second modality is known as the store and forward tele-health in which the information is being stored first which includes patient’s data, reports, x-ray images etc and it is then forwarded to professionals via telecommunication links.
The benefits of Tele-health encompass an unprompted access to health care services which, therefore, facilitates early diagnosis of the diseases and help in finding the solutions for basic health related problems. Furthermore, it has reduced the cost of health in providing quality care to the community living in the remote areas and decreased the uneven distribution of the paramedical staffs like doctors/nurses and even the availability of hospitals. Through tele-health, people with chronic illnesses also get benefits in compliance with their follow ups, and medications. The wide spread use of tele-health services could also allow the patients to access the tertiary health care facilities, reduce the frequent hospital visits through home monitoring, facilitate people for taking second opinion for their illnesses.
Moreover, tele-medicine has bridged the gaps by providing access to specialized hospitals, doctors and nurses. A systematic review conducted by Khoja and Durrani in 2007 revealed that Tele-health initiatives in Asia have increased the access to health care services i.e. they has improved the quality care, decreased travel time, decreased cost and have gained access to the specialists.
Conversely, shortage of health care professionals and proper infrastructure are few of the challenges faced by the tele-health. However, in Pakistan tele-health has been initiated successfully in Jinnah Postgraduate Medical Centre (JPMC) which provides tele-consultation to the under developed areas. Moreover, eHealth Association of Pakistan (eHAP) is the institution whose mission is to promote adoption and use of eHealth as an integral component of health services and education in Pakistan. Sehat first is also one of the institutions in Pakistan which provides tele-health consulting services that supports the local clinic staff with IP-based Video Phone consultations with a qualified physician which saves time, money and resources.
We always think that technology includes online patient’s records and online monitoring makes health care professionals smarter but there is also another aspect of this technology, Tele-health is also making patients smarter and empowering their health. Yet, there is a lot more to be done to make tele-health a powerful channel of health care delivery. Government should also work on the cohesiveness of health care and IT infrastructure so that underprivileged people living in rural areas could more and more get accessibility to quality health care services in a cost effective manner.
The ICT (Information and communication technologies) Age has dawned, but not yet for all. Let us show that we can unite the great potential of ICT with the needs of poor.
~Kofi Annan~
References:
1. Tele-Health Care. (2009). Existing Infrastructure of Health care in Pakistan 2009. Retrieved
March 19, 2010, from http://blogs.tele-healthcare.org/2009/01/existing-infrastructure-of-health-care.html
2. World Health Organization EMRO Office. (2005). E-Health in the Eastern Mediterranean 2005
Retrieved March 19, 2010, from: http://www.emro.who.int/his/ehealth/AboutEhealth.htm
3. World Health Organization. (2009). Health Expenditure indicators2009. Retrieved March 19,
2010, from http://www.emro.who.int/emrinfo/index.asp?Ctry=pak
4. Durrani, H., & Khoja, S. (2007). Tele-Health in Asia: A Systematic Review. Retrieved March 19,
2010, from Aga Khan University, Department of Community Health Science Website
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