Implementing Telemedicine & E-health in Developing Countries; Lessons from Developed Economies

Implementing Telemedicine & E-health in Developing Countries; Lessons from Developed Economies
CHAPTER ONE: INTRODUCTION
1.0 Background
Telemedicine is defined by WHO (2010) as “The delivery of health care services, where distance is a critical factor, by all health care professionals using information and communication technologies for the exchange of valid information for diagnosis, treatment and prevention of disease and injuries, research and evaluation, and for the continuing education of health care providers, all in the interests of advancing the health of individuals and their communities” (P8). Telemedicine provides many health services both in preventive health care as well as in medical education. Combi, Pozzani and Pozzi (2016) explain that varying information systems are applicable in delivery of care: hospital-based electronic patient record (EPR), patient administrative system, tele-pathology, tele-radiology, tele-psychiatry, tele-dermatology, tele-oncology, and so on. Application of telemedicine in healthcare is significance as it helps in improving the management of diseases, increase patient satisfaction, increase productivity, reduce cost and prevent medical errors.
According to Benedict and Schieter (2015), telemedicine assists in delivery of care between locations that are separated geographically by the use of medical expertise through the application of telemedicine and E-health. Physicians from one location may diagnose, treat and provide consultation to patients at remote regions. This illustrates the significance of telemedicine in rural and remote regions which have challenges accessing healthcare services. The aspect of telemedicine has been greatly applied in rural areas in developed economies a concept which developing countries requires to borrow from these rich economies. Although developed countries have adapted and improved telemedicine, technical and organizational factors continue to inhibit developing countries from fully using E-health.
Majority of developing countries need to apply telemedicine as it is beneficial in many situations like when physicians and patients in rural areas requires assistance in the provision of care, when there is inadequate medical specialist, and when the ratio between physicians and patients is high. Besides, majority of these countries are overpopulated, which increases the physician patient ratio. In addition, some populations in rural areas are not able to access care. Therefore, the current study explores the condition of information structures the current situation of telemedicine and E-health in developing countries and what they can borrow from developed countries. There exist several literatures in respect to telemedicine in developed economies.
1.1 Rationale
Majority of developed countries have effectively utilized telemedicine and are reaping the benefit of the technology in improving care delivery (Frost, Tran, Khatun, Friberg & Rodríguez, 2018). This is because telemedicine in developing countries is an efficient tool in the provision of quality healthcare, efficient way of sharing healthcare knowledge and a good communication tool. Developing nations have an essential lesson to learn from developed economies. Majority of developing countries particularly in Africa are overpopulated with high number of people living in rural regions which are challenging to accessibility of healthcare services. Such countries hence require telemedicine as it will assist in linking medical personnel with patients in rural regions where it is challenging for the population to easily access health. My enthusiasm in the public health issue in developing countries is due to the high number of people in rural areas who are not in position to access healthcare services. These populations may be in better position of receiving such services through the aspect of telemedicine and E-health. During my graduate level, I had an opportunity to study community medicine where I had a chance to explore on health issues facing developing countries. I identified that majority of health issues particularly preventive medicine can be effectively reduced if not eliminated by telemedicine. To fully adopt these technologies in these countries, they require to borrow strategies of using telemedicine and E-health from developed economies which have successfully implemented the technology in their system. As a health professional, my interest is exploring current conditions of telemedicine in developing countries. This is because telemedicine in developing countries has the ability to provide a better opportunity for sharing best practices with health professionals, increase inter-hospital and inter-departmental collaboration and communication, reduce the cost of health system’s operations, enhance better resource allocation, and reduce waiting times for patients. Therefore, it is crucial to explore on Telemedicine and E-health in developing countries and identify some of the tactics they can borrow from developed economies to ensure success of the technology.
1.2 Research Aim and Research Objectives
The aim of this work is to identify how developing countries can implement Telemedicine and E-health in the delivery of care by learning the strategies that have been employed by developed economies. Hence, the objectives of the study are:
To identify the current situation of information structure in healthcare systems in developing countries
To explore on the barriers or challenges facing developing countries in the implementation of telemedicine and E-health
To identify the strategies that developing countries can borrow from developed economies to successfully implement telemedicine and E-health
1.3 Research Questions
Therefore, this dissertation will be based on the following research questions:
What is the current situation of information structure in healthcare systems in developing countries?
What are the barriers or challenges facing developing countries in the implementation of telemedicine and E-health?
What strategies can developing countries borrow from developed economies to successfully implement telemedicine and E-health?
1.4 Study Design
The current research follows a qualitative research methodology where the author will gather data through systematic reviews of articles that explore on the aspect of telemedicine and E-health in developed and developing countries. The articles to be used are not more than five years from the date of publication. This ensures that the study constitutes of recent information on telemedicine both in developing and developed countries. The reason for following a qualitative research design is because it is inductive and helps a researcher to generate new hypothesis.
1.5 Contribution of the Study
The study provides an overview of current telemedicine programs in developing countries as well as other scopes of implementing telemedicine and E-health. The study consists of challenges or barriers that are faced by developing countries. The generated findings will benefit authorities in developing countries to outline the status of telemedicine in their countries and its benefits to increase the effectiveness of care provision. The study also identifies the strategies employed by developed countries where the authorities can borrow in the strategies, and remodel existing telemedicine programs. Additionally, the current study will form baseline for future researches related to information technology in healthcare sector in developing countries.
1.6 Research Organisation
The current study will be organised as discussed below. The introduction chapter will be followed by chapter two which I the literature review. In this section, the author will explore on the aspect the aspect of telehealth and E-health in developing countries. This discussion will be based on the theories of Actor network theory (ANT) and Information Infrastructure II. The name chapter will explore on the scope of telemedicine in developing countries as well as challenges or barrier of this technology in these countries. This chapter will be followed by chapter three which will discuss the research methodology and includes the purpose for the study, the research questions, explore on qualitive research design, data collection method, ethical consideration as well as the limitation of the study. Chapter four will follow which will include the findings for the study, followed by chapter five which is the discussion for the study in relation to above theories. The last chapter is on conclusion and recommendation and the reference list will be on the last section.

References
Benedict, M. and Schlieter, H., 2015. Governance guidelines for digital healthcare ecosystems. EHealth2015–Health Informatics Meets EHealth: Innovative Health Perspectives: Personalized Health, 212, p.233.
Combi, C., Pozzani, G., & Pozzi, G. (2016). Telemedicine for Developing Countries. Applied Clinical Informatics, 07(04), 1025-1050. doi: 10.4338/aci-2016-06-r-0089
Frost, M., Tran, J., Khatun, F., Friberg, I., & Rodríguez, D. (2018). What Does It Take to Be an Effective National Steward of Digital Health Integration for Health Systems Strengthening in Low- and Middle-Income Countries?. Global Health: Science And Practice, 6(Supplement 1), S18-S28. doi: 10.9745/ghsp-d-18-00270
WHO. (2010). Telemedicine Opportunities and Developments in Member States. World Health Organisation. Retrieved from https://www.who.int/goe/publications/goe_telemedicine_2010.pdf