I have been writing a few articles on telemedicine in developing countries for two weeks now. Before writing about this topic, I have to admit I had very little knowledge of the subject itself. After this two weeks of reading and writing, I think I have a fair idea what telemedicince is, the advantages, disadvantages and still trying to decide if PNG needs a network.
The advantages of telemedicine
There are some benefits of having a telemedicine network in a developing country and I think these mainly address the shortage of specialist human resource. For example, there is not enough doctors, especially specialists, in a country like PNG and this is one area that telemedicine can help. Improving and creating new professional network between doctors from developing countries and high income countries is another.
Providing a continueing medical education service for doctors in the bush will also help rural doctors to keep in touch with the rest of the world. After all, medical practise is determined by research data and we need to update ourselves once in a while.
These are but some of the advantages that telemedicine has to offer to countries like PNG.
The disadvantages of telemedicine
The major obstacle I see right now is the costs. The costs of not only setting up a network but actually sustaining the telemedicine network. Information communication technology seem to change every year and regular updates will be required.
My other concern is that there is a risk of the local health care system becoming “too dependent on outside help”. The telemedicine network in developing countries is usually set up with “out side help”. What will happen if the “out side help” decides to roll back its support?
Conclusion
And so I will stop here on the issue of telemedicine for the time being. However, I will continue exploring the posibility of a telepathology network in PNG and see if I can help set up one some day.
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I think it has a future though you make a good point that there is a risk of becoming dependent on outside help. But this can be addressed by raising education levels and getting more PNG doctors and medical and IT professionals out there. Telemedicine defintely has a role to play with broadening the experience and exposure of Doctors we have now though.
I don’t agree that technology is turning over so fast that it would create a great expense. The basic levels of tech we have now would suffice for many years to come. And at any rate, the PNG government is not exactly short of cash. The recent resources boom led by forestry and mining has seen a lot of income to the country. The money is there it just needs to be distributed and accounted for properly.
PS: I am looking into what sort of Micro-power generation scheme would be appropriate for a telemedicine clinic. Study is still at the early stages but at the moment Hybrid-Technology could be the way to go.
I think telemedicine, and my interest is in telepathology, certainly will greatly enhance the speed of diagnosis.
The challenge for me I think would be to convince those that control the purse that telemedicine can solve some our specialist shortage problems so they can fund such a project. After that, it would be another challenge to make sure I get enough money annually to keep the service going.
Certainly, as you said, money is not an issue. I just have to convince those that control it to give me some. In PNG, where priority spending seems to be lacking, I have a battle ahead of me.
Danger, keep me posted on your study results. Might come handy some day.
Before considering plans for telehealth, telemedicine and telenursing, the benefits around telehealth technologies have to be considered. That includes the benfits that the patient will have or the health care consumer in -terms of improved access to quality and where necessary “expert’ health care opinion and advise. Also be mindful of the local geographical environment.
There is much to be done in these field of telemedicine/telenursing/telehealth in PNG.
there are also criticisims of losing the therapeutic derived from a physical face to face encounter between the health care provider and the patient, the privacy and legal issues has to be resolved. In PNG, most the people do not have the money, skills, and access to computer networks and can not use the computer effectively. As a result these patient population( which will actually benefit the most from health information) are those who are the least likely to benefit form advances in information technology, unless politcal measures ensure equitable access for all. PNG approach to eHealth will be some 100 time.
Certainly the major limiting factor would be the technologies involved. But I do not think it’s a big obstacle.
The major thing to consider as you rightly pointed out would be the cost-benefit ration. Would the cost of introducing telemedicine benefit a significant portion of the population that need the services? And would the services improve from the current state of affairs?
One of the occupational hazards working in the remote areas of Pacific is the “De-Skilling”. I am certain that with examples set in Micronesia with the assistance and guidance from Dr.Person from Hawaii University. The novel way of utilization of telemedicine and offering surgical advice live on telemedicine and a difficult surgery was performed in the remote Micronesia. It was an orthopedic patient and was totally immobilized was difficult to transfer to Honolulu.
My point is even in PNG there remote areas where health workers need guidance on a day to day level.
As my personal experience of managing 52 health centers manned by single health worker known as “Health Assistant” in the remote Outer Islands of Marshall Islands training and providing day to day clinical guidance through the 2 Way communications radio was memorable. Those clinics were spread out in 19 atolls spread out in 700, 000 sq miles of ocean.
I strongly recommend to wealthy countries to invest in these sorts of technology rather than developing weapons for waging war against human kind.
The Papua New Guinean government should definatley look into establishing a telemedicine network in PNG. A larger proportion of the population is concentrated in rural areas, whether or not the telehealth information and communication technologies (ICTs) are the latest or as advanced as those used in developed countiries’ telemedicine systems should not be the issue, rather the fact the such a system should be set up. It is better help is available then not available. ICTs are costly, however, it is important to invest in telehealth for the sake of Papua New Guineans.