The increasing penetration of digital technologies and the ubiquity of smartphones and the internet have transformed several spheres of our lives. Healthcare is no exception.

With technological advances, it has become possible to consult physicians and specialists from the comfort of your home. The practice, known as telehealth or telemedicine, has come a long way since its first use in the mid-19th century.

It promises to revolutionize healthcare with fundamental benefits such as improved access, cost-effectiveness, and convenience.

While telehealth benefits all healthcare services, it is especially valuable for primary healthcare (PHC) which accounts for about 80% of a person’s medical needs in their lifetime. Fortunately, interest in PHC has regained after the recent renewal of the declaration of Alma-Ata by WHO.

As technology becomes more affordable and accessible, providing PHC through telehealth facilities can create a healthy society.

The State of Primary Healthcare During the COVID-19 Pandemic

The 1978 declaration of Alma-Ata wasn’t implemented on a substantial scale worldwide and reliable PHC remained a dream. To complicate matters, when the pandemic happened and wreaked havoc, no country was found 100% ready to manage it and provide quality primary care.

Strict quarantines and social distancing guidelines prevented people from seeking treatment for illnesses, including COVID-19. Moreover, with in-person clinic visits reaching a record low globally, healthcare providers could not extend help to the sick owing to staffing issues and heavy financial losses.

With a quarter of all global COVID-19 cases over and above numerous regular patients, the well-resourced USA became one of the worst-hit countries. High demand and low supply overwhelmed healthcare to an unprecedented level. Primary care worsened with issues such as delays in testing, irregular communication, inaccessible healthcare services, and inconsistent government guidelines. Even patients with chronic diseases weren’t able to get quality healthcare and had to wait long for follow-up visits.

How Telehealth Services Saved the Day

Rather dormant before the COVID-19 catastrophe, telemedicine has since witnessed a remarkable upsurge. The use of telehealth services peaked at 78x in April 2020 just a month after COVID-19 was declared a pandemic. Although in the following months, it dipped and stabilized at around half the peak, it has surpassed the pre-COVID era. Telemedicine is here to stay.

Telemedicine proved to be a blessing during the pandemic for numerous people worldwide. Not only was it successful in preventing virus transmission substantially, but it also resulted in improved accessibility for people with mobility issues, better outcomes, and patient satisfaction.

Several studies conducted during and after the pandemic corroborated the positive effects of using telehealth services. One study by Mary Reed, a research scientist at Kaiser Permanente Division of Research, suggested telemedicine could improve primary care access in remote areas. Additionally, those who consulted through video were more likely to do it again. She commented positively, “This could be a sign that patients had a good experience and wanted to use video again.”

What Does the PHC-Telemedicine Alliance Look Like Today?

Today, more than ever, telemedicine is equipped to provide high-quality primary health care to people worldwide. Its proper integration with emerging technologies both in the medical and information sectors can make it a blaring success.

Telemedicine provides opportunities for a wide range of telehealth services from primary healthcare to secondary and tertiary care. People are increasingly moving towards virtual medical visits, making it a new normal.

Telemedicine is effectively used to provide primary care in several ways such as

• Audio/Video consultations
• Remote patient monitoring and treatment
• Online medication prescriptions
• Mental health management
• Personalized health monitoring, especially in remote regions
• Preventive healthcare education
• Remote training of healthcare providers

Several other advances have been made in the demand, usage, and implementation of telemedicine in the 3+ years of its expansion post-pandemic. Telehealth platforms have popped up like mushrooms and offer remote testing, patient education, continuous monitoring, and counseling services. Governments and regulatory bodies have quickly revised budgets and policies to promote telemedicine. Even insurance companies have made amendments to cover telemedicine expenses.

When combined with technologies such as wearables and IoMT, ML/AI, AR/VR, and cloud computing, telemedicine may emerge as a star in the healthcare industry.

Roadblocks on the Telehealth Highway for PHC – Is it Worth it?

Every new technology needs to pass through an acid test. Telemedicine is no different. It has a few challenges that must be addressed to streamline it for future generations.

One of the concerns is the lack of access to high-speed connectivity and PCs/smartphones in developing countries. Plus, several people lack digital literacy to operate the devices. It might exacerbate the very thing telemedicine is trying to mitigate – health inequities. Organizing awareness programs and making affordable devices available to the general public can take care of this.

Another issue is its non-acceptance by insurance companies and hesitance to cover the expenses. Forming laws that enforce reimbursement for telemedicine costs can solve this issue.

A prime concern of people with telehealth platforms is the question of privacy. They are worried someone might overhear their consultations or their data might get compromised and misused. Developing secure systems compliant with HIPAA or GDPR ensures consumer data protection.

Nonetheless, several steps are underway to overcome these challenges. Collaborations between tech leaders and healthcare providers support the funding and innovation required to make telehealth services accessible to underprivileged classes/regions. Several non-profits are also working towards the proliferation of technology and affordable healthcare in underdeveloped countries.

While there are a few challenges to telemedicine adoption, its benefits far outweigh the bottlenecks:

• Improved access for people in rural/underserved areas
• Convenient for people having logistical difficulties
• Cost-effective for both patients and providers
• Timely care for patients with critical illnesses
• Better patient outcomes and satisfaction

Telemedicine for PHC – The Road Ahead

PHC ensures the overall well-being of our communities. As per WHO recommendation, an additional investment of US$ 200 to 370 bn per year in PHC can potentially save 60 million lives in developing countries. Investing in telemedicine to make PHC globally accessible is one way forward.

In a global summit on PHC held in October 2023 to commemorate the 45th anniversary of the Declaration of Alma-Ata and the 5th anniversary of the Declaration of Astana, Dr. Kluge (Regional Director, WHO-Europe) issued a call to action to all countries, “…to reclaim the promise of achieving health for all through PHC,… and convert that promise into a reality that uses innovation, such as new technology that wasn’t available 45 years or even 5 years ago.”

The potential to improve healthcare access, quality, and affordability and embrace the multi-billion dollar industry exists right there. Collectively, we can realize the vision of making quality healthcare a birthright for every individual on the globe.

Author Bio

Joseph Ereyi

Joseph Ereyi is a finance and tax expert with a Bachelor’s degree from the University of Wisconsin-River Falls. He’s a devoted husband and father of two, who balances his professional life with a love for sports. Joseph enjoys playing basketball, staying active with regular workouts, and indulging his passion for golf. He’s also the proud founder of 24Hr Doc, reflecting his entrepreneurial spirit and commitment to healthcare innovation.