COVID-19 has accelerated digital transformation efforts in many countries. A key priority behind this progress has been to increase the reach and relevance of public services - particularly those focusing on saving lives and livelihoods. Telemedicine, healthcare services delivered through digital and other means, is proving important in the context of stretched or unavailable health systems. And, it could have a significant role in any post-COVID-19 world.
Its impact in Pakistan hints at this potential. By December 2020, the country has recorded more than 451,000 COVID-19 cases - resulting in over 9,000 deaths. A country wide lockdown imposed in March 2020 inhibited many patients from getting timely treatment for COVID-19 and other related issues in an already fractured and sprained healthcare system. Even as the lockdown was lifted in May 2020, many hospitals struggled to cope up with increased demand for qualified healthcare professionals to deal with the ongoing pandemic. Since November 2020, Pakistan has seen an increased surge in daily cases to over 3,700 in early December; the situation in the hospitals remain dire due to lack of resources and increasing number of cases.
Like in many other countries, patients in Pakistan are scared to visit hospitals to avoid COVID exposure. Elderly, pregnant women, and patients with pre-existing health conditions are at higher risk while also being more in need of medical help at all times. During this time of the ongoing pandemic, telemedicine is playing a pivotal role in acting as an enabler to help many patients in need.
The United Nations Development Programme (UNDP) Pakistan has partnered with Sehat Kahani, a health tech social enterprise with a network of 27 e-clinics across Pakistan, that connects patients to qualified doctors via a telemedicine based mobile and web solution— to accelerate the efforts to support Pakistan’s healthcare system.
To bring quality medical practice to Pakistan and further make the healthcare services more accessible for all, physicians and specialists of Pakistani origins were reached out through Yaran-e-watan to continue their practice through telemedicine platform. More than 30 consultants trained in pulmonology and critical care among other specialties joined the application during this critical time. The mobile application was made free for accessing teleconsultations so that the patients could avail health services through their smartphones within the vicinity of their homes. A 24/7 helpline was also launched to provide COVID-19 related information, referral to an online doctor for suspected cases and follow ups during home isolation for positive cases. More than 300,000 consultations have been done, out of which 3% were COVID-19 suspects.
UNDP and Sehat Kahani have also collaborated with the Ministry of National Health Services, Regulation and Coordination (MOH) in upgrading 60 ICUs in Pakistan’s public and private hospitals to Tele-ICU using the application. This has helped the ICU’s staff to connect to teams of skilled critical care nurses and intensivist doctors to monitor thousands of patients at hundreds of hospitals virtually. In the coming months, 4,000 doctors will be trained across Pakistan to use this platform. This remote monitoring technology at the ICUs provides an added level of clinical support, and helps hospitals prevent potential patient complications.
Laura Sheridan, Project Manager of Youth Empowerment Programme, UNDP Pakistan described the multipronged advantages of telemedicine platform and said,
'Telemedicine can be an accessible and affordable route to providing quality healthcare to patients especially those in remote communities where healthcare systems are inadequate. It also maximizes the potential of women physicians who are not being utilized to their complete potential owing to societal and cultural norms. The telemedicine platform not only helps in building a more equitable and resilient society but also contributes to UNDP’s goal of improving lives of the people of Pakistan.’
Dr. Sara Saeed Khurram and Dr. Iffat Zafar Aga, co-founders of Sehat Kahani explained their contribution during the pandemic;
‘We have observed a multiplier effect when we talk about COVID-19 affecting myriad lives globally. In the interim period Sehat Kahani tried to positively impact the lives of those who were affected, by making the GP services free for all its users back in March Times are tough, but we as a nation need to stand and fight together to ensure that we come out stronger and more synchronized.’
Telehealth has also been proven successful and effective in other countries like Brazil, India, Philippines and Nigeria during the COVID-19 pandemic. Beyond the COVID-19 pandemic, telehealth at scale has the potential to significantly improve health equity, especially in countries with low primary healthcare coverage, because it can improve the accessibility for patients who face challenges related to geography or disability.
But while telehealth services are now available in many countries around the world, public and private health providers are facing challenges to implement and scale up these services cost-effectively and systematically. The challenges typically relate to a lack of national policy and regulatory framework, weak governance structures, low client and provider adoption rates, weak health workforce capacity and digital infrastructure (and digital exclusion), as well as issues relating to service quality, data privacy, and institutional resistance to digital disruption. In addition, the rapidly evolving technology space and the overwhelming diversity of available tools have made it difficult for actors in health systems to identify, adapt or develop solutions that are appropriate to their specific context and needs.
Building on the successes of Pakistan and other countries, the UNDP Global Centre for Technology, Innovation and Sustainable Development in Singapore and the HIV, Health and Development Team (UNDP Bangkok Regional Hub) are working to highlight and enable these benefits - particularly in countries where healthcare systems can most benefit from the improved inclusion and quality of healthcare that telemedicine can deliver.
Calum Handforth, Advisor, Digitalisation and Smart Cities, UNDP Global Centre for Technology, Innovation, and Sustainable Development
Maryam Inam, Reporting and Communications Officer, UNDP Pakistan
Mehak Karim, Lead Grants and Research, Sehat Kahani
Ayesha Babar, Communications Analyst, UNDP Pakistan