The use of telemedicine in health and social care: myths, benefits, barriers
April 6, 2022 News

The use of telemedicine in health and social care: myths, benefits, barriers

Moldova is facing a rapidly ageing population. In 2020, the number of people over 60 years represented 21.8% of the country's total population, and the share of this age group is constantly increasing.  In response to this phenomenon, the public authorities and NGOs have developed several health and social care services to ensure that older people can live decently and independently in their own homes. But progress in these efforts has been hampered by the COVID-19 pandemic which has affected the effective and continuous provision of these services.

Telemedicine - a new form of care

Travel restrictions complicated the process of providing medical and social services, particularly in remote geographical areas. Social-medical centers have been forced to turn to alternative ways of communicating with their beneficiaries, and telemedicine has proven to be a safe and effective solution to this.

Telemedicine is based on the use of technology and the internet and can offer the opportunity to provide care and health services remotely, when the doctor and patient are in different locations.

First used in the 1950s by the aerospace company NASA to monitor the health of cosmonauts sent into space, telemedicine improved much more over the years and has continued to develop.

Despite its enormous potential and accelerating degree of technology, the use of telemedicine has registered modest rates of adoption. But the health crisis and the pandemic context has brought telemedicine out of the shadows and propelled it strongly into the forefront.

The benefits of telemedicine in health and social care services

It is true that telemedicine cannot replace a clinical medical examination, but it can fully substitute a primary consultation or a health monitoring consultation for elderly people or people requiring permanent care, generating benefits for both the patient and the staff involved in the medical act.

The benefits of telemedicine in health and social care services are numerous. It unburdens the primary healthcare system; gives patients access to healthcare professionals from home and abroad; reduces patient travel costs and waiting time for on spot visit; free people with reduced mobility from an arduous journey.

Not least, telemedicine limits face-to-face interaction and thus helps to stop the epidemic. Thanks to telemedicine, healthcare professionals are also safe and can provide quality healthcare from wherever they are.

Myths and fears about telemedicine in health care services

Although it combines many advantages, myths have not bypassed telemedicine, and these untruths prevent the solution from being embraced more widely.

The most common myths spread about telemedicine are:

- Telemedicine is difficult to access for older people

Fact: Telemedicine involves the use of technology, specifically the use of a computer or a mobile phone or tablet connected to the internet. But the interaction between healthcare professionals  and patient, either audio or video, is very similar to the audio or video interactions that the elderly have with their beloved (children, relatives, grandchildren) when using technology.

If the elderly have no difficulty using apps such as Viber, Messenger, WhatsApp, then they will easily be able to access telemedicine services.

- Online consultation will not be as high quality as face-to-face consultation

Fact: The quality of online consultation is no different from the quality of face-to-face consultation. If the patient's health is stable and the patient does not require a clinical examination, but only needs monitoring or interpretation of tests or results, then the information the patient would receive in the doctor's office would be exactly the same as received in an online consultation.

- The appointment with the doctor will be limited in time and will be scheduled at times inconvenient for the patient.

Fact: Like the in-office consultation, the online consultation is allotted an exact number of minutes.

The advantage of the online consultation is that the doctor will devote a time slot exclusively to the patient with whom he/she is connected and will not be interrupted by various external factors (e.g. another patient knocking on the door).

As regards consultation times, the patient has the possibility, just as in the case of an in-office consultation, to choose the times that are convenient for him or her, but which respect the schedule announced by the doctor.

- The doctor cannot prescribe a treatment in case of an online consultation

Fact: An online consultation does not block the doctor from prescribing treatment if the patient's health condition requires it.

Barriers to telemedicine in the Republic of Moldova

Like any new practice, telemedicine has multiple challenges. Among the most severe problems are:

- The lack of a regulatory framework governing telemedicine and its adaptation to European standards. Currently, there are more than 41 legal acts in various fields, about 10 key actors operating 21 health information systems that are not interconnected and interoperable. All this makes it difficult to implement telemedicine and access data, and requires keeping dual records of digital and paper data.

- Lack of technical quality standards in the field and lack of educational guidelines in this respect.

- Lack of a homogeneous digital infrastructure across the country, uneven internet penetration and the disproportionate equipping of households with modern computers or telephones.

- The need to increase public confidence in telemedicine.

- Limitation of the medical specialities in which telemedicine can be applied.  Currently, telemedicine is most commonly used in family medicine, dermatology, endocrinology and psychological therapy services.

Although the barriers to telemedicine cannot be overlooked, it is an excellent alternative for elderly patients, people with reduced mobility or people who need a follow-up consultation or interpretation of tests or results.

Moreover, telemedicine could represent a turning point for the medico-social care system in Moldova and could be the solution to the many problems we are facing, namely: the rapid ageing of the population, the proliferation of chronic diseases, the need for home care of the elderly and the uneven territorial distribution of telemedicine services.

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Caritas Czech Republic, in partnership with the Homecare Association, has launched a pilot project for the implementation of telemedicine in 8 medical-social centres in the country. The initiative, with a budget of EUR 345,000, aimed at equipping the health centres with the necessary technology to provide telemedicine services, training the staff of these centres in the use of the equipment and, last but not least, regulating and creating working standards in the field of telemedicine so that this pilot initiative can be replicated and extended nationwide.