While deployment and adoption of telemedicine in the Asia-Pacific region is still in the early stages, the lack of skilled health workers and improving network infrastructure are increasing demand for such services, said one researcher.
Guan Cuntai, program manager, intelligent systems for personalized and connected healthcare at the Institute for Infocomm Research (I2R), noted that telemedicine deployment in the region is still in its early stage and yet to enter the mainstream.
However, adoption of telemedicine is starting to accelerate, particularly in countries with remote rural areas that are short of trained medical personnel, he noted. These countries include India, the Philippines and China.
Singapore HealthPartners CIO James Woo says remote patient monitoring is necessary even in a small nation like Singapore to help patients maintain their own health.
Guan pointed out that within Asia-Pacific, commercially available telemedicine services include teleconsultation, telediagnosis, telemonitoring and chronic disease management such as cardiovascular symptom monitoring through electrocardiography (ECG). The Apollo Hospitals Group in India, for instance, uses telemedicine for cardiology, dermatology, radiology and rheumatology, he said.
Singapore Health Services (SingHealth), the city-state's largest healthcare group, has also invested in telemedicine projects. SingHealth's group CIO Benedict Tan stated in his e-mail that these projects include its diabetic retinopathy program, teleradiology, telestroke and a health diary mobile app for rheumatoid arthritis.
Elaborating, Tan said the diabetic retinopathy program shortens the turnaround time for grading retinal photographs from four weeks down to within an hour. Previously, doctors had to grade these photos after clinic hours. With this program, Tan said the photos are electronically sent to a team of accredited graders hired by SingHealth for grading, thus cutting down time and freeing up doctors to focus on their core responsibilities.
Its teleradiology program, too, helps to balance the load from different SingHealth hospitals by allowing radiologists, regardless of where they are based in, to help read and report diagnostic images, the CIO said. For simple images, these are outsourced to a third-party vendor, he added.
Marc-Alexis Remond, global director for government, industry solutions and market development at Polycom Asia-Pacific, also highlighted some of the company's telemedicine projects in the region. In South Korea, he noted, the Korea Correctional Facilities have deployed a telemedicine network across four prisons in Daegu, Jinju, Gongju and Cheongju using its telepresence technology. This network allows prisoners remote access to medical assistance, thus cutting down on resources spent to transfer patients to hospitals and time, he noted.
Even as demand for telehealth services gains traction, Guan noted that changes in existing patient care processes to accommodate such services will be one of the major challenges medical institutions will face.
Remond added the lack of defined policies and regulations for telemedicine in the region is another obstacle. "Government-driven initiative is critical and a strong support from the administration ensures a long life for telemedicine programs," he said.
The Polycom director cited the Australian government as one that has taken an active role in promoting telehealth by incentivizing hospitals and healthcare professionals. For example, the country's Medicare program offers 50 percent bonus to specialists who utilizes telehealth technology while doctors, nurses and midwives who participate in video consults with patients stand to receive 35 percent of bonuses. This, Remond said, helps make telehealth more attractive and investments justifiable.
Lack of network infrastructure not a problem
Quizzed on whether the lack of a strong network infrastructure will hinder telemedicine adoption, Guan disagrees.
He said: "[In a country] where the infrastructure is not as good, simple telemedicine applications based on telephone, short message service (SMS) or Wireless Application Protocol (WAP) may be deployed."
That said, countries with good communications infrastructure are able to introduce more advanced telemedicine applications, the I2R manager added. Singapore's next-generation Nationwide Broadband Network (NGNBN), for one, allows for high-definition video telehealth conferencing to be deployed, he explained. SingHealth's Tan agreed. He said the nation's high-speed broadband network means that in addition to text information, the company can now introduce multimedia information such as images with better resolution and video teleconsultation.
"This is important as we are facing a nationwide shortage of healthcare professionals and an increase in the number of chronic disease patients," he said.
"To overcome the shortage of healthcare professionals, larger healthcare institutions such as SingHealth can provide remote support and advice to community hospitals and nursing homes. As for the increasing numbers of chronic disease patients, well established telecare can help them better manage their condition and reduce visits to clinics and hospitals. This saves time and money for both patients and healthcare institutions."