Implementation of Telemedicine Services in Lower-Middle Income Countries: Lessons for the Philippines

Regardless of the promising potential of telemedicine to address healthcare problems, especially in lower-middle income countries, its success rate has been unsatisfactory and many telemedicine services fail to sustain their implementation shortly after initial funding or after a pilot phase. Therefore, it is important to document existing models of telemedicine implementation in these countries, to identify commonalities and extract experiences that would be useful for implementers, policy makers and future researchers. This review seeks to review and describe the experience of Low and Middle Income Countries (LMICs) in implementing telemedicine services. Evidence extracted from the included studies were analysed through a narrative synthesis which suggests a multi-sectoral approach for implementing telemedicine. It highlights the importance of education, financing options, policy, technology, governance, and partnership, in the wider picture of a sustainable telemedicine implementation among developing countries such as the Philippines. Moreover, the literature reveals both top-down and bottom-up approach for successful telemedicine implementation. These approaches include strengthening the local health workers and integrating telemedicine into the health system. Studies included in this review have been helpful, but there is an obvious lack of studies with high level of evidence that can yield generalisable, thus findings must be inferred with prudence. Even so, this review described and summarised the data which allowed description of factors and lessons in the implementation of telemedicine in LMICs