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

The Role of Telehealth in Disaster Management: Lessons for the Philippines

According to the WorldRiskIndex 2016, the Philippines is the third country most at risk of disasters in the world. Typhoon Haiyan, the strongest on local record, caused widespread destruction to life and property. Current disaster management strategies in the country do not include telehealth as a formal tool in disaster mitigation, response, or recovery. This study reviewed research incorporating telehealth in disaster management from multiple low and lower middle income countries like the Philippines to address this gap by identifying lessons the country might be able to adopt. Studies show that most initiatives centre on evaluating telehealth’s effectiveness during the response phase. Unsurprisingly, mobile technology and satellite communications predominated, and most projects were launched using donor funding. Use of telehealth in disaster management in the Philippines could begin by recognising and including telehealth in formal government protocols. The government could leverage the National Telehealth Service Program of the University of the Philippines National Telehealth Center. Documentation and systematic research on telehealth’s expected positive contributions to disaster preparedness and response should also be initiated