CORRESPONDENCE

Telehealth opportunities for South Africa have been brought into focus by the COVID-19 pandemic

To the Editor: COVID-19 has starkly highlighted the fragility of the South African (SA) healthcare delivery platform. The unfolding of the COVID-19 epidemic coupled with over-stretched healthcare resources has given rise to the emergence of telehealth as a critical component of the healthcare crisis solution. Lockdown measures, reduced access to transport and patient safety concerns relating to visiting health facilities have all contributed to greater acceptability and accessibility of telehealth since the start of the pandemic. Globally, telehealth uptake has accelerated at a phenomenal rate in the past 2 years, and continues to do so.^[1] Telehealth holds the promise to significantly impact on some of the most challenging current problems of the SA healthcare system, including access to quality healthcare, cost-effective delivery, and addressing the disparate distribution of the limited number of healthcare providers.^[2,3] We are at an opportune moment to leverage telehealth to bridge inequity in access to quality healthcare for our citizens and need to ensure that this is achieved responsibly, with multi-stakeholder inclusivity and a renewed sense of urgency.

In this context we refer to telehealth as the broader application of technology to facilitate healthcare delivery, rather than telemedicine, which is a subset comprising the clinically appropriate use of technology-assisted consultations when in-person care is not feasible or preferred, or which may be mediated by another healthcare professional.

Sufficient planning and solid partnerships have made a major difference to developing effective national responses to the COVID-19 pandemic. Data-driven networks with both public-private and government-to-government partnerships have proved essential in this context.

While there are still significant challenges facing the adoption of telehealth, the responsibility to strive to provide access to quality healthcare rests on every contributor to the healthcare industry. Partnerships and collaboration at all levels (strategic, implementation -and evaluation) remain paramount to driving the adoption of patients and supporting doctors and clinicians with the necessary tools and strategies to deliver this service within an appropriate regulatory and ethical framework. In the context of the SA healthcare system, it is crucial that the planning encompasses public and private sector delivery and the opportunities for these to be harmonised.

To this end, we have established a multi-stakeholder advisory body, the Africa Telehealth Collaboration (ATC), which will crystallise a common medium-term telehealth ambition through collective effort at industry level, leading to a co-ordinated effort and an objective collation of resources to support addressing the aforementioned opportunities and challenges. We have identified the key focus areas for the ATC as:

• Education and training for healthcare professionals

• Infrastructure requirements and implementation support

• Regulatory requirements and industry engagement

• User perspective and concerns (patient or practitioner)

• Developing a research repository

• Provision of best practice guidelines.

We welcome widespread engagement and inputs.

Fathima Paruk, Unben Pillay, Dino Rech, Gloria Maimela, Thulani Matsebula, Roseanne Harris

Africa Telehealth Collaboration, South Africa

https://africa-telehealth.org

roseanne.harris@wits.ac.za

References

1. Portnoy J, Waller M, Elliott T. Telemedicine in the era of COVID-19. J Allergy Clin Immunol Pract 2020;8(5):1489-1491. https://doi.org/10.1016/jjaip.2020.03.008        [ Links ]

2. Olu O, Muneene D, Bataringaya JE, et al. How can digital health technologies contribute to sustainable attainment of universal health coverage in Africa? A perspective. Front Public Health 2019;7:341. https://doi.org/10.3389/fpubh.2019.00341        [ Links ]

3. Mars M. Telemedicine and advances in urban and rural healthcare delivery in Africa. Prog Cardiovasc Dis 2013;56(3):326-335. https://doi.org/10.1016/j.pcad.2013.10.006        [ Links ]