2020 Vision: What COVID Taught Me About Healthcare Systems

By Daniel Abrego

Managing healthcare systems this year has been an eye opener for me. The deficiencies in structural institutions, the supply chain inefficiencies, the lack of consensus on priorities and even cultural factors making systems resistant to change. The pandemic revealed uneven distribution of doctors, geographical barriers exacerbated by Covid restrictions, health insurance still uncommon and discrimination caused by uncertainty and fear.

However, most problems also offer unique opportunities and it is impossible to stop hoping.

What I have learnt this year, is that the key to bridging these disparities is through digital transformation. Telemedicine, and more broadly, telehealth, can provide accessible and reasonable healthcare and medicines to greatly protect and improve the health and well-being of populations. While this has been successfully carried out in developed countries, Latin America is woefully behind in digital transformation because few countries have a national digital health strategy.

Yes, Uruguay has been quick to adapt, with one study by Global Health Intelligence quoting that 54% of its hospitals are offering telemedicine. Guatemala is not far behind at 45%. Panama’s lawmakers have approved a very solid telemedicine law this year and the Dominican Republic’s new government is evaluating its implementation. While these countries are mid-size markets that have quickly achieved a high degree of technological connectivity, larger markets such as Argentina and Mexico are still to partake in the benefits of telemedicine. One thing is for sure. The surge for this demand is not going away even post-Covid, and everyone from physicians to patients must be made aware of the benefits of telemedicine.

What is telemedicine?

Imagine a centralized system where all patients have their data sent to a central database. Every person has a personal account in the real-time portal where they can access their healthcare records, insurance details, as well as have access to medical information and live consultations. Telemedicine can work in parallel with the Internet of Things to monitor chronic conditions and allow physicians and pharmacists to check in at any stage of diagnosis or prescription.

What are the benefits?

Since the cost benefits of reaching more people while easing the burden on hospitals are obvious, I would like to highlight other benefits that will be relevant even post-Covid.

First, telemedicine is valuable for mental health, which is a growing public health concern. Patients suffering from anxiety disorders, domestic abuse etc. can get the help they need from virtual visits and continuity of care from their familiar and comfortable home surroundings, enabling greater honesty and dialogue through counseling.

What about the physician sitting at home who can derive extra income through virtual consultations instead of being idle and not providing any service at all? At the same time, his patient does not need to take extra time off work, has less chance of catching or spreading contagious illness by visiting hospital (either at the hospital or during the journey there) and can get quicker referrals to a specialist.

Let’s not discount people who have mobility issues. Those who would like to visit a doctor but can’t. At least they will benefit from virtual interactions and come to realize it is as good as in-person healthcare.

And while the perception is that people will lose jobs to a computer, the opposite is true. Patients are more likely to be sent to local clinics for further checks or procedures which feed back into local businesses and develop local talent.

Changing the way people think

The World Health Organization highlights the need for coordinated actions, with political will, capacity building and attention to specific needs. I do believe governments have health as a priority but I also believe this is easier said than done. Each country is at a different level of maturity in terms of digitizing and regulations. However, Covid has been a reality check and has provided painful lessons. It is forcing political and social change with glaring signs about which direction we should be taking and what needs to be executed. It is up to us whether we advance in a positive or harmful way.

Yes, there are concerns that can be brought up: start up costs are too high, older patients and doctors won’t take to the technology, insurance companies are not on board, IT literacy is low, and patients prefer real-life bedside attention. You can poke holes in anything, but the bottom line is that regulations can be changed overnight, both state and private funding will come with this new shift in paradigm and vulnerable populations are going to be assisted rather than neglected.

It is a challenge but governments need to bring down barriers. They need to encourage public and private sectors to work jointly in overcoming communications and infrastructure gaps in the region.

Most importantly, to ensure success, telemedicine needs to be an integral part of the state’s health system. It should be considered a key part of the national health strategy. It is technology meeting healthcare, it is not a side business. Technology plays a big role in our lives and making telemedicine mainstream will radically improve patient health while reducing cost of care.

Daniel Abrego is Managing Director at Farla Medical International S.A. His role is to lead Farla’s efforts in delivering end-to-end solutions to Latin America’s largest institutions. He has a long standing interest in the pharmaceutical field and advises on integrating technology with healthcare through expanding Inter Hospital Logistics across Latin America.