Telemedicine: Ready or not, here it comes!

BY: NEIL H LAWRENCE

Tuesday, April 02, 2019

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One could argue that telemedicine has been around informally since the telephone and electronic mail became popular in the 90s, given that privileged patients since then had their doctor or pharmacy on speed dial for support, therefore not having to move a muscle.

Telemedicine is defined as the remote diagnosis and treatment of patients by means of telecommunications, which eliminates the need for a physical meeting.

Talks of telemedicine have been more pronounced of late, but why?

Similar to how demand and supply drive the foreign currency movement, the need for more accessible and faster medical care is propelling the relevant decision-makers and innovators to revamp the regulations and systems that govern this area.

Moreover, there has to be a complete overhaul and integration of these systems to facilitate the optimal end to end experience for patients. The key areas are:

• Setting appointments with and seeing a doctor online;

• Sending lab test requests online;

• Sending prescriptions to a pharmacy online for pickup or delivery. This is more effective if stock levels for the pharmacies are integrated;

• Maintaining one database for patient history; and

• Payment to doctor, lab or pharmacy online (including health insurance adjudication).

Some elements of the above are already in place for Jamaica but in isolation and independently managed, which makes the integration effort further south. For telemedicine to work effectively with minimal risks, legislation will have to drive the process so that all systems and integrations follow suit via clear approval mechanisms. The ongoing policing is also important to mitigate cases such as misdiagnosis or drug abuse that perhaps are risks today even without telemedicine. The key is to minimise the potential for hundreds of unregulated applications in the market managing our health.

In developed countries such as the United States or United Kingdom, seeing a doctor write a physical paper prescription is like seeing a ghost. The norm is for the doctor to use his/her computer to send an e-prescription once the patient names the pharmacy from which they intend to pick up the medication. Imagine how difficult and confusing it is here in Jamaica for foreigners!

Of note, however, is that these developed countries have over 90 per cent Internet penetration, which is useful to telemedicine's success (or any other internet-based solution), versus Jamaica currently at 60 per cent. For maximum effectiveness of telemedicine, internet accessibility has to improve via initiatives to lower smartphone prices and data plans by telecommunication companies, or provide more managed, free Wi-Fi areas similar to what Growth-Tech is doing through the Jamaica Urban Transit Ccompany.

Notwithstanding, circa 20 per cent of households in Jamaica have fibre-to-the-home (FTTH) connection, which is the high-speed Internet needed for video conferencing between patient and doctor.

Surprisingly, this percentile is on par with the United States (source FTTHCouncil.eu) and positions Jamaica as the top Caribbean country to implement the full ecosystem of telemedicine soonest, given its existing and imminent technological advancements.

The scene in clinics, doctor offices, hospitals and pharmacies is dismal and jam-packed most days. Telemedicine could treat many of the out patient cases and leave a residual (more serious cases) for the required face-to-face doctor interaction.

Chronic related illnesses have also been proven to work in other countries through telemedicine, which is a significant contributor to the crowds in the mentioned locations. However, its effectiveness with telemedicine will require the patient to use a small device capable of capturing vitals (blood pressure or temperature), and relay real time results to the doctor.

Jamaica is moving with the rest of the world in this regard and creating the platforms for telemedicine. Health Minister Dr Christopher Tufton launched the telemedicine pilot project late last year in St Catherine, which is a clear indication that telemedicine is a high-agenda item.

In addition, Advanced Integration Systems and MDLink are also making significant strides in this area, to the overall benefit of Jamaica and the Caribbean. Embracing this development will certainly allow the island's local industry to flourish, not to mention the convenience to the patient.

Neil H Lawrence is the CEO of Growth-Tech, a technological company and leading Wi-Fi provider in Jamaica with a vision to see connectivity, like oxygen, available to everyone everywhere. He can be contacted at 876 946 9776 or by email at


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