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CC BY-NC-ND 4.0 · Yearb Med Inform 2021; 30(01): 126-133
DOI: 10.1055/s-0041-1726484
Section 3: Clinical Information Systems
Working Group Contribution

Telehealth and the COVID-19 Pandemic: International Perspectives and a Health Systems Framework for Telehealth Implementation to Support Critical Response

Arindam Basu
1   University of Canterbury, Christchurch, New Zealand
,
Craig Kuziemsky
2   MacEwan University, Edmonton, Canada
,
Magdala de Araújo Novaes
3   Medical Sciences Center, Telehealth Center, Clinics Hospital, Federal University of Pernambuco, Recife, Brazil
,
Araujo Kleber
4   Telehealth Center (NUTES), Federal University of Pernambuco, Recife, Brazil
,
Fernando Sales
5   Technology and Geosciences Center, Telehealth Center, Federal University of Pernambuco, Recife, Brazil
,
Najeeb Al-Shorbaji
6   eHealth Development Association of Jordan, Amman, Jordan
,
José F. Flórez-Arango
7   Texas A & M University, College Station, United States of America
,
Shashi B. Gogia
8   Society for Administration of Telemedicine and Healthcare Informatics, New Delhi, India
,
Kendall Ho
9   University of British Columbia, Vancouver, Canada
,
Inga Hunter
10   Massey University, Palmerston North, New Zealand
,
Sriram Iyengar
11   University of Arizona, Phoenix, United States of America
,
Oommen John
12   George Institute for Global Health, University of New South Wales, Sydney, Australia
,
Sheila John
13   Sankara Nethralaya, Chennai, India
,
Gumindu Kulatunga
14   Postgraduate Institute of Medicine, University of Colombo, Colombo, Sri Lanka
15   University of Southampton, Southampton, UK
,
Vije Kumar Rajput
16   Keele University, Staffordshire, UK
,
Prasad Ranatunga
14   Postgraduate Institute of Medicine, University of Colombo, Colombo, Sri Lanka
15   University of Southampton, Southampton, UK
,
Jai Ganesh Udayasankaran
17   Sri Sathya Sai Central Trust, Puttaparthi, India
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Summary

Objectives: Telehealth implementation is a complex systems-based endeavour. This paper compares telehealth responses to (COrona VIrus Disease 2019) COVID-19 across ten countries to identify lessons learned about the complexity of telehealth during critical response such as in response to a global pandemic. Our overall objective is to develop a health systems-based framework for telehealth implementation to support critical response.

Methods: We sought responses from the members of the International Medical Informatics Association (IMIA) Telehealth Working Group (WG) on their practices and perception of telehealth practices during the times of COVID-19 pandemic in their respective countries. We then analysed their responses to identify six emerging themes that we mapped to the World Health Organization (WHO) model of health systems.

Results: Our analysis identified six emergent themes. (1) Government, legal or regulatory aspects of telehealth; (2) Increase in telehealth capacity and delivery; (3) Regulated and unregulated telehealth; (4) Changes in the uptake and perception of telemedicine; (5) Public engagement in telehealth responses to COVID-19; and (6) Implications for training and education. We discuss these themes and then use them to develop a systems framework for telehealth support in critical response.

Conclusion: COVID-19 has introduced new challenges for telehealth support in times of critical response. Our themes and systems framework extend the WHO systems model and highlight that telemedicine usage in response to the COVID-19 pandemic is complex and multidimensional. Our systems-based framework provides guidance for telehealth implementation as part of health systems response to a global pandemic such as COVID-19.

Keywords

Telemedicine - telehealth - COVID-19 - coronavirus - Pandemic - Health Systems


Publication History

Article published online:
21 April 2021

© 2021. IMIA and Thieme. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
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