Will telemedicine outlast Covid-19 in Kenya?

Telemedicine has witnessed explosive growth globally during the Covid-19 pandemic. While the technology that enables telemedicine has been around for a long time, Covid-19 catalysed its large-scale adoption by patients and providers for the first time.

I believe telemedicine is here to stay. It will be a primary way that patients access medical care, long after Covid-19 is over. I say this with one big caveat: telemedicine is most effective when used as a tool within a broader, patient-centred healthcare system.

When most people think of telemedicine, they picture a video call with a doctor. The patient could be at home, the doctor in her office (or even at home), with the two interacting virtually through a screen. Through that “virtual visit” the doctor can ask questions about the patient’s condition. While the doctor may not do a complete physical examination over a video call, she can look at rashes, see where the patient is pointing, and understand the patient’s general condition.

Many diagnoses can be made based on the patient’s history alone. However, many diagnoses require confirmation with laboratory or imaging tests. In some telemedicine platforms, such as Penda Health’s Pigia Penda or Daktari Africa, doctors can order tests which can be done at nearby laboratories and results relayed to them. Similarly, any medications required to treat the condition, could be prescribed remotely and picked at a local pharmacy, or even delivered to the patient’s home.

Besides laboratory testing and medications, many conditions require a detailed physical examination. Some sensitive ones are best suited for in-person conversation. Others may require measurements, samples, or biopsies, which necessitate in-person visits. In other words, comprehensive healthcare cannot be provided through a screen alone – a strong brick-and-mortar network helps doctors provide the full continuum of care that patients need.

For chronic conditions, there is a tremendous opportunity for patients to save time and money by addressing some aspects of care remotely through telemedicine. Patients with hypertension and diabetes can communicate their blood pressure and blood sugar readings with their doctors remotely. When those parameters are well controlled, no changes may be necessary. However, when doctors notice a series of abnormal readings, they could consult with the patient remotely to determine any changes to the treatment plan.

Similarly, for pregnant mothers, an important aspect of care is providing information on what to expect during pregnancy, and discussing common issues such as nutrition or swelling of the feet. In many cases, this becomes more impactful and beneficial to the patient than what is typically received in the busy and crowded ante-natal clinics.

Even before the Covid-19 pandemic, there were several telemedicine solutions being developed. This includes Pigia Penda, Daktari Africa and MyDawa. Penda Health runs “Pigia Penda”?—?a 24-hour telephone hotline, where anyone can get their medical questions answered. It is meant to provide a high-quality option over the phone for people avoiding hospital facilities unnecessarily. Pigia Penda is backed by a network of brick-and-mortar health facilities all over Nairobi, in case one needs in-person follow-up, laboratory testing, or drug delivery. 

What, then, is the future of telemedicine?

After the pandemic, telemedicine will still thrive. Particularly, when patients can layer telemedicine services on top of their existing brick-and-mortar services, and integrating them seamlessly into a system of healthcare. Many providers are thinking about how to do this exactly. At Penda, we hope to share our lessons learned with the entire industry. At the end of the day, the goal is one – ensuring patients get safe and effective health care conveniently.

- The writer is chief medical officer at Penda Health.