Telemedicine hampered by lack of doctors, connectivity in rural areas

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POOR BROADBAND internet access and the doctor shortage are major obstacles to telemedicine adoption in rural areas, a tech industry expert said.

“In the National Capital Region, there is a high doctor-patient ratio. There are 10 doctors for every 10,000 patients, which is supposed to be okay. The average across the countryside is about 2.5 to 2.8 doctors for every 10,000 patients. That is the one that needs to be addressed,” Jay Fajardo, chief executive officer and co-founder of telehealth platform provider Medifi, said at the BusinessWorld Insights online forum on March 31.

“Unfortunately, the countryside is also where we lack connectivity. Devices are not an issue,” he added.

In the Philippines, 80% of telemedicine, or the use of electronic communications and information technologies to provide health services, happens “asynchronously,” according to Mr. Fajardo. “It’s not real-time. If somebody sends a message, the doctor responds at his convenience, and the consultation happens over a long period of time.”

“The idea that telehealth is a one-to-one interaction is not real, and that impacts well on the need to have good bandwidth,” he said.

Benedict Patrick V. Alcoseba, vice-president and head of ICT Business at PLDT Enterprise, said the three ways to address the connectivity issue are investment, localization of content, and network expansion.

“We do agree that we play a big portion in how we can digitally enable not only the health industry but also other industries that rely on connectivity. The most recent capex (capital expenditure) guidance for 2021 was I think around P91 billion for PLDT, but it’s not just about how much we invest but what other initiatives we do,” he said.

“The way for us to improve connectivity to access content is not just to build bigger highways toward that content. A big impact can also happen if we have that content hosted locally,” he added.

He said PLDT is currently in talks with global content providers to localize their content for the Philippines.

“This will help speed up access to their content and make the experience much better for a wider section of the population. In parallel to that would be the expansion of all our networks into the areas where they are needed most. It’s ongoing,” Mr. Alcoseba also said.

Makati City Mayor Mar-Len Abigail S. Binay said the way to increase access to healthcare services through technology is by empowering barangays and instituting programs that can immediately address ICT access-related issues.

“All our barangays have computers. Even during the pandemic, we established what we call ‘Dyipni Maki’ (a mobile learning hub project) for our students. This project has computers and internet access. In terms of healthcare and even vaccination registration, we are making these computers available for everybody in the barangays,” she said.

“We’ve also developed a QR code for contact tracing as well as for the vaccination program,” she added.

Raymond Francis R. Sarmiento, director of the National Telehealth Center (NTHC), University of the Philippines-Manila, said the NTHC has been working with the government on innovation in public health, including drafting a working framework for telemedicine.

“Part of the work that we are doing at the National Telehealth Center would be to empower not just communities but also our academic partners, collaborators from the private sector, and most especially strengthening our partnership with the Department of Health and all other government agencies and instrumentalities to push forward our digital health agenda,” he said.

Hastings Holdings, Inc., a unit of PLDT Beneficial Trust Fund subsidiary MediaQuest Holdings, Inc., has a majority stake in BusinessWorld through the Philippine Star Group, which it controls. — Arjay L. Balinbin