Telemedicine: A key solution to rural healthcare challenges

Colleagues from NHS England recently came together with primary care and global health leaders from England, Scotland, Georgia, North Macedonia and Sweden in Glasgow to share knowledge, aspirations and best practice of telemedicine improving access to healthcare services in rural areas.

In today's rapidly evolving healthcare landscape, telemedicine has emerged as a powerful solution to address the healthcare access challenges faced by rural populations across the globe. Telemedicine enables healthcare professionals to provide specialist care remotely, reducing the need for patients to travel long distances for healthcare services. The World Health Organisation (WHO) as far back as the 1990s suggested that one of the most significant impacts of telemedicine is that it increases accessibility to healthcare services in rural areas. In late April, primary care and global health leaders across 5 countries (England, Scotland, Georgia, North Macedonia and Sweden) came together in Glasgow arranged by WHO Europe and hosted by Digital Health and Care Scotland, over 2 days to share knowledge, aspirations and best practice.

In Georgia, telemedicine is being used to connect primary care doctors with specialists, improving the quality of care provided to rural populations. However, upskilling primary care doctors in clinical skills remains a significant challenge. To enable primary care doctors to use telemedicine effectively and efficiently, the government of Georgia needs to focus on providing adequate training and resources to improve their clinical skills.

In Sweden, nurses play a pivotal role in providing healthcare services to rural populations. Small cottage hospitals manage emergency care and often do not have an on-site doctor on weekends and overnight. But telemedicine is being used to connect nurses with remote doctors, enabling rural populations to access specialist care. The use of telemedicine in rural healthcare settings in Sweden has shown how this technology can be used to improve healthcare access for rural populations and address the challenges faced by rural communities.

Northern Macedonian colleagues shared their challenges around digital infrastructure and the need for professionalisation of the primary care workforce. However, given the aspiration to tackle health equity and challenges around General Practitioner capacity in remote and rural areas, using technological means to improve access is seen as a promising solution. Making a measurable economic argument for reform in healthcare delivery, increasing access for primary care doctors to these technologies and supporting the development of digital infrastructure are some strategies North Macedonia and other countries can adopt to achieve a significant impact on healthcare outcomes.

It was heartening to hear our Scottish NHS colleagues share their differences in primary care commissioning and the growth they have had in a multidisciplinary approach to primary care delivery. They have been able to blur professional boundaries and use telemedicine as an enabler to make quality healthcare available to their rural populations.

As the English delegation, we shared how we have been able to target recruitment to General Practice training to areas which are under doctored areas, as well as the role that telemedicine played in the response to the coronavirus (COVID-19) pandemic. We were also pleased to share our data from the Artifical Intelligence (AI) Roadmap which demonstrated growing technologies in the remote monitoring area, where we see the potential for data-driven technology to enhance remote patient monitoring and better support patients in the community.

Telemedicine is a promising solution for improving rural healthcare services worldwide. By providing adequate training and resources to primary care doctors and leveraging the skills of nurses, telemedicine can enhance the quality of care provided to rural populations. Governments and healthcare organisations need to prioritise the development and implementation of telemedicine programmes to ensure that rural populations equally have access to high-quality healthcare services. The consortium will continue to come together to share knowledge and build an ongoing community of practice, to overcome the shared barriers and challenges we face around primary care workforce, adoption of technology and serving remote and rural communities.