Policy Memo Assignment on Emerging Landscape Of Telehealth Services: Key Issues & Challenges

Question

Task: Suppose that you are a consultant working for Hong Kong Health Authority. You are tasked to write a policy memo assignment to recommend what policy actions should be taken to boost telehealth technology adoption while minimizing unintended consequences.

Use materials Harnessing STI for Growth.
Your policy memo will be evaluated based on the quality of writing and analysis. In specific, your memo will be graded in the following four aspects:
1. Clarity in writing
2. Persuasiveness in argumentation3. Analytical rigor (use of evidence and comprehensiveness)
4. Demonstration of understanding of relevant materials (concepts, theories, and tools) covered in the class.

About writing a Policy Memo:
Objectives: Examining a pre-existing policy problem and communicating challenges, opportunities, and recommendations to a targeted audience.
Audience: Stakeholders, Policymakers, etc
Content: Persuasive in nature, use literature and data to draw attention toward a problem. Explain different ways to address it.
Finally, present your solution and defend it.

Answer

2. Executive summary
Digitalization in healthcare has been promoted by healthcare officials to provide equitable, affordable and universal healthcare facilities. The research on policy memo assignment signifies that the ASEAN countries are accepting the alleviated challenges of healthcare to create better infrastructure and with the advent of COVID 19, the need for Tele-health services are more than ever. The key objective of the memo is to examine pre-existing policy problems, communication opportunities and challenges and opportunities, recommendations.

3. Background and context
The social and economic development of ASEAN countries are reliant on the policies made by the government as the resource disparity in the region is prominent and proper aspects need to be implemented for better growth and development. As evidenced by Suzuki, et al, (2020), apart from Singapore, Brunei and Malaysia, other ASEAN countries fall short of medical services and thus, telemedicine services can provide universal and affordable service to the population of other ASEAN countries. Hong Kong has around 7.1% of the elderly population which accounts for a high incidence of non-communicable diseases, it is important to impart medical facilities to the elderly population who otherwise cannot avail of the service due to old age Intan Sabrina, andDefi, (2021). COVID 19 pandemic has further underscored the need for digital telemedicine and the lockdown measures have increased the need to avail medical services by virtual mediums. In the light of the need for telemedicine services, the policies need to be implemented based on tele-consultation where triage is provided and doctors are connected through online tele-consultation. The policy should include E-pharmacies where medicines are also available through online mediums. Health management services also need to be implemented in the policy to maintain a proper diagnosis process. Insurance policies should provide assistance in claiming the medical bills. Audiences regarding the issues can be classified into two parts including stakeholders and policymakers

4. Recommendations

Figure 1:Adoption of tele-health services before COVID 19 and after COVID 19
Source: (Bhaskar, et al., 2020)

• Tele medicinal services should be IOT based technological advancement where tele-medications should be done keeping in mind the treatment, diagnosis, follow-up, and tele-monitoring services.
• Elderly populations need continuous monitoring and continued care which can be provided with responsible attributes of hospital stay with active role-playing in the patients that support multidisciplinary services.
• As per the views of Jha, et al., (2021), the policy should also be made in the administrative management of patients where lab services and billing and delivery of the reports are mandatorily provided in-home care service.
• Hong Kong’s Ping a Good Doctor in 2019 was a success and the policy will be focussed on creating new arrangements of tele-health with proper service maintenance that may provide assistance in increasing the population to take up tele-health services.
• As mentioned by Martinez, et al, (2020), the policy also focuses on the remote model where telemedicine van must provide services in the rural and remote areas to maintain an equitable and centralized platform of health.
• As Hong Kong is a High-density city the people in the country are mostly not aware of the regulations of telemedicine and thus, notable reimbursement of medicines has been farfetched for the population. The new policy mentions the regulatory guidance for reimbursements which intends to help the population at large.
• The mental illness like psychiatry or psychotherapy should also be included within the landscape of telemedicine regulations that can help with the issues of anxiety, depression among the population in need.
• The policy should also mention licensing process of the healthcare practitioners working in tele-medicinal forum. Proper training facility will also be provided that will ensure better aspects of tele-medicinal services to the conservativepopulation of Hong Kong.
• The previous policies have no mentioning of licensing or any regulatory measures which need to be incorporated into the new policy so that, the policies should have a proper authenticity of the government institutions that can take the population in confidence.
• Around 20% of the populations in Hong Kong has only availed the facility of tele-health services which has shown the reluctance of the population and the new policy should be able to communicate with the population properly to convey the benefits of the service.

5. Alternatives
Tele medicines has alternative or virtual video calling facilities or at home medical services given by some doctors. However, with the advent of pandemic the other alternatives of tele-medicines cannot be availed as many doctors find it problematic to visit the patient which may incur into gettinginfections. The vaccinations drive has also been made through vans around the remote places to provide the medicinal facilities to the remote dwelling residents.

6. Limitations and Barriers
• The most important barrier being the infrastructural skills as in many places the internet connections or the machines for the implementation of the telehealth services cannot be placed.
• As per the documented study by Sahashi, and Sugimura, (2021), complex use of IOT based services that can cause delay in providing effective medical facilities; the policies should mention proper skills and trainings needed.
• The government policies are often overlooked as there is a lack of strategic alignment of the participants in the projects related to tele-medicines.
• The hierarchical structures of the healthcare organizationcan also be a threat in accepting the policies as conflicts about professional recognition and insecurity can be prioritized over the concern of the patients.
• Many people may resist the acceptance of the new technology and may resist the application of the policies due to cultural prejudice or certain notions regarding tele-medicines.
• The lack of emotional bonds between the healthcare professional and the patient may become a thorn in the way of implementing the policies of tele-medicines, however, the communicablediseases should has better treatment facility in tele-medical services than in traditional methods.
• As evidenced by Luo, et al., (2021), the expense of the IOT based medical facility is not a feasible amount. Government needs to implement proper internet facilities, monitoring facilities that can help the patient to have proper benefits. Thus, the policy should mention the approximate costs which may provide clarity of vision regarding the expenses.
• The barrier can also be posed by officials who believe that clinical medicinal services might provide better assistance than tele-medicines given the standardized practice of medicine in the healthcare environment.

7. Conclusion
In conclusion, it can be said that Tele-medicines are the need of the hour but it should be implemented in accordance to the regulations and laws. The proper guidelines mentioned in the policies will help provide new and enhanced experience to the patients. The tele-medicinal services also provide opportunities in the realm of technology that can bridge the gaps and maintain an agile perspective with new collaborations and healthcare infrastructures.

Reference
Bhaskar, S., Bradley, S., Chattu, V. K., Adisesh, A., Nurtazina, A., Kyrykbayeva, S., ... & Ray, D. (2020). Telemedicine across the globe-position paper from the COVID-19 pandemic health system resilience PROGRAM (REPROGRAM) international consortium (Part 1). Frontiers in public health, 8, 644.

Intan Sabrina, M., &Defi, I. R. (2021). Telemedicine guidelines in south East Asia—a scoping review. Frontiers in Neurology, 11, 1760.

Jha, A. K., Sawka, E., Tiwari, B., Dong, H., Oh, C. C., Ghaemi, S., ... & Jha, A. K. (2021). Telemedicine and Community Health Projects in Asia. Dermatologic Clinics, 39(1), 23-32.

Luo, J., Tong, L., Crotty, B. H., Somai, M., Taylor, B., Osinski, K., & George, B. (2021). Telemedicine Adoption during the COVID-19 Pandemic: Gaps and Inequalities.Policy memo assignment Applied Clinical Informatics, 12(04), 836-844. Martinez, K. A., Keenan, K., Rastogi, R., Roufael, J., Fletcher, A., Rood, M. N., & Rothberg, M. B. (2020). The association between physician race/ethnicity and patient satisfaction: an exploration in direct to consumer telemedicine. Journal of General Internal Medicine, 35(9), 2600-2606.

Sahashi, S., & Sugimura, H. (2021). Lecture No. 10 AI and telemedicine: how is technology transforming the horizons for global health?. Japanese Journal of Clinical Oncology, 51(Supplement_1), i41-i44. Suzuki, T., Hotta, J., Kuwabara, T., Yamashina, H., Ishikawa, T., Tani, Y., & Ogasawara, K. (2020). Possibility of introducing telemedicine services in Asian and African countries. Health Policy and Technology, 9(1), 13-22.