Persisting Barriers to the Adoption of Telemedicine in Latin America After the COVID-19 Pandemic (Part 2)
By Daniela Chueke
Although the COVID-19 pandemic played an important role in the adoption of telemedicine and telehealth across Latin America, certain barriers needed to be addressed to effectively implement remote solutions focused on patient care. Health systems in Brazil, Chile, Mexico, and Colombia – the countries that have made the greatest strides in telemedicine in the region – continue to work to ensure that this modality of care is implemented and widely accepted.
Lessons Learned: Have Barriers Been Overcome?
As Juan Pablo Uribe, Global Director for Health, Nutrition, and Population at the World Bank, noted, “The pandemic has shown that health systems need to be well funded and able to deal with shocks and surges.” In this respect, we concur with his reading that many countries in Latin America and the Caribbean did implement effective and innovative measures, including the expansion of remote health and telemedicine services during the pandemic. They increased the use of data in decision-making processes and established new public–private partnerships that expanded access to healthcare during peaks in the pandemic. These innovations can be harnessed and utilized to push forward a series of broader and more lasting reforms to achieve greater resilience in the health sector. In the field of telemedicine and telehealth, the lessons learned left some promising upsides.
Plenty of experiences implemented – with many documented
Greater cooperation and collaboration between the institutions and professionals involved in the implementation, whether results are positive or negative
The Communication of Medical Knowledge
Technology has made it possible to discover and connect people with the technical knowledge to make institutional improvements. While technology is no replacement for the value of tacit knowledge exchanged through direct human contact, it does help people locate the knowledge they need and network with each other. Telemedicine facilitates the seeking of second opinions, remote training for specialists, continuous medical training, case presentations, and many other instances of communicating and exchanging medical knowledge.
Patients became more active in managing their health
Formation of Interdisciplinary Teams and Collaborative Work
The creation of a permanent space for exchange is essential to influence high-level decisions between public or private health sector institutions, professional associations, health professionals, scientific associations and societies, and civil society.
Advances in regulatory frameworks
Current Regulations per Country
Lastly, each country currently has different regulations in effect as part of their efforts to implement telemedicine and telehealth. In Argentina, before the pandemic, National Mental Health Act No. 26,657 already recognized telemedicine as a valid tool in mental health care. Argentina’s Ministry of Health has also issued specific resolutions to regulate telemedicine in the country. There is also Act 27.706 of 2020, establishing the Unified Federal Program for Computerization and Digitalization of Medical Records of the Argentine Republic, Act 27.553, and Decree 98/2023 of 2023, establishing new regulations on Digital Medical Prescriptions and Telecare.
In Brazil, telemedicine is regulated by the Federal Council of Medicine (CFM by its initials in Portuguese). In 2018, CFM Resolution No. 2.227 was issued, setting out the ethical and technical standards for practicing telemedicine. During the pandemic, the country regulated the use of chat and video calls as channels for medical consultation. Regarding the use of WhatsApp, during COVID, Act 13.989 on Telemedicine authorized the use of telemedicine for the duration of the crisis caused by the coronavirus (SARS-CoV-2).
In Chile, Act No. 20.584 regulates the rights and duties of patients and establishes rules for telemedicine. The Ministry of Health has also issued regulations and technical guides for the implementation of telemedicine there. In Colombia, Act No. 1438 of 2011 and Decree No. 538 of 2015 establish the rules for telemedicine implementation. In addition, the Ministry of Health and Social Protection has issued specific guides and guidelines for practicing telemedicine in the country.
Finally, in Mexico, the General Health Council issued Official Mexican Standard NOM-024-SSA3-2019 in 2020, regulating the use of information and communication technologies to provide health services. The standard includes provisions for telemedicine and teleconsultation.
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