What you need to know
Taiwan's success at fighting off Covid-19 may have stalled the adoption of telemedicine.
Taiwan’s medical system has not endured much stress from Covid-19 thanks to the government’s effective response.
While the pandemic is changing medicine practice internationally, will Taiwan be less prepared for healthcare service disruptions in the future?
Covid-19 has forced healthcare providers to use and promote telemedicine. Patients seeking routine checks can avoid the risk of traveling to hospitals and clinics physically and being exposed to the virus.
Telemedicine reduces travel time, cost to travel, and time off work for the patients. It is also easier for patients to schedule follow-up care with the same clinician. Likewise, healthcare professionals are also less likely to be exposed to unnecessary health risks. In the event of a mass infection or other emergencies, the use of telemedicine could continue to use quarantined clinicians to care for patients remotely while others perform in-person care.
Taiwan must learn from the failures of other countries’ approaches to Covid-19. Some patients abroad with chronic diseases have postponed care and checkups out of fear of contracting the virus. Treatment delays may increase costs or even result in deaths if not addressed in a timely manner.
Policymakers must take a hard look to prepare the country’s healthcare system when staffing, capacity, and resources are stretched beyond traditional limits.
Remote diagnostics are also becoming more acceptable. Electronic stethoscopes that do not require removing protective equipment to listen to vital signs have protected clinicians from infection. Patients who are healthy enough to recover at home can use devices such as internet-connected thermometers, pulse-oximeters, and blood pressure cuffs to send data to AI algorithms for real-time monitoring and assessment. Patients using home equipment to monitor their symptoms would free hospital beds and resources to treat more serious cases.
Unfortunately, calls for telemedicine to be used in routine clinical practice have not taken shape in Taiwan. While the National Health Insurance Administration (NHIA) implemented telemedicine during Covid-19 for individuals undergoing home isolation or quarantine, this service was limited only for Covid-19 patients to contact clinicians if they felt unwell.
Telehealth-related services can and should be expanded for other conditions. NHI already reimburses telemedicine services for those in home isolation and quarantine. Given that there is a regulatory and financial framework to provide these services, it is not far fetched for a technologically-advanced country like Taiwan to offer remote health services when it is appropriate.
Providing care to people diagnosed with a chronic disease is already challenging in Taiwan’s aging society. A 2013 study found that 17.1 percent of the population suffers from multiple chronic conditions. Patients with chronic conditions are vulnerable to an overburdened system during times of inadequate staffing, overcrowding, and limited supportive care.
Taiwan’s medical institutions must be ready for future disruptions similar to the severity seen abroad. Prudent use of available technologies can allow the country to maintain public health even in times of crisis. While telehealth services are one such method, institutions also need to consider how to support and treat patients with underlying chronic conditions under restrictive environments. A particular challenge will be assisting older patients and those who are less familiar with telemedicine apps and devices.
Telemedicine can also better triage patients in advance for hospitals to better address urgent issues. Patients in Taiwan average 14 healthcare visits annually, one of the highest in the world. Many of these visits could likely have been addressed remotely. Telemedicine would allow patients with complex issues to have additional face-to-face time with doctors if minor cases were adequately routed.
Preparing the technology now before a potential national lockdown will reduce a scramble to provide continuity of care for chronic disease patients and vulnerable populations. Having adequate IT systems, apps, and equipment setup to document telemedicine calls while protecting patient privacy cannot happen overnight. Neither are clinicians ready to deliver remote consultations without adequate training and resources.
The question is whether Taiwan’s healthcare system will embrace telemedicine. The technology, the framework, and the means are available. As other countries learn to embrace telemedicine through the trial-by-fire period of Covid-19, Taiwan can begin bolstering its healthcare infrastructure and incorporate a digital, innovative health strategy before the next global health crisis hits.
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TNL Editor: Daphne K. Lee, Nicholas Haggerty (@thenewslensintl)
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