Parastatals' involvement in the telemedicine implementation programme in South Africa / Motlale Cecil Ramonotsi

Abstract

Social implications• It has been highlighted in the literature study that social issues surrounding Telemedicine include questions such as, if health care is a right, can Telemedicine services reasonably be withheld anywhere where there is access to telecommunications and who will be allowed to provide telecommunication services. Some of the social issues included Telemedicine concerns about reduced comfort of human interface between a patient and a doctor. However in some instances patients reported being more self assured and better focused without the physician being physically in the room. Another issue cited is that technical systems may be poorly adapted to the human infrastructure of health care. It was mentioned that sustainable Telemedicine programs also require attention to organisational business objectives and strategic plans that are not always evident in current applications. Economic implications - It has been cited that Home Telemedicine, which enables ambulatory patients to live at home under the supervision of home health nurses, is viewed as effective in reducing costs that may be occurred by expensive inpatient stays in nursing home facilities. Literature states that despite its advantages, clinicians may see Telemedicine as an economic threat due to increased competition, structural alliances, and surpluses of some categories of health professionals. In addition, the current lack. of payment for Telemedicine service is considered to be one of the major barriers to its deployment Most third party payers have taken a "Wait and see" approach toward Telemedicine reimbursement. Other economic considerations include the cost of equipment and of information transmission. It has been cited that, for rural study determined that a major impediment to the widespread implementation of Telemedicine in rural areas is the lack of resources for acquisition of appropriate telecommunications equipment. Secondly an empirical study was done, and provinces were chosen (Kwazulu Natal, Mpumalanga and Eastem Cape) to replicate the findings to a national level. This was done means of field study of which two structured questionnaires (for health care providers and consumers) were used to diagnose and conclude on factors to be considered for implementation of Telemedicine in South Africa. The results of the questionnaires were processed statistically. Based on the literature study concerning the ideal Telemedicine implementation and system, and the empirical results, it was possible to determine the gap, problem areas and issues of Telemedicine implementation programme in South Africa. The research c1earty showed the numerous areas for focus and improvements exist. To bridge the present Telemedicine implementation gap that exists in South Africa, a practical and feasible Telemedicine implementation framework. and plan was recommended. Although some research studies have been conducted and have not yet convincingly shown the economic returns on Telemedicine system, the recommendations presented in this study seek to show tangible economic benefits of a practical Telemedicine system suitable for South Africa. The study shows that the achievement is attainable through private partnership strategies such as Parastatals' involvement in the Telemedicine implementation programme.