The Potential of Telemedicine in the Rural Eastern Mediterranean Region for Noncommunicable Diseases: Case Study from Jordan

Abstract

Telemedicine is the integration of technological advancements within health care systems, where distance is a critical factor, to respond to the health needs of communities. In the Eastern Mediterranean Region (EMR), the prevalence of noncommunicable diseases NCDs has increased in the last decade with cardiovascular diseases and kidney diseases ranking within the first top ten mortality ranks in the region. This rise in NCD prevalence is accompanied with an increase to the access of Internet technology, making the incorporation of telemedicine an asset in terms of increasing access to health care especially for people in remote areas. In Jordan, the Ministry of Health has been a pioneer in the EMR in integrating telemedicine to improve access to health care services, especially in rural areas. The Jordan initiative resulted in three telemedicine interventions, where they have focused on the experience of patients and access to telecardiology, teledermatology, and telenephrology services in two hospitals in the north and south of Jordan. The aim of this chapter is to draw together lessons learnt from these three interventions. The studies aimed to assess the impact of live interactive telemedicine consultations in cardiology, dermatology, and nephrology for diagnosis and management of the diseases and to assess the presence of an association with improvement in patients’ quality of life and savings in cost and time. Results indicate that telemedicine services were successful in establishing diagnosis (71.1%, 43.2%, and 62.5% in disease categories, respectively) and treatment plans (77.3%, 67%, and 62.5% in disease categories, respectively) among patients or changing previously established diagnosis (17.1%, 19.3%, and 12.5%) and treatment plans (16%, 9.1%, and 31.2%) due to telecardiology, teledermatology, and telenephrology consultations, respectively. This impact not only improved the patients’ quality of life but also decreased cost through reducing travel and waiting times to and from clinics. However, there are certain barriers for the implementation of telemedicine within the health care system. Overcoming these barriers may lead to a promising future in this region. Also, for telemedicine to be implemented within the health care system, certain efforts need to be put into practice on the policy level. These include including telemedicine on national agendas, developing a legal framework, and allocating a comprehensive budget for it. Moreover, there is a need for training on the benefits of telemedicine on the community level and building capacity in implementing it.