EHS-COVID (415) Digital technologies (4) Telemedicine supported strengthening of primary care in WHO South East Asia region

19 June, 2021

Citation, abstract, summary points and comment from me below...

CITATION: Gudi N, Konapur R, John O, et al. Telemedicine supported strengthening of primary care in WHO South East Asia region: lessons from the COVID-19 pandemic experiences. BMJ Innovations Published Online First: 20 May 2021. doi: 10.1136/bmjinnov-2021-000699 Full text:


The COVID-19 pandemic has exposed the fragmentation of the healthcare delivery systems and highlighted the role of resilient primary healthcare systems for a robust public health response during health emergencies. Primary care while being the first point of contact between the citizens and the health systems has received scant attention or targeted investments over the past several decades. Through this narrative review, we aim to outline the potential role of telehealth in augmenting health systems capacity. While teleconsultations have increased exponentially during the pandemic, evidence suggests that utilisation of primary care for non-emergency and non-COVID-19 conditions such as chronic medical conditions has significantly decreased, suggesting that most telemedicine utilisation has been to address an immediate crisis. In countries with pre-existing national digital health framework and enabling regulatory environments, telehealth interventions while strengthening the public health response to COVID-19 also supported the continuum of care at the primary care level. Even after COVID-19 is controlled, telemedicine has the potential to address persistent obstacles to primary care in the South East Asia region, including scarcity of trained healthcare workers, access challenges and costs associated with in-person care. Telemedicine holds promise in strengthening primary care and has the potential to catalyse achieving universal health coverage.


- During the pandemic, several countries in the SEA region passed various legislations and issued telemedicine practice guidelines resulting in increased uptake and acceptance of telemedicine among patients and providers.

- There is a need [for] robust evidence around the role of telehealth in strengthening primary care.

- Potential opportunities...

1. Integrated service systems (primary, secondary and tertiary) and information systems;

2. Efficient referral systems;

3. Engaging all the stake holders;

4. Evidence-based change management strategies;

5. Capacity building and increased community engagement.

COMMENT (NPW): The five 'opportunities' described above are listed but how they might be implemented is not fully described. These are complex challenges. I invite others to comment.

Neil Pakenham-Walsh, HIFA Coordinator,