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Telemedicine: Solutions and Challenges for Health Workers in Rural Indonesia in the Response to the COVID -19 Pandemic

Published online by Cambridge University Press:  16 May 2024

Rikas Saputra*
Affiliation:
Universitas Islam Negeri Raden Fatah Palembang, South Sumatra, Indonesia
*
Corresponding author: Rikas Saputra; Email: rikassaputra_uin@radenfatah.ac.id
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Abstract

Technology and telemedicine are needed to provide the necessary solutions for public health in rural areas. Lack of stable internet access and digital literacy hinders the effective use of telemedicine. Governments and service providers can work together to extend coverage, increase internet speed in rural areas, and provide training and education to ensure adequate digital literacy.

Type
Commentary
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health, Inc.

Dear Editor,

Telemedicine technology has revolutionized how health care services are delivered, especially in previously isolated rural areas of Indonesia. By facilitating remote consultations, telemedicine allows patients in frontier, remote, and disadvantaged locations to communicate virtually with doctors and health workers.Reference Humayun, Almufareh and Al-Quayed 1 This is especially important during the COVID-19 pandemic, as reducing physical contact is essential to inhibit the spread of the virus.Reference Woods, Hutchinson and Powers 2 In addition, this technology opens the door to greater health care accessibility, allowing those previously hindered by distance or transport limitations to receive medical consultations.Reference Baker, Xiang and Atkinson 3

Telemedicine has become an essential tool in patient health monitoring, especially for those undergoing self-isolation or monitoring after hospital discharge, which often occurs during the COVID-19 pandemic.Reference Tersalvi, Winterton and Cioffi 4 Advances in sensor technology and mobile applications allow health care workers to monitor patients’ conditions in real time without physical contact.Reference Albahri, Albahri and Mohammed 5 This mainly benefits patients in rural areas of Indonesia, where access to health care facilities is often difficult.Reference Agustina, Dartanto and Sitompul 6

In the face of limited infrastructure and energy in response to the COVID-19 pandemic, health and accessibility of medical services in several areas, such as Laowowaga village, Lukhu Lase, Meafu, Muzoi, Tefao, Tetehosi Sorowi, Tugala Lauru East Lahewa sub-district, and North Nias Regency Indonesia, are challenging.Reference Sengupta, Roy, Ganguly and Baishya 7 However, technology and telemedicine can address the gap in several ways. Firstly, telemedicine allows health workers to provide remote service consultations to patients in frontier, remote, and disadvantaged locations.Reference Meier, Noel and Kaspar 8 Using a phone, smart tablet, or computer, patients can contact doctors or medical personnel through video calls or online chat.Reference Taiwo and Ezugwu 9 This allows patients in rural locations to get medical advice directly from health professionals without travelling long distances to a health center.Reference Haleem, Javaid and Singh 10

Technology and telemedicine are revolutionizing health care, especially in rural areas. Patients can consult with doctors remotely with an internet connection and a smartphone. Effective education and communication through guides, campaigns, and local support are increasing the use of telemedicine in remote areas, facilitating access to health care.Reference Goodridge and Marciniuk 11 Health workers in East Lahewa, North Nias use technology to monitor patients in post-hospital self-isolation. Patients are given temperature sensors and app-connected devices for health monitoring. Instructions and training are provided for the use of the device. Health workers monitor the patient’s condition in real-time through data from the device.Reference Kalid, Zaidan and Zaidan 12

Costs covering device purchase, software setup, and maintenance come from the Indonesian government’s health care budget. Patients are taught to use the device with guides and tutorials. Technical support is available through a hotline. The patient’s ability to use the technology is assessed through demonstrations and follow-up checks, ensuring effective health monitoring.Reference Islam, Mahmud and Muhammad 13 Healthcare professionals review the analyzed data and send care instructions back to the patient via a smartphone or computer to receive, store, and analyze the data, and a network ensures stable internet connectivity. Costs can vary widely depending on the scale of implementation and the specific technology used; the Indonesian government’s health department covers the Health Services Budget.Reference Bhimraj, Morgan and Shumaker 14

Although the potential of technology and telemedicine is on the rise, several challenges exist.Reference Kichloo, Albosta and Dettloff 15 Firstly, the limited availability of telecommunication infrastructure, such as cellular networks, telecommunication stations, and electricity in several rural areas, especially in East Lahewa Sub-district, North Nias Regency, still needs to be improved.Reference Salemink, Strijker and Bosworth 16 There is no stable internet access due to inadequate telecommunications infrastructure, such as mobile networks, telecommunication stations, and electricity. The area is remote, which makes the installation of infrastructure more complex, thus hindering the effective use of telemedicine.Reference Omboni, Padwal and Alessa 17 The government of Indonesia and telecom service providers have worked together to expand coverage and improve internet speeds in rural areas.Reference Situmorang, Suryanegara and Gunawan 18 Second, adopting technology and telemedicine requires adequate digital literacy among health workers and rural communities.Reference Scott Kruse, Karem and Shifflett 19 Continuous training and assessment are conducted to ensure that health workers effectively use the “PeduliLindungi” application.Reference Putri and Hamzah 20 In addition, public awareness and education on telemedicine’s benefits are also needed to improve access to these services.Reference AlKhanbashi and Zedan 21

Funding statement

The authors declare that no funding was received for this paper.

Competing interest

The authors declare no conflicts of interest in this paper.

References

Humayun, M, Almufareh, MF, Al-Quayed, F, et al. Improving health care facilities in remote areas using cutting-edge technologies. Appl Sci. 2023;13(11).Google Scholar
Woods, JA, Hutchinson, NT, Powers, SK, et al. The COVID-19 pandemic and physical activity. Sport Med Heal Sci. 2020;2(2):5564.Google Scholar
Baker, SB, Xiang, W, Atkinson, I. Internet of things for smart health care: technologies, challenges, and opportunities. IEEE Access. 2017;5(c):2652126544.Google Scholar
Tersalvi, G, Winterton, D, Cioffi, GM, et al. Telemedicine in heart failure during COVID-19: a step into the future. Front Cardiovasc Med. 2020;7:17.Google Scholar
Albahri, OS, Albahri, AS, Mohammed, KI, et al. Systematic review of real-time remote health monitoring system in triage and priority-based sensor technology: taxonomy, open challenges, motivation and recommendations. J Med Syst. 2018;42(5):80.Google Scholar
Agustina, R, Dartanto, T, Sitompul, R, et al. Universal health coverage in Indonesia: concept, progress, and challenges. Lancet. 2019;393(10166):75102.Google Scholar
Sengupta, M, Roy, A, Ganguly, A, Baishya, K, et al. Challenges encountered by health care providers in COVID-19 times: an exploratory study. J Health Manag. 2021;23(2):339356.Google Scholar
Meier, JV, Noel, JA, Kaspar, K. Understanding psychology students’ perspective on video psychotherapy and their intention to offer it after graduation: a mixed-methods study. Front Psychol. 2023;14.Google Scholar
Taiwo, O, Ezugwu, AE. Smart health care support for remote patient monitoring during covid-19 quarantine. Informatics Med Unlocked. 2020;20:100428.Google Scholar
Haleem, A, Javaid, M, Singh, RP, et al. Telemedicine for health care: capabilities, features, barriers, and applications. Sensors Int. 2021;2(July):100117.Google Scholar
Goodridge, D, Marciniuk, D. Rural and remote care. Chron Respir Dis. 2016;13(2):192203.Google Scholar
Kalid, N, Zaidan, AA, Zaidan, BB, et al. Based on real time remote health monitoring systems: a new approach for prioritization “large scales data” patients with chronic heart diseases using body sensors and communication technology. J Med Syst. 2018;42(4).Google Scholar
Islam, MM, Mahmud, S, Muhammad, LJ, et al. Wearable technology to assist the patients infected with novel coronavirus (COVID-19). SN Comput Sci. 2020;1(6):19.Google Scholar
Bhimraj, A, Morgan, RL, Shumaker, AH, et al. Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients with COVID-19. Clin Infect Dis. 2020;2019:120.Google Scholar
Kichloo, A, Albosta, M, Dettloff, K, et al. Telemedicine, the current COVID-19 pandemic and the future: a narrative review and perspectives moving forward in the USA. Fam Med community Heal. 2020;8(3):19.Google Scholar
Salemink, K, Strijker, D, Bosworth, G. Rural development in the digital age: a systematic literature review on unequal ICT availability, adoption, and use in rural areas. J Rural Stud. 2017;54:360371.Google Scholar
Omboni, S, Padwal, RS, Alessa, T, et al. The worldwide impact of telemedicine during COVID-19 : current evidence and recommendations for the future. Published online 2022:735. doi:10.20517/ch.2021.03.Google Scholar
Situmorang, AC, Suryanegara, M, Gunawan, D, et al. Proposal of the Indonesian Framework for Telecommunications Infrastructure Based on Network and Socioeconomic Indicators. Informatics. 2023;10(2):133.Google Scholar
Scott Kruse, C, Karem, P, Shifflett, K, et al. Evaluating barriers to adopting telemedicine worldwide: a systematic review. J Telemed Telecare. 2018;24(1):412.Google Scholar
Putri, Citra Eka, Hamzah, RE. Pedulilindung application as a comprehensive communication management in Indonesia. Moestopo Int Rev Soc Humanit Sci. 2022;2(2):108119.Google Scholar
AlKhanbashi, R, Zedan, H. Telemedicine policy availability and awareness: directions for improvement. Smart Homecare Technol TeleHealth. 2022;9:19.Google Scholar