BOGOTA, Colombia – As it works to more efficiently fight COVID-19, Chile is developing new regulations to support and boost telemedicine with an eye on the current outbreak but also on improving the provision of health care in the country in the long term.
“Pathologies different from COVID-19 are the ones in which telemedicine in the country is trying to focus,” Gabriela Garnham, general manager at the Medical Devices Association of Chile (Adimech), told BioWorld.
Patients with chronic conditions, who are at a greater risk from COVID-19, are being prioritized as the focus for telemedicine progresses.
“There’s a fear among patients of utilizing health services, and also the health care system is trying to avoid the gathering of patients at hospitals,” Garnham explained.
All elective surgeries are on hold in the country for the duration of the COVID-19 crisis. Chile has more than 12,300 confirmed cases and over 174 deaths.
Chile was already moving forward with the introduction of a large set of telemedicine processes, but the introduction was accelerated to deal with the outbreak.
The med-tech sector is one of the least regulated in a country that is one of the least regulated in the region. With that in mind, Chile is rapidly putting in place a regulatory infrastructure to speed up telemedicine processes.
The National Center of Health Information Systems (CENS), an organization that includes the Ministry of Health, the National Institute of Health, universities and key stakeholders in the pharma and med-tech sectors, issued a set of guidelines on good practices and recommendations for telemedicine and telehealth during the COVID-19 pandemic.
The initiative, which was already being discussed before the outbreak, follows other telehealth initiatives that are helping up space at hospitals and allowing them to focus on COVID-19 patients.
In 2019, the government launched Digital Hospital, an initiative aimed at decongesting the physical public health system while providing faster services to patients and reaching people living far from hospitals with advanced diagnostics services.
“Radiology services have been available for a long time, and there's also reading of CAT scans for urgent services. There's a 24/7 network to which all public health systems are connected,” said Garnham.
There are now pilot projects underway for diabetes patients to use devices and apps that can transmit their health statistics and status of patients to physicians, as well as from patients undergoing anti-coagulation treatments. Patients without critical needs are being dealt with through telemedicine.
However, postponing physical health services, or partially replacing them with technology solutions, also means that a tsunami of patients that have delayed their visits to the hospitals could potentially overwhelm hospital capacity once restrictions are relaxed.
Leaving no patient behind
“The sector is already working on how the day after will be. All those patients have not stopped becoming sick, and at some point, we will see unbalanced patients, or those with more advanced pathologies, arriving at the hospitals,” said Garnham.
“Before COVID-19 there were already waiting lists for the patients. The challenge will be to cope with the great volume of patients that are ‘in pause,’” she said.
A main concern is the elderly population. The most vulnerable to COVID-19, but which, in Chile, has shown great resilience and capacity to adapt to the trends and technology to stay healthy.
“With the elderly population, there’s the challenge of technological adaptation, to avoid having them going to the health centers with all what that represents,” said Garnham. “And yet they have demonstrated that they are, in fact, able to learn how to use the technology. They are buying things online and using services that we never thought they would ever be able to. Human beings are full of surprises when it comes learning new skills,” she said.
And those tech skills to connect elderly with physicians in times of COVID-19 are, of course, an advantage to keep patients as far as possible from hospitals, when there no urgent needs.
The country's public health system is already recognizing the telehealth consultations and reimbursing hospitals for the costs of those appointments for several specialties, as if they were physical consultations. All thanks to COVID-19, and which create huge opportunities for the telemedicine sub-sector in Chile, which was not expecting such a shift, and in which telehealth companies can profit while bringing the required technology to connect physicians and patients.
According to CENS, there are now 40 specialties for which telemedicine is recognized and paid-for by the country’s public health system, meaning that opportunities for telehealth companies are on the rise in Chile, as they are in many other regions of the world.
“Some of our partners are rethinking and redesigning their processes and thinking how they can help the medical community to cope with the challenges ahead, and that is why our association represents the industry and the innovation, and we have to think how to bring sustainability to the health system as well,” she said.
While hospitals await an avalanche of COVID-19 patients that hasn't arrived yet, the Chilean med-tech sector is also focused on availability of resources for the crisis. Ventilators and beds available at the ICUs are the main are of concern for many.
According to the Chilean government, there are about 560 ventilators available and there is a shipment of more on the way, which were ordered earlier this year.
Garnham is confident that a shortage of ventilators will not be a problem in Chile.
“We still have ICU and ventilators’ capacity and the figure has stayed relatively stable,” she said as she highlighted that ventilators are not only required by COVID-19 patients, but also by a different range of patients that also need to be treated.