I am informed that our policymakers even before the arrival of Covid-19 had been planning on the implementation of Telemedicine to supplement the delivery of health services in Ghana. The Covid-19 (C19) pandemic and its negative impact on our already fragile healthcare infrastructure including Human Resources would compel our government to fast track modalities needed to roll out such a needed supplemental service.
Covid-19 as a health crisis with consequential human tragedy is already throwing our livelihood into disarray. The effect, though variable, spares no country from America to Zimbabwe. It is feared that in the next few weeks the devastating effects of C19 will be accelerated as a result of increased transmission of the disease. The negative economic outlook in oil exporting countries such as Ghana(due to fall in global price) as well as decreased demand for non oil African exports would have a terrifying GDP effect on Africa. Supply chain disruption from overseas into Ghana and Africa would equally decimate our fragile economy albeit the genius performance by Ministry of Finance and The Bank of Ghana under the leadership of President Nana Akufo Addo. The severity of the consequences of C19 is dependent on how we as a nation are able to stem the tide of the pandemic.
Given our limited current resources, human behavior changes specifically social distancing( at least six feet apart), hand washing, use of hand sanitizers, mask wearing, avoidance of face touching etc,etc are all important societal adjustment to C19. In our hospital we have adopted the slogan: S A F E ( Six Away From Everyone) which are all helpful but we realize how challenging it is to comply with such recommendations. While I pray that people would see the importance of social distancing we need to be prepared for the worst case scenario in case of a surge that WHO has predicted is likely to hit Africa as the new epicenter. If that happens and our capacities are stripped, we are doomed in a continent where the ratio of ventilators is one to a million people compared to 4000 to a million in the western world where C19 still managed to bring those countries to their knees.
So what can our Health System do to promote social distancing while at the same time provide needed care to our non-Covid 19 patients? Restaurants are closed and so are schools to maintain social distance. But hospitals cannot be closed for the same reason.
Accelerating the roll out for Telehealth can give the health care delivery system the vibrancy it needs. I recognize an array of issues that has to be considered in order to get the legislative backing required to implement Telehealth which is intuitively a sensible thing to do especially in this critical moment of ours. The Healthcare system was already fragile before Covid-19 and the prevalence and incidence of non-Covid 19 illnesses have not lessened and together they push the system to a near breaking point. In The US today, The Federal Government has passed a temporary measure permitting providers to utilize Telehealth as a means to evaluate non emergent cases to ease the pressure on the overall healthcare system and in so doing to promote social distancing. In this current state of Covid 19 crises staying away from the hospital is the prudent thing to do. But some cases need to be evaluated in the hospital. Therefore how do you promote social distancing in a busy Emergency Room or doctor’s office?
The proliferation of cell phones could encourage the government of Ghana to fast track a legislative instrument needed to allow Telehealth including video application to become part of the mainstream healthcare services. This will also make healthcare more accessible.
But the government cannot do this alone and it requires a public- private partnership to accomplish the mission both immediate term and long term. The Telecom companies for their own survival and as one more of their social responsibilities would need to design an affordable rate for Telehealth services.
The Ghana Medical Association with their brilliant members can weigh in to sharpen the mechanism suitable for our local conditions to implement Telehealth. If we all agree that there are more benefits in implementing Telehealth for the common good then we must focus on the goal and create a reasonable path to it.
The National Health Insurance would need to review a compensation structure for such a service and
The Ghana Medical and Dental Board together with The Pharmacy Board would set guidelines on prescriptions and other orders etc.
So let’s put on our Practical Thinking Caps and within the limitations of our healthcare and Human Resources to do the best thing we can under the present circumstances.
Be S A F E
Six (six feet)