Public-private partnerships could bring long-term telemedicine to resource-poor areas
While telemedicine has been touted as a potential care delivery strategy in remote and low-resource settings, successfully sustaining these services has proved difficult. The key to long-term deployment, recent research suggests, could lie in key partnerships between public health systems and entrepreneurial providers of telemedicine.

While telemedicine has been touted as a potential care delivery strategy in remote and low-resource settings, successfully sustaining these services has proved difficult. The key to long-term deployment, recent research suggests, could lie in key partnerships between public health systems and entrepreneurial providers of telemedicine.

“Telemedicine is very helpful in extending the reach of healthcare to medically underserved regions.” Radha K. Mahapatra, professor in the Department of Information Systems and Operations Management at the University of Texas at Arlington’s College of Business, told MobiHealthNews. “However, implementing telemedicine in rural areas in low-income countries poses many challenges due to lack of resources, from technical infrastructure to human capital and financial capital.”

In his case study, which was presented at the Americas Conference on Information Systems 2017, Mahapatra and colleague Sahadeva Sahoo, a retired employee of the Indian Administrative Service, investigated a model currently employed by OTTET Telemedicine, a non-profit, non-government organization servicing India’s Odisha state. OTTET entered an arrangement with the state’s government to augment the local public health system by linking to private specialty hospitals or other large state-run medical facilities.

These connections, Mahapatra and Sahoo wrote, were enabled by information communication technologies (ICT). OTTET built 127 Telemedicine Operations Centers (TOCs) outfitted with laptops, video cameras, mobile diagnostic devices, and patient health record software in rural areas that could link with non-local private care partners.

The program has been a long-running success, according to the study, with 900 telemedicine technicians trained and approximately 500,000 patients served since 2009.

These results, they wrote, can be attributed to multiple factors inherent to the public-private partnership model. When the funding grants of other public health development projects expire, systems often fail due to a lack of local ownership. OTTET’s model, on the other hand, sought “micro entrepreneurs” willing to offset the $9,000 to $12,000 TOC startup costs and have a stake in the locally-operated centers. OTTET also gained local support for the telemedicine program’s success by training unemployed local youths to man each center and operate the telemedicine technology. All the while, these centers enjoyed the support of the state government’s regulatory oversight and technical support — services that required little to no additional costs to the public health service.

Mahapatra and Sahoo’s analysis suggests that OTTET’s program is not only sustainable, but appears to still be growing despite the various difficulties of introducing telemedicine to rural populations. The organization’s strategy to link government services with private stakeholders should be further examined, they argued, and should serve as a blueprint for future rollouts of rural telemedicine programs and other similar initiatives.

“There is a need to conduct more studies to understand the contingent conditions that lead to sustainable development through ICT-based projects. OTTET Telemedicine certainly offers a significant data point in this stream of research, and shines a light on the path to sustainable development,” they concluded.