Leveraging technology to reach global health: The case of telemedicine in São Tomé and Príncipe health system
• Telemedicine is contributing to reduce inequalities in access to healthcare in a LMIC.
• Global health:10 years cooperate with portugal has helped STP developing its service.
• Telemedicine used in the country had an impact on 14 medical specialities.
• Momentum´s framework was used to assess telemedicine's critical success factors.
• The challenge is the transition for full appropriation by STP's ministry of health.
Many African healthcare systems are seeking innovative solutions to improve access to specialized care. Accordingly, Sao Tome and Principe (STP) has adopted telemedicine to overcome the shortage of healthcare professionals, since 2011, and to support daily connections with Portuguese specialists, through a teleconsultation platform. This study presents a comprehensive assessment of the telemedicine service development, evolution, and impact in global health in the context of a low and middle-income country (LMIC).
A case study approach was used and combined with the Momentum framework's critical success factors to successfully launch telemedicine services analysis, in order to help understand implementation and scale-up processes, as well as the role of strategic partnership in leveraging healthcare services with technology.
From 2011 to 2019, the telemedicine service in STP performed a total of 4,966, real-time teleconsultations, 137,976 exams, and clinical files introduced in the telemedicine platform. At present, fourteen medical specialities are providing remote access to care from Portugal. The most frequent specialties were teleradiology (72%), teleophthalmology (13%), teleotorhinolaryngology (9%), and telepediatric (4%). Moreover, behind this platform local human resources were trained to perform teleconsultations with autonomy. Additionally, the Marquês Valle Flor Institute's leadership has been a successful factor.
These results suggest a consistent evolution of the service established through the system's integration into the daily routine and with the Portuguese health service. This sustainable telemedicine service is therefore an excellent example of the contribution that information technologies can make to LMIC, especially in the context of universal healthcare coverage.
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