A research team from the University of Toronto's Dalla Lana School of Public Health is looking to implement telemedicine for managing chronic diseases in Pakistan to study whether it can be used by specialists in the cities to support health providers in rural communities.

According to a media release, the team will deploy digital technologies, such as the ECHO training platform, to enable senior doctors in Karachi, a capital city in the south, to mentor health workers and see patients in rural parts of Punjab Province. Patients will also be given access to a mobile app to help them monitor their blood pressure and blood sugar.

The researchers will focus first on treating vulnerable patients, as well as offer remote COVID-19 treatment and education. 

WHY IT MATTERS

Xiaolin Wei, the research lead and an associate professor at DLSPH, claims that chronic disease care in the many parts of Pakistan has "fallen apart," with rates of diabetes and hypertension rising and patients discontinuing treatment due to high cost. Data obtained by the US-based Institute for Health Metrics and Evaluation showed that in the past decade, ischemic heart disease, stroke, and diabetes were among the top 10 causes of death in the country. Wei noted the "great potential" for remote care management for chronic illnesses as these are the rising burden of disease in low and middle-income countries. 

THE LARGER TREND

It was fairly recent that Pakistan has become open to virtual health technologies, which were deployed to help it battle the ongoing pandemic. At the start of the outbreak, it launched a free telehealth service via WhatsApp. The federal government also set up an online emergency response service called Yaran-e-Watan that allowed Pakistani doctors from abroad to provide care to patients back at home. 

Despite this, there is still a "dire need" for appropriate infrastructure and legislation to facilitate telemedicine in Pakistan, said Pakistani researchers last year in a letter to the editor of Ann Acad Med Singap, the journal of the Academy of Medicine in Singapore. They urged the National Digital Health Authority of Pakistan to take on the responsibility of enforcing telemedicine laws and guidelines as hurdles to digital health adoption remain, such as poor service and lack of telemedicine knowledge. 

There was considerable progress when in October last year, a bill institutionalising telemedicine and telehealth in the southeastern province of Sindh was passed on a committee level. The proposed measure, once passed, will require practitioners to first register with the government before offering online care services.