key: cord-0934974-egml3sca authors: Nagra, Muhammad Haneef; Ehsan, Sumaira; Ahmad, Umair; Ali, Majid; Hussain, Hafiz Amjad; Bakar, Abu title: Implementation of a telemedicine service during COVID‐19 pandemic in Pakistan date: 2021-05-18 journal: Int J Clin Pract DOI: 10.1111/ijcp.14310 sha: 3124049b4fc24028c2d4a713e57665385eb3caff doc_id: 934974 cord_uid: egml3sca AIM: In this feasibility study, we aimed to implement a pilot telemedicine service at our healthcare facility in Faisalabad, Pakistan, and describe our experience. METHODS: Telemedicine service was established by Faisalabad Medical University at two of its affiliated locations: (i) a 24‐hour COVID‐19 Telephone Helpline was established at the Director Emergency Office, Allied Hospital, and District Headquarter (DHQ) Hospital. (ii) A Telemedicine Clinic comprising consultants and postgraduate residents from different specialties was established at Chief Office, Allied Hospital. The data related to the number and categories of calls and advice provided were collected from 27th March 2020 to 31st July 2020. RESULTS: A total of 4582 calls were received, at both locations, during the study period, out of which 2325 callers (51%) were male, and 2257 (49%) were females. At Allied Hospital, 172 patients were advised accordingly for their complaints, whereas, at DHQ Hospital, 320 patients were advised accordingly for their complaints. At the Telemedicine Clinic only, a total of 2436 calls were received during the study period, 1474 (60%) callers were male, and 962 (40%) were female. The majority of the calls were received by medicine (43%), dermatology (21%), and paediatrics (11%) specialties, respectively. CONCLUSION: Despite some limitations, the benefits of telemedicine in this COVID‐19 era are enormous and it is feasible to implement telemedicine services in developing countries. The developing countries must invest in the internet and technology access to facilitate telemedicine and other e‐health services for not only curbing this pandemic but also to promote a more efficient healthcare system after the pandemic. residents from different specialties was established at Chief Office, Allied Hospital. The data related to the number and categories of calls and advice provided were collected from 27th March 2020 to 31st July 2020. Results: A total of 4582 calls were received, at both locations, during the study period, out of which 2325 callers (51%) were male, and 2257 (49%) were females. At Allied Hospital, 172 patients were advised accordingly for their complaints, whereas, at DHQ Hospital, 320 patients were advised accordingly for their complaints. At the Telemedicine Clinic only, a total of 2436 calls were received during the study period, 1474 (60%) callers were male, and 962 (40%) were female. The majority of the calls were received by medicine (43%), dermatology (21%), and paediatrics (11%) specialties, respectively. Conclusion: Despite some limitations, the benefits of telemedicine in this COVID-19 era are enormous and it is feasible to implement telemedicine services in developing countries. The developing countries must invest in the internet and technology access to facilitate telemedicine and other e-health services for not only curbing this pandemic but also to promote a more efficient healthcare system after the pandemic. gaining control over the pandemic in a short time. 2 Pakistan has not been different. Following the detection of the first COVID-19 case on 26th February 2020, a smart lockdown was implemented across the country on 24th March 2020. Healthcare services were put on alert sustaining a balance between emergency, special care, and outpatient department services while keeping all the precautionary measures in place. Remote monitoring and follow-up of vulnerable patients and distance consultations, as telemedicine, have been an integral part of the health services. 3, 4 A study conducted in 2017 reported an effective delivery of healthcare to several underserved communities via telemedicine. 5 A similar study more recently has reported that telemedicine can play an important role in this pandemic by preventing the virus spread and utilising the time of healthcare professionals effectively as well as alleviating mental health issues. 6 In this feasibility study, we aimed to implement a pilot telemedicine service at our healthcare facility in Faisalabad, Pakistan, and describe our experience. In order to facilitate the patients with respiratory tract complaints, dedicated COVID-19 telephone desks, with specific landline numbers, were established at Allied Hospital (two landline numbers) and DHQ Hospital (three landline numbers) with the doctors specifically trained for telemedicine service. These landline numbers worked round the clock for 24 hours and 7 days a week. A specific performa was designed, as a call log sheet, to record the name, address, and mobile phone number of the caller as well as the date and time of the call and advice given by the doctor providing the telemedicine service. The doctor's assessment and the corresponding advice were based on the scoring system shown in Tables 1 and 2. The data related to the number and categories of calls and advice provided were collected from 27th March 2020 to 31st July 2020. Our staff also followed up the symptomatic patients (data not presented in this report). The study received ethical approval from the Ethical Review Committee of Faisalabad Medical University. A total of 4582 calls were received, at both locations, during the study period, out of which 2325 callers (51%) were male and 2257 (49%) were females. The majority of the calls (72%) were received between 27th March and 4th May which was the national lockdown period (Figure 1 ). • Remote monitoring and follow-up of vulnerable patients and distance consultations, as telemedicine, have been an integral part of the health services. • Telemedicine services have been introduced and proved to be effective and efficient in the pre-COVID-19 era. • Our study describes the successful implementation of a telemedicine service in Faisalabad, Pakistan, during the COVID-19 pandemic. • Our study adds to the growing evidence that, despite some limitations, telemedicine services can be implemented feasibly in developing countries during the COVID-19 pandemic. A total of 2436 calls were received at this clinic only during the study period, 1474 (60%) callers were male and 962 (40%) were female. The majority of the calls were received by medicine specialty (1047, 43%), dermatology specialty (508, 21%), and paediatrics (263, 11%) specialty, respectively ( Figure 2 ). Telemedicine is an emerging field and can be a very useful tool for consultations for vulnerable people. Despite some limitations, the benefits of telemedicine in this COVID-19 era are enormous and our experience adds to the growing evidence that it is feasible to implement telemedicine services in developing countries. The developing countries must invest in the internet and technology access to facilitate telemedicine and other e-health services for not only curbing this pandemic but also to promote a more efficient healthcare system after the pandemic. The authors would like to acknowledge the efforts of all the doctors, postgraduate residents, and technicians for their ongoing contribution to the implementation and successful running of the telemedicine service. The authors declare that they have no conflicts of interest. MHN designed the project and supervised the study. All authors (except MA) were involved in data collection, analysis, and interpretation. MA contributed to the drafting of the manuscript. All authors approved the final draft of the manuscript. The data that support the findings of this study are available from the corresponding author upon reasonable request. COVID-19-looking beyond tomorrow for health care and society Successful elimination of COVID-19 transmission in New Zealand Evolution of telemedicine in the space program and earth applications Introduction to the practice of telemedicine Evolving role of telemedicine in health care delivery in India. Prim Health Care Open Access Role of telemedicine in healthcare during COVID-19 pandemic in developing countries The role of telemedicine during the COVID-19 epidemic in China-experience from Shandong province Role of telehealth in the management of COVID-19: lessons learned from previous SARS, MERS, and Ebola outbreaks Telemedicine in dermatology: findings and experiences worldwide-a systematic literature review Comparative Effectiveness Review No. 216. AHRQ Publication No. 19-EHC012-EF Telehealth for global emergencies: implications for coronavirus disease 2019 (COVID-19) Building on the momentum: sustaining telehealth beyond COVID-19 Implementation of a telemedicine service during COVID-19 pandemic in Pakistan