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Telemedicine in Resource-Limited Setting: Narrative Synthesis of Evidence in Nepalese Context

Authors Siddiquee NKA, Poudyal A, Pandey A, Shrestha N, Karki S, Subedi R, Sah AK, KC D

Received 21 August 2019

Accepted for publication 13 December 2019

Published 3 January 2020 Volume 2019:6 Pages 1—14


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Yelena Yesha

Noor Kutubul Alam Siddiquee, Anil Poudyal, Ashok Pandey, Namuna Shrestha, Shristi Karki, Ranjeeta Subedi, Arun Kumar Sah, Dirghayu KC

Nepal Health Research Council, Kathmandu, Nepal

Correspondence: Noor Kutubul Alam Siddiquee
FK Exchange Fellow. Nepal Health Research Council, Apt- 11D, Mars Tower, Grande Towers, Tokha, Kathmandu, Nepal
Tel +977 9840260572

Abstract: The traditional model of health services imposes limitations, especially in resource-limited countries like Nepal. Introduction to information technology can mitigate various challenges like geographic complexity, urban-rural disparity, poor accessibility, shortage of healthcare professionals, inadequate health facilities, higher cost, and time. Nepal is a resource-limited country with diverse geographic features making it hard to have proper access to healthcare facilities. Telemedicine service has the potential to improve service quality and accessibility of the disadvantaged and underserved population by overcoming the existing challenges. The objective of this review was to explore the roles of telemedicine in vanquishing existing challenges. Seven data sources (namely CINAHL, PubMed, POPLINE, Web of Science, Scopus, DOAJ and Summon) were consulted using five keywords (telemedicine, telehealth, eHealth, mHealth and Nepal to find the literature using the Boolean operator AND) to obtain the relevant materials. The narrative synthesis method was used to review papers and to analyze the findings. This review selected 27 papers for further analysis by scrutinizing 1161 initial search results. The most common features of telemedicine services so far, implemented or piloted in Nepal, were addressing geographic remoteness (21%), a shortage of in healthcare service providers (11%), saving time (11%), addressing challenges of extreme conditions (10%), cost saving (9%), service quality (9%) and real-time services (8%). Some other features of telemedicine were communication, transportation, referral, collaboration, addressing challenges in proper diagnosis and the shortage of health professionals. In a nutshell, the review findings suggested improved service quality, increased collaboration and accessibility and decreased the disparity in comparison with traditional health service models. Although it cannot be said that telemedicine in Nepal has been mainstreamed, yet the appeal is increasing due to its positive impact, especially in rural and hard-to-reach areas where with a lack of healthcare set-up and professionals.

Keywords: barriers, health facilities, health professionals, opportunities, quality

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