How telemedicine collaborations can give Asia’s underserved communities access to healthcare

The use of telemedicine services boomed during the COVID-19 pandemic as patients searched for alternatives to physically visiting a clinic. But the ability for clinicians to consult remotely is also hugely important for healthcare outside of Asia’s major cities, where it could bring medical and dental care to millions of underserved patients.

Telemedicine is a viable way to deliver care to remote and rural areas, while empowering patients with knowledge that bolsters public health. It’s a cost-effective way for countries, such as Indonesia and Vietnam, to progress towards the United Nations' Sustainable Development Goal (SDG) 3 on health and well-being, enabling Universal Health Coverage.

But we shouldn’t underestimate the task. Delivering care to everyone requires closer collaboration between governments, industry and NGOS. Business also has a key role to play in democratising care.

Life expectancy across Asia has increased over the past decades as healthcare outcomes have improved. But there’s still a significant gap between healthcare in cities and in remote parts of Asia.

One study found that patients in urban areas of Indonesia are more likely than rural patients to use outpatient hospital services, inpatient facilities or both simultaneously. That’s perhaps not surprising, given cities have more access to hospitals and clinics.

So, if a doctor is too far away or serves too many patients, healthcare suffers. Patients either can’t access care easily, struggle to afford it, or maybe can’t afford to miss work to travel to a far-flung clinic.

An additional limitation is the workforce. Staffing hospitals is a challenge almost everywhere, but it’s even harder in rural and remote settings. The World Health Organization (WHO) predicts a shortfall of 10 million health professionals globally by 2030, with lower and middle-income countries facing the most acute shortages. The WHO recommends one doctor or dentist per 1,000 patients, but in many rural or remote areas of Asia, it’s closer to one for every 10,000. The UN’s SDG report shows that COVID-19 has likely worsened progress to universal health coverage, with 70 countries reporting disruptions to vaccinations, while diet and nutrition services also faced limitations.

The ongoing shortfall in dental care in developing Asia is particularly noteworthy. Only 10.2% of Indonesians have access to dental care and 86.4% of Indonesian adults have never visited a dentist. In Vietnam, the average 65-year-old has seven missing teeth.

Telemedicine could prove enormously helpful in bridging this gap. It provides a low-cost alternative to visiting a dentist or a doctor and serves an educational role, bolstering public health initiatives simply by teaching patients about good hygiene habits or the basics of oral care.

At a minimum, everyone should wash their hands before every meal and every time they use the bathroom. Yet, 40% of the world’s population do not have a basic facility with water and soap for handwashing at home. If a patient sees a doctor because of a cold or COVID-19, it’s a great opportunity for that doctor to remind the patient that by taking the proper precautions, they might stop it from spreading to their family members. This also applies to diarrhoea, which still claims thousands of lives in Asia, usually infant children.

To achieve these goals, telemedicine requires some infrastructure. It’s dependent on internet connectivity, which is typically better in cities. Even so, access is improving. There were 76.6 mobile broadband connections per 100 inhabitants across Asia-Pacific Economic Cooperation countries as of 2020.

Although it’s typically cheaper than physically visiting a doctor, telemedicine might still be out of financial reach for the poorest customers. Unfamiliarity and tech illiteracy poses major obstacles to adoption too.

If something is worth doing, it’s worth doing at scale. The best way to scale up telemedicine is through teamwork. Governments, NGOs and businesses have an unprecedented opportunity to improve access to healthcare. They also have a responsibility to ensure that the disparities that affect traditional healthcare aren’t transferred into telemedicine.

For governments, that could mean funding critical infrastructure, using the education system to address workforce issues and setting up a regulatory structure that helps to deliver the right services. For NGOs, there are a variety of roles, ranging from developing the technology to using apps to deliver care.

The private sector has a role to play to accelerate uptake. Unilever, for example, is using its reach to promote telemedicine pilots through the Pepsodent oral care and Lifebuoy soap lines. These pilots use accessible technologies, such as QR codes, which are printed on our products, to connect customers with free or subsidised consultations with healthcare provider-partners. WhatsApp, another common tool, is used to facilitate connections to connect people to services. These programmes have been successful in Indonesia and Vietnam and we hope to expand them into other markets across Asia.

Building trust around telemedicine is a critical process and using a business with existing widespread access can help. Product commercials, which are seen by millions, can promote science-backed behaviours, such as regular hand-washing. Some even depict healthcare professionals, normalising regular checkups and positioning them as a necessary complement to personal hygiene.

To expand telemedicine quickly and widely, healthcare providers can meet people where they already are – such as shopping for their daily home essentials that help them stay healthy and clean.

Telemedicine is still scratching the surface of what is possible, particularly in emerging markets. Governments, NGOs and businesses have a responsibility to work together to ensure it democratises health and improves access for as many people as possible.