Telehealth solutions have empowered both patients and healthcare providers to continue care in innovative ways through virtual consultations, remote monitoring, health data capture and analysis, and patient education. Having existed long before the pandemic, telehealth exploded from the need to provide ongoing access to healthcare, particularly primary healthcare services, within the limits of early Covid-19 regulations. In the post-pandemic context, there is a continued demand for telehealth solutions from those who use, provide, fund, and administer healthcare services.

At Kaelo, healthcare services have expanded over the last few years to include a fully remote Virtual Clinic. The clinic offers real-time remote consultations with multiple levels of primary healthcare providers, such as nurses and general practitioners. Patients are effectively triaged and managed across a broad range of acute non-emergency conditions, and receive support for controlled chronic conditions. When patients require care beyond the virtual setting, they are referred to the relevant level of in-person care depending on their needs and level of medical aid or insurance coverage.

Owing to South Africa’s unique healthcare landscape, many South Africans will traverse both public and private settings at some point during their healthcare journey. Telehealth solutions reduce the burden on patients navigating a fragmented healthcare system by directing patients to relevant points of care. As “gatekeepers” to the healthcare system, primary healthcare providers generally perform this role in person. Telehealth consultations offer a unique opportunity to improve access to care by expanding geographical reach as well as the patient’s choice of primary healthcare provider.

The convenience of connecting with a health professional virtually reduces the complexities of transport, long waiting times, and the overall cost of a consultation with the patient. Telehealth services, such as the Virtual Clinic, have the potential to guide the healthcare journey prior to the first point of in-person contact, improve multidisciplinary care coordination, and reduce unnecessary referrals and associated costs.

However, telehealth solutions have also been criticized for exacerbating health inequities in vulnerable populations – for example, settings with limited internet access and infrastructure, or for individuals without digital literacy skills. Furthermore, multiple studies highlight that the majority of telehealth consultation services represent new utilisation that would not have otherwise occurred, rather than a substitution for in-person care. This raises concern for potential overutilisation.

Industries providing these services have a responsibility to promote patient well-being while simultaneously managing the risk of inappropriate use. Implementation of telehealth services therefore requires a considered approach that is complemented by both health and digital literacy support. Striking the balance has the potential to reframe primary healthcare systems by improving efficiency and accessibility in a scalable manner. Ultimately, telehealth can be leveraged to enhance the role of the gatekeeper and improve health systems delivery within and across disciplines or public and private healthcare systems.

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