Community Partnership
1. Planning for telehealth programs must acknowledge and respond specifically
to the local needs and expectations of the rural community and its health workers.
The active input of rural communities and their health workers must be an integral
component at all stages in the planning and implementation process for telehealth.
System Specification and Design
2. That an integral part of establishing telehealth programs is to ensure that
the system that is implemented adheres to data structure recommendations and
communication protocols standards that afford optimum compliance with regional,
national and international systems.
Security and Confidentiality
3. Specification of security protocols in telehealth must adhere to internationally
recognised standards. The implementation of these standards should not adversely
impact on rural health workers.
Local issues
4. Rural communities must have access to the level of telecommunications service
and bandwidth capable of delivering at least the minimum level of telehealth
services for their identified needs.
5. Rural communities must not be penalised by any changes to the local economic
environment created when communication systems are installed to support telehealth
systems.
Implementation - Local, Regional and Global Issues
6. Rural communities should seek to work with other interested parties in cooperative
ventures to improve local communications infrastructure.
7. All countries, in particular developing countries, should be encouraged to
actively seek regional and global partnering relationships with Universities,
industry and foundations in other countries to develop and support telehealth
applications
Implementation - Regulatory Issues
8. Policy issues and decisions relating to telehealth should not adversely affect
the local delivery of healthcare in rural communities.
9. Regulatory issues and barriers that may impact on interstate or international
delivery of telehealth services should be clearly identified and addressed at
a national level.
Implementation - Reimbursement Issues
10. Planning for and implementation of telehealth services should address the
issue of reimbursement of parties involved in the teleconsultation process.
Implementation - Ongoing Funding
11. Funding for telehealth must include allocations to provide sufficient levels
of recurrent expenditure for technical support, and ongoing maintenance and
upgrading of equipment.
Implementation - Staff Training
12. A comprehensive promotion and training program in the use and application
of information and communication technologies for health, including dissemination
of experiences from existing telehealth projects, is a mandatory component of
any telehealth project. Such programs should recognise the diverse and differing
needs of rural health workers and the clients and communities that they provide
services to.
13. All projects involving the application of information and communication
technologies to health which are funded by national health authorities should
be required to have training in the operation of the technology integrated within
the project.
Implementation - Evaluation
14. The development and measurement of process, outcome and impact evaluation
criteria for telehealth services must be a fundamental component of any telehealth
program.
15. Health authorities should increase the scope and level of research activities
for the use of information and communication technologies in health by establishing
research agendas for telehealth.
At the international level, there is a need for the establishment of an evaluation
resource that should be auspiced by organisations such as WONCA or WHO.
Impact of Telehealth on Rural Health Services - Access to Services and Service
Delivery
16. Telehealth services must be used to support and improve, but not to replace
the local delivery of health care services for rural communities.
17. Telehealth service patterns should wherever possible reflect and support
existing referral and access patterns of rural communities to secondary and
tertiary services.
Impact of Telehealth on Rural Health Services - Recruitment and Retention
18. Programs addressing the recruitment and retention of health workers to rural
communities should place a high priority on information and communication technologies
where it is planned to introduce telehealth services.
Impact of Telehealth on Rural Health Services - Continuing Education
19. The information and communication technologies installed to provide telehealth
services should be made available to the rural health workers to access continuing
education and training.
20. Telehealth programs have the potential to play a crucial role by providing
continuing education as an integral part of the consultation process. This should
be actively encouraged by:
* fostering a high degree of collegiality in the consultation process,
* allowing for the educational aspect in the budget and time management process
and
* actively encouraging the participation of the referring health worker in the
consultation process.