The most innovative catch of COVID-19 Telehealth Center was that it was a quick and cost effective solution available at a critical pandemic situation.
The objective of this initiative was to ensure effective and quick healthcare for citizens in every corner of the country during the crisis irrespective of their economic/social status or physical location (urban or rural) so that no one would be deprived from the basic healthcare right.
Our doctors used to make calls to every Covid-19 positive patient with daily data from the DGHS. Patients could also call for doctor consultation. Doctor’s assessment, daily/weekly follow up and emergency coordination assistance (Ambulance, hospitalization, food & medicine supply and funeral support) were all available with just one call and with the lowest feasible cost (only regular mobile operator charge to make a call).

Through “COVID-19 telehealth center” we provided telehealth services by maintaining social distance during the Covid-19 crisis. After the pandemic, this initiative was taken over by the DGHS as a project under “Shastho Batayon” in 2021.

BASIS: Provided well-furnished lab
Synesis IT Limited: Provided technical support
Icon Systems Limited: Provided technical support (ICT facility equipped lab, Server)
Shastho Batayon: Provided Human Resources (Doctors, Health Information Officers), Customer Relationship Management (CRM) and call center related technical support.

Stakeholders: DGHS (Overall Supervision) and a2i's ICT Division (Management and Operation)
- Reduced pressure on hospitals, helped to control virus’ community transmission.

Beneficiaries (4 types of patients): Suspected Covid-19 positive, Covid-19 positive, post-Covid-19 health complications, post Covid-19 vaccination health complications.
-Patients didn't need to travel to hospitals. They availed healthcare service from any corner of the country staying at home and maintaining social distance.

Till 30th November 2021, COVID-19 Telehealth Center has provided 1,561,068 telehealth services to about 704,890 patients involving 50 Doctors and 30 Health Information Officers (HIOs). The impacts generated from implementing this initiative are the following:
- Doctors’ and patients’ distance was reduced. The cost of health treatment has also reduced.
- The tendency of taking antibiotics without doctors’ consultations has reduced.
- Distant medical consultations have lessened the rapid community transmission of the virus.
- Scope of health research has expanded as all patient related data has been stored in an ICT-based database.
- Patients' satisfaction level has increased.
- Experience of such an initiative during the pandemic may assist government and other stakeholders to formulate and implement new and effective policies for the health sector.

Challenges:
- Mobile network and connectivity issue in accessing patients in remote areas.
- Absence of a trained medical assistant to measure the patient's vitals- temperature, BP, oxygen saturation, etc.
- Difficulty to modify treatment procedures balancing with new variants of Covid-19.
- Doctors, HIOs and the management team were at risk of getting infected due to physical presence at the center.
- Recruiting proper HR for the center during the pandemic.
- Difficulties to pay salaries to doctors and HIOs in time due to not having quick fund allocation.

Mitigation:
- To solve inadequacy of doctors & HIOs, we recruited young, energetic people who were willing to provide their service to help patients during the crisis.
- Training sessions to make doctors aware of the new variants of Covid-19 and its treatment procedures.
- As the pandemic worsened, we shifted our treatment activity to a Virtual Private Network connection so that doctors and HIOs could continue telehealth service from their home.

With the practical experience of this initiative’s implementation, we identified some areas which are necessary for the success of such an innovation.
- Proper leadership and planning capacity
- Strong willpower
- Empathy for patients
- Adequate and trained workforce
- Having available resources like funds and IT infrastructure
- Strong Mobile network connectivity
- Establishing public and private stakeholder collaboration
- Having national level telehealth implementation policy and guidelines.

To bring 14,000 government community clinics under telehealth, DGHS has taken up a project of Tk 1600 crore entitled "Digital Health Service Management Implementation Project in Health Institutions" where Tk 100 crore has been allocated for the telemedicine. Under this, telemedicine will be piloted in 8 unions of 8 upazilas of 8 divisions of 8 districts and a2i will be providing technical support. A project of ICT Division named Smart Society is also going to replicate it, 28 community clinics of 4 islands will be the piloting area. We hope that in the future, 92 government telemedicine centers can be incorporated, with telehealth targeting the marginalized population as beneficiaries during pandemics. Telehealth can also be coordinated with specialized hospitals i.e. BIRDEM, BSMMU, Heart Foundation etc., to treat patients with comorbid diseases including diabetes, kidney disease, hypertension, etc.

- It is possible for a beneficiary to get a doctor by themselves at any time, at any location and for any disease - through telehealth.
- Sometimes just a conversation with a doctor brings peace to a physically sick patient’s mind that he/she is getting treated and will be okay.
- The treatment procedure can be more effective if it includes a Diagnostic report review option in the CRM.

COVID-19 Telehealth Center has been awarded with WITSA Global ICT Excellence Award 2021.
https://witsa.org/witsa-announces-2021-global-ict-excellence-award-winners/