Transforming healthcare through continuing medical education: World Telehealth Initiative at the Central Regional Referral Hospital, Bhutan

BHUTAN HEALTH JOURNAL

Authors: Nomina Pradhan, Monu Tamang, Jessica Koval, Kasey O’Neil, Choeda Gyaltshen

Abstract

Telemedicine supports both patient care and continuing education of healthcare professionals. Medical knowledge is prone to quick obsolescence, requiring healthcare professionals to regularly update with the rapidly evolving medical field. Healthcare professionals can use telemedicine facilities to build capacity and provide evidence-based patient care. Herein, we describe how the Central Regional Referral Hospital and the World Telehealth Initiative established telehealth infrastructure in the hospital that brings together global experts and local healthcare professionals to enhance patient care through Continuing Medical Education and training.

Introduction

The medical field is constantly evolving, making it essential for healthcare professionals to remain updated regularly. Continuing Medical Education (CME) is a means of knowledge upgradation to ensure provision of evidence-based patient care1 . With technological advancement, telemedicine is a platform to deliver CME remotely. Telemedicine as defined by the World Health Organization as the delivery of services by health professionals, using information and communication technologies for the purposes of diagnosis, treatment, research and evaluation. Furthermore, it is known to facilitate the continuing education of health professionals, when distance is a critical factor. CME is a means of discussing emerging clinical guidelines, treatment protocols and new medical technologies3 . In-person CME is challenging due to the inflexible schedule of healthcare workers as well as the financial implications associated with travel, accommodation and event fee4 . CME provided online via telemedicine mitigates these challenges and also has a wider reach5 . In fact, many health systems now use digital technology to not just provide CME remotely but also to provide healthcare services remotely, helping reduce disparities6. Telemedicine is not new to Bhutan. Pilot projects of telemedicine initiated earlier, such as the pilot tele-radiology project linking Bumthang Hospital with the national referral hospital in Thimphu, could not be sustained. The probable factors for failure include slow internet speed, erratic power supply and lack of skilled human resources, limited financial support, inadequate infrastructure, poor communication systems and time constraints amongst clinicians. These challenges have confined telemedicine to an experimental phase in Bhutan. However, telemedicine made a comeback during the COVID-19 pandemic where it was used for both clinical and educational purposes. We describe the collaboration of the Central Regional Referral Hospital (CRRH) with the World Telehealth Initiative (WTI) in implementing telehealth services at CRRH.