A total of 40 countries within the European region of the World Health Organization (WHO) have a national telehealth strategy, either as part of a broader digital care strategy or otherwise. The most common forms of telehealth within this region are teleradiology, telemedicine and telepsychiatry. So concludes the WHO from a new study on telecare.
That study was conducted by WHO's European Division and Norwegian Center for eHealth Research, based on a 2022 study. The study took the experiences and insights from Norway as an example of the progress and challenges in developing telecare in the 53 countries in this region since the Corona pandemic.
Added value of telecare
WHO defines telecare as the provision of health services where patients and health care providers are separated by distance. This may include consultations via video calling, remote monitoring using wearable devices or chronic disease management via mobile health apps. Telehealth can help achieve universal health coverage by improving patients' access to high-quality and cost-effective health and wellness services no matter where they are, making it an accessible option for people living in remote areas and those with disabilities.
Since the beginning of the pandemic, countries in the European region have made rapid progress in the adoption and use of telehealth and other digital health solutions. The regional survey shows that teleradiology is leading the way, being adopted in more than three-quarters (84%) of countries. Telepsychiatry and telemedicine are also becoming increasingly popular, with just over half (51%) of countries offering telepsychiatry and about three-quarters (77%) offering telemedicine or remote patient monitoring.
Earlier this year, WHO announced that it has established a dedicated digital health network for the 53 member states in the organization's Europe region. The goal of the health network is to review and resolve issues related to the digital transformation of health care to foster a culture where patients and staff can benefit from affordable, safe and person-centered technology.
Norway leads by example
Norway has made significant progress in telehealth, particularly in response to the COVID-19 crisis. The country is a leader in teleradiology, a service that has been in existence for more than 30 years, and has also seen an increase in the use of telemedicine and telepsychiatry.
Recent innovations include the integration of artificial intelligence into image analysis, which is expected to improve diagnostic accuracy and reduce waiting times in radiology departments. Norway has also made permanent regulatory changes to support telemedicine, such as allowing e-consultations for the issuance of sick leave certificates, which was legalized in 2023. In addition, digital platforms such as eMeistring, which provides online therapy support, have become crucial to the delivery of mental health services.
Challenges and solutions
Although Norway and other countries in the region have made progress in telehealth, funding, infrastructure and human resources were identified as key barriers to increasing use and implementation across the region. Moreover, telehealth programs often lack systematic evaluation, which is essential to determine whether a technology is safe, cost-effective and appropriate for the local context and needs.
Only just over a third (37%) of countries reported an evaluation of their telehealth services. In Norway, a trial of digital home monitoring for chronic diseases showed improved patient safety and fewer hospitalizations. However, the trial also raised concerns about cost-effectiveness, as new telehealth services require significant operational resources.
Essential tool
Telehealth, including the Norwegian initiatives, continues to prove its value as an essential tool for access to health care and offers promising solutions for equitable and efficient care delivery across the region. At the same time, the results of Norway's research and experience highlight the need for comprehensive telehealth strategies that integrate legal, financial and infrastructural support to ensure the sustainability of digital health services.
The “Regional digital health action plan for the WHO European Region 2023-2030” seeks to implement horizon-scanning and landscape analysis to identify solutions that are patient-centered and can be scaled up at the national or regional level. As countries continue to refine their telehealth services, regular reviews and alignment with broader health policy goals are essential. WHO/Europe's 2024 “Support tool to strengthen telemedicine” is intended to help countries improve their telehealth services at various levels, from individual health facilities to national health systems.
