Countries in the Latin America and Caribbean region have been struggling with centralized healthcare access and inequity. For example, in Colombia, the number of practicing doctors per 1000 population amounts to 1,8 (1,1 for nurses). Countries like Colombia and Mexico are at the end of rankings regarding access to healthcare or life expectancy. What’s more, the COVID-19 pandemic led to a national crisis. This disruption has created serious national problems at many levels, threatening the countries’ social order and economic balance.
To counteract these potential socio-political and economic crises and address the additional constraints in accessing health services resulting from healthcare professionals shortages and COVID-19, Latin American countries have conducted a historic rollout of digital health solutions to their national medical systems.
Digital health solutions are mainly being introduced in the form of electronic health records (EHR or EMR) and video consultation technologies. Latin American startups emerging in telemedicine-telecare have quickly gained territory in hospital-level clinical solutions.
This article will provide an update on the current state of digital health development in the most major member countries of Latin American economies
Argentina’s healthcare is a government-managed and subsidized system that controls all its regional structures in its 24 jurisdictions. The steps of Argentina into digital health have been set in different ways, from the adoption of telemedicine solutions (video consults and, to some extent, electronic prescriptions) to the adoption of more extensive standards, such as the plan of the government of Argentina to apply SNOMED to their medical data systems in order to reach interoperability in the future.
Regarding interoperability, the Argentinian government has created (additionally) an interoperability HUB where all the stakeholders (public and private) can integrate to provide synergies that should translate into better patient outcomes. Interestingly, this plan also considers providing free training, which is required to understand the standards and leverage the adoption of these. This differs from the rest of the region. These kinds of training and initiatives usually come at high costs for the health IT companies and professionals who want to adopt the defined standards and integrate.
The COVID-19 pandemic catalyzed the development of digital health strategies in Brazil. Among the key initiatives, it is worth noting the creation of actual governance organizations (such as the National Health Data Network – Rede Nacional de Dados em Saúde) in preparation for the rollout of a massive Data-driven healthcare strategy that involves technology. Brazillian experts see this disruption as a possibility of significant change in how they structure healthcare and healthcare is being delivered (centralized vs. decentralized). This will involve telemedicine, remote monitoring, remote diagnostics, telerehabilitation, etc.
Other members of Mercosur, such as Uruguay, continue to create strategies and solutions for development in digital health. The size of the nation makes their situation to be more bearable than in countries like Brazil. However, due to the economic growth and the access to highly trained IT and software developers, Uruguay is positioning itself as a source of digital health startups just as it previously promoted itself as a powerhouse in other regions of tech development (Such as Fintech). Additionally, Uruguay has established government agencies and programs focused on digital health, such as Salud.uy. These programs are also accompanied by policies that ensure that digital health solutions have the required quality and that the standards are followed by national health institutions (public and private).
As explained at the beginning of the article, Mexico is one of the countries in Latin America with the most inequitable national healthcare coverage – the number of medical doctors per 1000 population is very low, and the life expectancy is approx. 4 years less than in the USA.
This situation, mixed with the COVID-19 emergency, has developed a severe healthcare accessibility problem, which deteriorated the current limited healthcare system. Therefore, the need for digital solutions became evident to ensure the continuation of healthcare services while complying with social distance regulations.
In Mexico, although telemedicine is necessary, it keeps facing significant challenges. This is why it has not been extended at the same speed and way as it is the case in Chile or Argentina. Mexico is currently facing a regulatory issue, where there is no consensus on when and how telemedicine will be implemented. Neither is the official channel achieving adoption from the medical community, which fights against the expansion of remote solutions and the implementation of digital technologies in the day-to-day clinical practice.
Even with these limitations, Mexico sees tremendous potential in telemedicine and remote healthcare services. Organizations are being created at state levels to leverage the adoption and regulatory standardization of digital health.
Chile has always been the innovator of the Americas, one of the countries that bring up most startups in med-tech, fin-tech, insure-tech, etc. The country has been facing political unrest – before the beginning of the COVID-19 pandemic, a series of protests led to political chaos in Chile’s major cities.
The pandemic brought a deeper level of unrest in the lives of the Chilean population and the government. The digital health strategy, which was already ongoing with the Chilean program “Digital Hospital, has seen a tremendous rise in priority. A result is an enormous number of initiatives coming from the South-American countries, some of them developed with world-class technologies. According to IDB (Inter-American Development Bank), from the unequal development of regulatory standards in all Latin-American countries, Chile (And Uruguay) have the most developed normative and regulatory landscape.
Although the road to access in healthcare is very long, regulatory pathways are the foundation to build up and roll out the digital health services strategy. The COVID-19 has been a catalyzer for many of these countries. However, we continuously see four trends that must be addressed in order to achieve expansion and access, and which will be discussed in the following article:
- Adoption from providers
- Adoption from patients
- Connectivity/access to technology
- Digital health education.
Rodrigo Alvez, Doctari / Lapsi Health / Accenture (Uruguay)
Gabriela Moreno, PeMex / Escuela Superior de Medicina (Mexico)