Abstract
Background: Telemedicine is considered a part of digital health and represent s a technological advancement in information technology that can promote effective, efficient, and timely medical services for both providers and recipients in Thailand. The COVID 19 pandemic had been a significant factor leading to transformative changes and advancements in telemedicine services. Many public and private hospitals integrated telemedicine into their standard services. A lthough telemedicine services have been around in Thailand, there remained a lack of national telemedicine policies and compr ehensive guidelines for clinical practices and monitoring and evaluation to support the current and future planning Objectives: This research project consisted of three studies : P art 1 focused on studying the development and provision of telemedicine in Thailand, specifically examining the development and utilization of telemedicine in various levels of Thai healthcare facilities (tertiary, secondary, primary, and specialized hospitals) including the factors affecting the development and provision of telemedicine Part 2 aimed to extract lessons from telemedicine services in other countries to serve as guidelines for the development and implementation of telemedicine for Thailand; and Pa rt 3 analyzed data on the telemedicine utilization and trends in telemedicine usage at different levels of hospital and overall at the national level under Universal Coverage Scheme (UCS) which aimed to investigate the situation s under the utilization of telemedicine services and to understand the impact of using telemedicine services for both preceding and subsequent to the declaration of the National Health Security Office policy. Methods: Part 1 and part 2 adopted a qualitative approach to collect and analyze data using frameworks, including document reviews, in depth interviews, and group discussions. Part 3 used a quantitative approach to analyses secondary data from the health database s at the National Health Security Office and associated hospitals. Stakeholder consultation meetings were conducted to obtain feedback from all relevant stakeholders since the project inception to knowledge dissemination. Results and Discussion: The development of telemedicine aimed to address service related issues in healthcare facilities, such as patient congestion, lengthy waiting times for services, and difficulties accessing services during the COVID 19 pandemic or for patients living in rural areas. Various healthcare facilities presented diverse telemedicine service models. Analyses of telemedicine service usage data revealed that the majority of users were within the working age group (25-59 years old), and predominantly female. During th e COVID 19 pandemic period, there was a higher frequency of telemedicine service utilization, revealing statistically significantly than non pandemic periods. Experience sharing from India and Singapore highlighted similar areas for this work to focus on. According to the findings of all three parts, it could be concluded that sustainable development and provision of telemedicine required deliberation in six building block s: 1) care coordination and collaboration 2) regulations and operational standards 3) workforce readiness 4) budgeting and reimbursement systems 5) infrastructure and 6) services and ap plications. Moreover, sustainable telemedicine provision relied on four critical factors including digital literacy among the public (both service providers and recipients), demand for service provision and reception, safety, and the inclusivity of services accessible to all segments of the population. This research project provides an initial review and overview of the current system, and this information can be used to support the future monitoring and evaluation plan of telemedicine, an area which has now been included as future of healthcare.
