By Roger Mahadeo Thursday, July 19 2012

Managing Director 800 STAR Limited

THE 29-year-old male labourer of Couva recalled – it was past 11 at night; an undetermined problem was causing his mother severe discomfort and he was miles away from the nearest healthcare facility.

In this real life case, the young man pondered; “Should I take her to hospital now or could it wait until the morning. How long would we have to wait once we got there? I may have to miss work and she really seemed to be in discomfort. What could I do?”

Fortunately for him the solution was close at hand. He is one of tens of thousands of consumers in Trinidad and Tobago (TT) that subscribe to MedStar, a 24 hour toll free Nurse Line accessing registered nurses in Canada.

Within ten minutes he was on the phone with a friendly and qualified Canadian nurse, describing his mother’s symptoms and getting useful advice to help make his mother comfortable. Information and communications technology (ICT) has changed the way we solve day to day problems. ICT’s have been impacting healthcare service delivery in the same way it has influenced banking, insurance, and education just to name a few. The result is efficiencies in time and cost for businesses and their customers.

According to the World Health Organisation, Telehealth is the integration of telecommunications systems into the practice of protecting and promoting health.

WHO acknowledges that Telehealth corresponds closely to its international activities in public health. “…….the telephone is remarkably reliable, inexpensive and highly interactive relative to other information mediums. No information medium can match the telephone network…personal, interactive, speedy, inexpensive and easily used.” Department General, WHO.

Traditionally, if someone was experiencing “non-urgent” medical symptoms, they would have to make a self-assessment about how to address their symptoms. They could go to the doctor or go to the ER room. In 40 percent of cases of visits to the doctor’s office or the ER, patients do not require any medical treatment. The choice to go to a healthcare professional is made even more onerous if it means a long wait in the ER room because of limited staff resources. Limited access to medical services in rural or underserved areas may leave persons with no choice but to physically go to a doctor and that has other “hidden costs” associated with accessing healthcare like travel costs and lost time at work. Today patients do not need to make unnecessary visits to obtain medical advice about their medical symptoms.

Telephone Nurse Triage is only a small part of the Telehealth movement that is sweeping the globe, and is fast becoming one of the most common uses of Telehealth technology. Telephone based nurse triage, primary care and health information have been offered in developed countries since the late1990’s. Today it is available to about 150 million people in the United States, Britain, Australia, Canada, New Zealand, and elsewhere.

Telephone Triage nurses require special skills and specialty certifications are now offered in telephone nurse triage. Accreditation bodies exist, like the American Accreditation Healthcare Commission (URAC), to certify and monitor medical call centers and to ensure that the highest industry standards are maintained.

The function of the telephone triage nurse is to determine the severity of the caller’s complaint, and direct the caller to the appropriate emergency services, recommend medical follow up based on their assessment using approved triage protocols and decision support systems, and provide self care advice, where necessary.

In a recent report, the GSM Association, the global trade association for Mobile Network Operators (MNO’s) identified health hotlines that emerged in developing countries. Already more than ten million people in Mexico, India, Pakistan, Bangladesh, Latin America, Southeast Asia and the Caribbean have access to MedStar services.

In TT, MedStar gives its clients access to a 24/7 Canadian-based Nurse Helpline service and a medical discount card for use at pharmacies and other primary care providers. The clientele is drawn from TSTT fixedline subscribers and more recently from the insurance sector with Nagico Trinidad.

MedStar is a partnership between FONEMED LLC (www.-fonemed.com) of America and 800 STAR Limited (www.800star.biz) of TT. FONEMED LLC is internationally accredited by the URAC as a Health Information Centre (HIC), serving over five million customers through established operations in Canada, Greece, Bangladesh, Philippines, Mexico, Puerto Rico and the Dominican Republic.

Established in 1999 in Trinidad, 800 STAR is the leading indigenous Assistance Services Provider for the Caribbean region. It specialises in marketing round-the-clock access to services including roadside and accident assistance, medical assistance, and call centre support services to more than 175,000 customers.

Health hotline providers contend that proper information, provided at the right times, can dramatically reduce the overall cost associated with healthcare. Informed individuals can prevent adverse health outcomes, treat some conditions themselves, and make the right decisions during medical emergencies.

Individuals who suffer from chronic conditions like diabetes and hypertension also benefit from easy, inexpensive access to professional healthcare advice. All of these actions can reduce the cost of health care and improve its quality.

With over four billion mobile phone connections world wide, Health hotlines like MedStar’s Nurse Line help by making each phone a quick and affordable access point where people can obtain quality health information. It is a low-cost, widespread infrastructure model for the delivery of health information and solves several of the constraints associated with providing primary care healthcare services under the traditional cost-settings

Healthlines like MedStar’s Nurse Line provide the opportunity for Telecom Operators and Insurance Companies to not only offer a much needed service to their customers but to also contribute to managing healthcare costs and indirectly relieve some of the burden on public health systems. This can also improve the quality and efficiency of the healthcare system.

“This (MedStar) is a tangible application that demonstrates how telecommunications can be used to improve the lives and knowledge of all citizens.” says Mr. Selby Wilson, Former Secretary General CANTO, and CTU advisour.