Transforming lives: The role of open source in scaling telemedicine and telehealth

Telehealth and telemedicine remove geographical barriers to healthcare. They each use remote telecommunications systems and modern technology to give people access to healthcare services, no matter where they live. 

But while the two terms share the same mission and are often used interchangeably, there are differences between telehealth and telemedicine.

Telehealth covers a broad range of healthcare services. These include preventative, promotive and curative care, along with the administration of medication and provision of health-related educational resources.

Telemedicine is a subset of telehealth and has a narrower focus than its parent term. It’s geared towards providing clinical services, such as monitoring and diagnosis.

Telehealth and telemedicine use modern technology to enable people to get the treatments and care they require. Patients can get virtual consultations, have their health status consistently monitored, get their medications administered automatically and more.

There are some key benefits to this, such as:

• Improving people’s healthcare outcomes through greater monitoring and follow-up care

• Saving time for people by removing the need for them to travel to a health facility

• Cutting people’s exposure to infectious diseases in hospitals and surgeries

• Giving people from remote or rural areas easier access to healthcare

• Preventing health issues from developing or progressing

• Reducing the cost of healthcare for people

But it’s not only patients who benefit from telehealth and telemedicine. Healthcare providers can boost their productivity and efficiency, as they’re able to increase the number of patients they see and can do so in less time.

The benefit for national healthcare providers is they can have healthier people and economies. Additionally, any reduction in healthcare costs achieved from using telehealth or telemedicine services frees up funds for governments to invest elsewhere, such as in education, the environment or pensions.

The benefit for private healthcare companies is they can elevate their revenue, as the output of their staff rises and their patient bases grow. This means they have additional capital to invest in new technologies, so even better healthcare outcomes can be achieved for their patients.

Scalability is crucial to telehealth and telemedicine because they’re about breaking down the geographical barriers to healthcare delivery — in theory, they won’t have scaled to their full potential until everyone can access the healthcare services they need. 

This grand mission of universal access means there are numerous operational and technical aspects of telehealth and telemedicine where healthcare providers must account for scalability, such as: 

• Meeting growing demand

• Geographic reach

• Adaptation to peak loads

• Cost efficiency

• Enhanced patient experience

• Innovation and technology adoption

• Data management

• Integration with health systems

• Compliance and security

A key insight from Nearform’s experience of defining, designing and delivering telemedicine and telehealth solutions is that, for technology to be able to scale with the above aspects, it can’t be based on simply digitising what already exists — it requires building a platform from scratch, so scalability is inherent from the outset.

This need to build anew is something Nearform identified when developing a scalable telemedicine platform — in under 12 months — for Cardo Health, a digital health company with a mission to democratise healthcare with AI. Cardo Heath required a platform that would scale easily and reconfigure to different geographic markets (across multiple continents) that each have their own unique requirements. The company needed a platform that would accelerate its growth and deliver sustained business impact. 

Ongoing change and scaling was facilitated by the use of a loosely coupled architecture approach to the requirements and integrations needed for each market. In addition to this, Nearform built the Cardo Health solution using Open Source technologies to give Cardo Health a more cost-effective and commercially sustainable solution. 

The end result was a fully integrated suite of apps that catered for the specific needs of patients, clinicians and practice managers. The platform was initially launched in Mexico, but is now easily scaling to accommodate the first 1.5 million service users for Cardo Health across multiple markets. The business now has an innovative and resilient solution that enables it to confidently move forward with its transformative mission.

Nearform’s work with Cardo Health demonstrates that competing in the ever-scaling telehealth and telemedicine markets doesn’t have shortcuts to success. In this example, leveraging Open Source Software (OSS) provides several key benefits uniquely suited to telehealth, such as transparency, agility, security, cost-efficiency, and scalability.

COVID-19 supercharged the growth in telehealth and telemedicine. According to statistics from a report conducted by the US Department of Health and Human Services (HHS), telehealth visits were 6200% higher in 2020 than in 2019. This trend of increasing telehealth visits has “stabilised” at 38x pre-pandemic levels.

This enormous growth was powered by lockdowns limiting or stopping people’s physical access to healthcare services. However, this isn’t to say that growth in the market has stopped. Indeed, the telehealth market was valued at $83.5 billion in 2022 and is predicted to rise to $455.3 billion by 2030.

A key reason that the use of telehealth and telemedicine is expected to continue rising is the increasing availability of high-speed internet and mobile devices.

More and more people are gaining access to digital resources and it’s expected that 71% of the global population will have internet access by 2027. Smartphone ownership is also predicted to increase from 6.6 billion in 2022 to 7.9 billion in 2028.

The future of telehealth and telemedicine is bright. Technological developments are expanding the range and quality of services that can be provided, as well as reducing the cost to patients. Some of the core trends underpinning this include:

• 5G network expansion

• Even greater data security

• The Internet of Medical Things (IMOT)

• Augmented Reality (AR) and Virtual Reality (VR)

• Artificial Intelligence (AI)

• Cloud native solutions

• Advanced robotics

Advances in technology are making the delivery of telehealth and telemedicine services easier, better and cheaper. But is the growth of these services needed? The answer can be powerfully answered in the affirmative by looking at population aging statistics.

The World Health Organization stated in 2022 that “people worldwide are living longer.” It predicted that “by 2030, 1 in 6 people in the world will be aged 60 years or over”, adding that “by 2050, the world’s population of people aged 60 years and older will double.”

Why is this important? Because people’s need for healthcare rises exponentially as they reach their mid-60s, as the graph below from the UK’s Office for Budget Responsibility (OBR) demonstrates:

Millions of people are unable to access the healthcare services they need. Healthcare organisations have the opportunity to leverage OSS in their telemedicine and telehealth investments to accelerate their time to market and develop a more secure, more scalable offering. This means they can deliver much-needed care to millions of patients, agnostic of location.