Letter to the Editor: In response to “Role of Telehealth in the Management of COVID-19: Lessons Learned from Previous SARS,MERS,and Ebola Outbreaks”

I read with great interest the recent article “Role of Telehealth in the Management of COVID-19: Lessons Learned from Previous SARS, MERS, and Ebola Outbreaks” by Keshvardoost et al. ¹ In their article, the authors review some of the salient benefits of telemedicine and provide important examples of its successful use in previous viral outbreaks including SARS, MERS, and Ebola. They also highlight how China in particular was quick to deploy telemedicine in the context of the current coronavirus pandemic (COVID-19), and indeed China's enthusiastic embrace of virtual health care technology has no doubt been instrumental in its success in curbing hospital-based viral transmission and in regaining control over the virus's spread.

However, the authors also assert that “…in the majority of developed countries, telemedicine is recognized as routine health care services.” This statement is misleading, and it certainly does not reflect the situation in the United Kingdom, one of the most developed countries on the planet, and whose highly celebrated National Health Service (NHS) was in 2017 ranked the best health care system in the world. ²

As a graduate of a UK medical school, and having practiced clinical medicine across numerous different clinical settings including hospitals, pediatrics, and general practice, I have seen firsthand how the NHS has been indisputably reticent in its enthusiasm for telemedicine and virtual health care. Telemedicine has comprised only a very small component of routine health care services across medical specialities, and the traditional face-to-face patient–doctor interaction has been an unwavering and long-standing cornerstone of our paradigm for health care delivery. Indeed, it has only been the arrival of the COVID-19 pandemic that has truly kick-started our health care system into hurriedly welcoming and developing its capacity for telemedicine.

The reasons for inertia in the United Kingdom's move toward telehealth have been manifold. Strict regulations concerning data protection and security under European Union Law and the General Data Protection Regulation (GDPR) have certainly been a substantial and formidable obstacle not only to telemedicine implementation in the United Kingdom but also throughout the European Union. Another issue is that while the technology for telemedicine has been developed, the infrastructure to support it is lacking. Finally, concerns have been raised by both patients and clinicians alike as to whether telemedicine technology is too difficult to use. ³

As the COVID-19 pandemic continues, and the importance, value, and efficiency of telemedicine and technology-enabled health care become increasingly recognized, it may well be that telemedicine becomes a new norm in our routine health care services. However, at present, there is still a long way to go.