Telemedicine, Mental Health; How the Pandemic Changed Health

COVID-19 exposed healthcare system failures but it also showed a new way of providing services due to the acceleration of the digital revolution. The pandemic still going strong and continuously changing the health industry, which will eventually help the population have greater access to healthcare services. However, these new opportunities carry big challenges, agreed industry experts.

“With already 70 percent of the population with access to internet, the Mexico we live in has changed in many aspects, including in its approach to healthcare services. Nowadays, people inform themselves through social media, look for medical solutions on internet and turn to telemedicine. Some patients even take for granted that doctors should use digital platforms,” said Enrique Culebro Karam, Director at Central Media.

Mexico is a limited country in terms of health access. According to OECD, the country is located in 34th place out of its 37 members in doctors available per 1,000 inhabitants, last place in hospital beds available per 1,000 inhabitants and 35th in percentage of GDP used for health expenditure.

Mexicans are more adapted to e-commerce, which will affect the business model of health companies, according to Culebro. Even when the pandemic ends, videoconferences will remain and change the way health services are provided.

COVID-19 also shifted dramatically the mental health industry. “One of the positive aspects of the pandemic is that there is no return to the stigma people had about mental health. Psychiatrists became more important than ever after the lockdowns and other measures that COVID-19 brought,” said Edilberto Peña de León, Director General at CISNE México. About 70 percent of the global population changed their sleeping patterns during the pandemic and depressive disorders increased by 20 percent, he added.

The digital transformation triggered by the pandemic also impacted the mental health industry, which became more open to telemedicine, according to Peña de León. Remote healthcare opened new possibilities for psychiatrists and doctors in general, who are now able to attend patients from different places. “Ten percent of my medical office’s patients are from different states and even countries,” said Peña de León.

“In 2018, Mexicans’ peak connection times were early in the morning and late at night, which means they used these media for entertainment. During the past two years, usage peaks shifted to the afternoon, which tells us that people are using internet for more productive tasks including the search for health information,” said Culebro.

Videoconference usage rate grew 25 times during 2020, according to Culebro, opening big opportunities not only for telemedicine but for doctors’ constant medical learning and communication. “Nowadays, there is no need to be flying around the world to keep preparing ourselves or listening to conferences. Even communication with colleagues and the pharmaceutical industry has become more direct and effective,” said Peña de León.

The technological acceleration has been useful in many medical areas but it has not replaced in-person visits. While surgical operations still need to be done on-site, telemedicine could help in post-operatory monitoring and communication with patients, according to Iván Encalada Diaz, Vice President at Consejo Mexicano de Ortopedia y Traumatología AC. Telemedicine opens the field to more possibilities to serve patients.

Benefits almost invariably carry responsibilities and challenges. The health sector’s digital transformation is not the exception. The main challenges involve regulations and the creation of a clear legal framework that protects patient data and helps public institutions, according to Leopoldo Cavazos Castro, Consultant at MYC Asociados en Regulación Sanitaria en México.

“It is imperative to create a government body that standardizes and applies the same regulations at every institution. COFEPRIS and the Ministry of Health have already made some advances in this regard. The ideal scenario is that every actor from the industry, doctors, pharmaceutical companies, public institutions and patients operate under the same, clear legal framework. Also, accelerating COFEPRIS’s approval mechanisms would help both the industry and people to have earlier access to effective treatments,” said Cavazos.

Standardization is not only important in regulation but also in the medical procedures themselves. “One of the biggest issues with our health system is standardization. We have more than 10 systems, such as IMSS, ISSSTE, Pemex and private sector, and surgical matters are treated differently in each of them. Itis difficult to have a correct, complete medical file, either physical or electronic in this way,” said Encalada.

Prevention campaigns and several adjustments are needed for the Mexican healthcare system to improve, according to Rafael Enrique Maciel Martínez, President at Asociación Mexicana de Genéricos. He argued that the pandemic showed that Mexico has to be “more proactive than reactive,” invest more money in its healthcare system, strengthen COFEPRIS and boost biocompatible medicines. “A strong COFEPRIS creates a strong industry and guarantees people’s access to quality and affordable medicines. Generic drugs are used when economic situations demand it. That is exactly what we need in Mexico: to produce quality generic medicines to fight against the most common illnesses, such as chronic-degenerative diseases,” said Maciel. The Mexican health system will improve with collaborative work between the different players of the industry, he argued highlighting the importance of the generics pharmaceutical industry to boost affordable, quality drugs.

Another benefit from the digital transformation brought about by the pandemic are digital prescriptions, which need special regulation but could develop a safer environment, according to Cavazos. Mexicans’ interest in researching medical stuff on internet have also forced doctors to create a digital persona. “Doctors have become digital. Our work is graded, rated and judged online. Patients search for the best doctors and we now have to work in creating a digital personality,” said Peña de León.