Implementing the Implementation Framework for Telemedicine to Address Non-Communicable Diseases in Thailand: What We Have Learned

Pairoj Chattranukulchai¹, Nuntakorn Thongtang², Sirisawat Kunanon³, Weranuj Roubsanthisuk³, Chaisiri Angkurawaranon⁴, Grit Leetongin⁵, Krisada Hanbunjerd⁶, Sirirat Tunpichart⁷, Manit Sittimart⁸, Nicha Moonkham⁸, Khachen Kongpakwattana⁹, Apichard Sukonthasarn⁹, the Thai NCD Collaboration Group

Affiliation : ¹ Division of Cardiovascular Medicine, Faculty of Medicine, Chulalongkorn University, Cardiac Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand; ² Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; ³ Division of Hypertension, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand; ⁴ Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; ⁵ National Health Security Office (NHSO), Bangkok, Thailand; ⁶ Bureau of Non-Communicable Disease, Department of Disease Control (DDC), Ministry of Public Health (MoPH), Nonthaburi, Thailand; ⁷ Community Pharmacy Association (CPA), Bangkok, Thailand; ⁸ Health Intervention and Technology Assessment Program (HITAP), Nonthaburi, Thailand; ⁹ Thai Hypertension Society, Bangkok, Thailand

For over two years, the coronavirus disease 2019 (COVID-19) has been spreading in Thailand and causing substantial disruption in noncommunicable disease (NCD) care. To resuscitate and develop telemedicine for NCD care, Thai NCD Collaboration Group has devised and carried out an implementation framework since 2020. In December 2021, disciplinary experts including NCD specialists, a pharmacist, health economists, a payer, and a policy decision-maker, reconvened to review the progress of implementation activities. Three key prioritized implementation activities were discussed. First, a simple protocol for hypertension management, which was to initiate the ‘decentralize to primary care services’ activity, was successfully developed and ready to roll out to multiple hospitals. Second, representatives from the Ministry of Public Health ensured that the ‘telemedicine advocacy’ activity was officially endorsed by the national health policy. They also acknowledged to support the implementation of the simple protocol at a national level. Third, for a ‘drug regulation and quality’ activity, a case study of limited access to cost-effective treatment was discussed, and an access strategy such as a co-payment model, was proposed as a potential solution to alleviate payer’s budget constraint. Overall, the progress of implementation activities is positive, still, ongoing monitoring is important to drive telemedicine for NCD care to be fully operational and sustainable nationwide.

Keywords : Telemedicine; Noncommunicable diseases; Thailand

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