Individual Consultant: Development of Telemedicine Framework (Fixed-term)

  • Mid-level, Long-term consulting assignment
  • Posted on 8 September 2020

Job Description

The COVID-19 pandemic has accelerated the need for virtual care solutions, especially telehealth and telemedicine, in the Pacific and globally. Telehealth and telemedicine services can facilitate the implementation of public health mitigation strategies such as physical distancing in healthcare setting while maintaining delivery of essential health services. Changes to health care delivery arrangements during the COVID-19 pandemic are necessary to reduce staff and patient exposure to COVID-19 in healthcare settings, preserve personal protective equipment (PPE), and minimize service disruption. Healthcare systems could employ virtual service approaches to patient triage, evaluation and care avoiding in-person encounters where possible. Ordinarily, telehealth and telemedicine can also be invaluable in connecting service providers and patients in need where remoteness or physical barrier is significant and could be appropriately employed in the Pacific beyond COVID-19 pandemic response. However, the use of telehealth and/or telemedicine has been limited across the Pacific. Although, some French territories and US affiliated states in the Pacific have adopted a certain level of telemedicine technologies to connect remotely dispersed healthcare facilities within the country to a central hub and to connect with partnering major health institutions.

Key constraints to optimal use of telehealth and telemedicine in the Pacific include technological, capacity, funding, and legacy issues. Most Pacific island countries and territories employ paper-based medical information systems including health registry, patient record, patient encounter and treatments plans, and have limited IT infrastructure. The operational experience of widespread deployment of telehealth and telemedicine for direct service delivery is limited and further hampered by insufficient revenue to establish fully streamlined telehealth/telemedicine platforms. There are also regulatory issues to consider and the need to ensure that the adopted technology is appropriate, can be optimally utilised, maintained, funded and serviced in a sustainable manner.

Nevertheless, across the Pacific, health care providers have started using mobile technologies to seek timely peer opinion on chest x-ray, computerized tomography images, lab results and for other specialist consultations, etc. During the COVID-19 Public Health Emergency, Pacific Island Countries and Territories are introducing some element of telehealth/telemedicine e.g. countries have established COVID-19 hotlines and are using “telehealth-like” services to serve patients e.g. using common apps such as FaceTime, Facebook Messenger, Zoom, or Skype. While many of these applications do not fully comply with HIPAA standards, there is readiness by service providers and clients to explore such virtual care approaches. It is therefore important to ensure that digital health tools and systems particularly for telehealth and telemedicine are harnessed during the COVID-19 response and opportunities for wider/longer term introduction into the Pacific in a systematic manner be explored now to ensure cost optimization and effectiveness.

PURPOSE/SPECIFIC OBJECTIVE OF THE ACTIVITY

This consultancy is to support systematic and tailored introduction and use of telehealth/telemedicine approaches for service delivery in selected Pacific Island Countries as a key element of the COVID-19 response. Additionally, the consultancy will support the development of a framework for longer-term introduction and use of telehealth/telemedicine in the Pacific based on needs assessments of the current operational environment.

Specifically, the objectives are to:

  • Lead the development or adaptation of relevant guidance documents on emergency use of telemedicine approaches in the Pacific within the Joint Incident Management Team (JIMT) structure for COVID-19 response;
  • Provide direct technical advice to five 5 named Pacific Island Countries and Territories regarding the introduction of limited telemedicine approaches as part of their COVID-19 response plans;
  • Develop recommendations for supported countries to aid transition from short-term emergency-focused telehealth/telemedicine approaches to more longer-term use.
  • Undertake a needs assessment including a review of existing telemedicine and telehealth approaches in use across the Pacific and identify any best practices and lessons learned;
  • Develop a framework or blueprint template guide for sustainable introduction of telehealth/telemedicine in the Pacific;
  • Develop a high-level roadmap for telehealth and telemedicine implementation for Pacific Island Countries and Territories;

DESCRIPTION OF ACTIVITIES TO BE CARRIED OUT

  • Short-term/emergency use of telehealth and telemedicine during COVID-19 pandemic response
    • Contribute to a PIC toolkit for telehealth introduction in time of COVID-19, with a focus on simple tools, checklists and examples for key aspects – including ICT, legal/regulatory, SOPs and protocols to enable safe, direct delivery of care to patients using telehealth and telemedicine including:
      • Practical Advisory note on regulatory and compliance issues to Ministries of Health adopting telehealth and telemedicine approaches for emergency use during the COVID-19 Pandemic
      • Technical briefing and advisory note on the use non-HIPAA compliant platforms e.g. Facetime, WhatsApp, Wiper, Skype, etc.
      • Recommendations for Tele-triage pathways, workflows and SOPs (Tele-triage pathways and workflows should be as user-friendly and simple as possible, both for the patient and the physician)
    • Report on Rapid assessment of available relevant technology with recommendations about quick and safe deployment during the pandemic response to increase functionality and protect patients
    • Support for 5 specified PICs to introduce limited telehealth (provider-Patient) which can be implemented rapidly to be ready for future lockdowns and/or COVID-19 outbreaks
  • Transition Beyond COVID-19
    • Develop or adapt/use existing tool to assess maturity and readiness for telehealth and telemedicine in the 5 supported countries and beyond
    • Report on the assessment of practices including recommendations and lesson learnt to support longer-term use of telehealth/telemedicine following experiences during COVID-19.
    • Develop concept note for the introduction and implementation of longer-term telehealth/telemedicine in the 5 supported countries
  • Longer-Term Telehealth/Telemedicine Framework for the Pacific
    • Technical Report identifying key operational considerations and implementation approaches for low-resource Pacific settings covering among others:
    • Current Practices/Operating Models in the Pacific
    • Product/Technology/Market Scan and recommendations
    • Policy and Regulatory environment issues
    • Workforce Capacity & Capability issues
    • Patient Safety, Cultural Compliance and Confidentiality
    • Interoperability and linkages to health information system
  • Develop Draft Operational Framework or Model for Telehealth/Telemedicine implementation for the Pacific
  • High-level Implementation RoadMap for recommended options with cost estimates for phased introduction and implementation

METHODS TO CARRY OUT THE ACTIVITY

Working with the telehealth working group, the case management cell, and the essential service delivery cell under the Health Operations Pillar of the JIMT, the consultant(s) will:

  • Organize and participate in relevant planning and consultation meetings
  • Lead the development of relevant guidelines and information products
  • Undertake desk reviews and interviews of key informants
  • Develop implementation timetable for the programme of work
  • Provide direct technical advice and inputs covering all the relevant domains
  • Produce scheduled updates and monitoring reports
  • This work could be done by a single consultant or a team of consultants working concurrently on the various aspects of the ToR in a streamlined manner.

QUALIFICATIONS & EXPERIENCE

The proposed team must have the following qualifications:

EDUCATION

  • Essential:
  • Degree in medicine, public health, epidemiology, health information management or a related field
  • Desirable: Master’s degree and clinical background preferred (clinical informatics)

EXPERIENCE

Essential:

  • Understanding of the telemedicine use in developing countries and/or internationally
  • Previous experience on health services delivery in small countries/populations in remote and low resources settings highly desired
  • Previous experience with similar work on telemedicine products
  • Experience with Pacific islands settings
  • Interoperability and standards, including health information exchange

Desirable:

  • Understanding of regional cooperation mechanisms
  • Understanding of shared services models

TECHNICAL SKILLS & KNOWLEDGE

  • Broad understanding of digital health infrastructure (e.g. data centre, networks, hardware) and application services.
  • Familiarity with industry standard approaches and standards for health information exchange and interoperability.
  • Solid understanding of regulatory issues of technology and their impact across government and the country.
  • In-depth knowledge of external services provisioning arrangements, including outsourcing. Health systems especially health service management.
  • Strong critical thinking, writing and presentation skills.

LANGUAGES

  • English

COMPETENCIES

  • The contractor should have demonstrated experience in working from distance

APPLICATIONS

Qualified and interested specialists should submit their CV {for individual contractors} or Company Profile {for institutional applications} and Expression of Interest {cover letter} to the Supply Officer through WP RO UNGM at < wproungm@who.int > by 22 September 2020.

The cover letter should outline how their experience and qualifications make them a suitable candidate for this position and should include their proposed daily consultancy fee and total cost estimate for the entire project (disaggregate between phases) and availability.

Please use Tender Notice No. 113699 as subject to all submission. Only successful candidates will be contacted

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