Telemedicine: Ensuring Continuous Cancer Care During COVID-19 Pandemic

Global Cancer Observatory (GLOBOCAN) reported that in 2020, a cumulative new cancer and cancer death cases in Malaysia were 48,639 and 29,350 respectively.

The inability of cancer patients to receive adequate medical support are among the factors for higher mortality during the Covid-19 pandemic.

Cancer patients are also at higher risk of developing more serious complications, a higher rate of hospitalisation, and even death. 

Malaysia has seen a surge in cases of Covid-19 in recent weeks. As one of the measures to contain the virus, the government has enforced a nationwide total lockdown.

During this period, most of the regular visits for cancer patients had to be postponed or cancelled. In some countries in Europe, telemedicine has allowed doctors to take care of their patients remotely. 

Perhaps we could provide similar service here in Malaysia. Telemedicine is not new in Malaysia.

In 1997, the Telemedicine Act or Akta Teleperubatan 1997 was enacted to strengthen health care delivery via telecommunications, information and multimedia technologies.

It is used to reshape the health care delivery system by making it more virtual, distributed, and integrated, resulting in better health care delivery and efficiency.

However, for the past 24 years, the Act has not yet been enforced, and it was mainly for provider-to-provider consultation. 

Other barriers to patients while accessing telemedicine are technical issues, broadband access, and digital literacy. These apply more for patients from low-income families and those who live in remote areas.

As of now, broadband access is not widely available across the country, and patients need to be trained and be IT-literate before they can start to use the technology.

All these issues require involvement from relevant agencies before telemedicine can be utilised effectively. Malaysia can adopt a success story from India, namely the Kerala Oncology Network or the OncoNET Kerala, which was launched in 2001.

The project consists of an oncology network at the Regional Cancer Centre (RCC), Trivandrum and telemedicine services in cancer detection, treatment, pain relief and patient follow-up at RCC and its centres which are far away from the hospital.

All the centres have been converted into teleclinics, connected with RCC through satellite communications. 

It is timely for Malaysia to revise and enforce its Telemedicine Act to allow for patients’ consultation and prescription, as it offers benefits for oncology services especially during a lockdown.

Other than that, partnerships between public health systems and entrepreneurial providers of telemedicine are also important to ensure the successfulness of the implementation of telemedicine, particularly among those in remote and low-resource settings.

The article was written by Dr Hadijah Yunos, Dr Mawadda Benhamza (Doctor of Public Health candidates), Professor Dr Moy Foong Ming and Professor Dr Noran Naqiah Hairi. It was first published on 11 June 2021 in Code Blue, Malaysiakini and My Sin Chew.