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Despite the clear benefits of telemedicine, there are still many barriers to its implementation in Europe
physician telemedicine

Insufficient technological knowledge, increased workloads and a lack of conclusive scientific evidence are obstacles to the regular use of telemedicine in Europe (Photo: Tima Miroshnichenko, Pexels)

Sònia Armengou/T. Bau

The World Health Organization (WHO) and the UOC jointly author a study examining the use of telemedicine in 53 countries in the WHO European Region

The use of this technology improves clinical outcomes and assists in monitoring patients with chronic diseases, and has logistical benefits for both patients and professionals

The lack of technological knowledge, excessive workloads and an absence of conclusive scientific evidence are among the main barriers for healthcare professionals

Technologies related to telemedicine have proven to be beneficial in various areas of medicine, including examinations, diagnoses, management, and the treatment and long-term monitoring of patients with chronic diseases, according to a new study organized by the World Health Organization (WHO) Regional Office for Europe and produced by the Universitat Oberta de Catalunya (UOC).

The study, which has been published in open access format, is entitled The Current Status of Telemedicine Use Across the World Health Organization European Region: An Overview of Systematic Reviews, and provides a summary of various systematic reviews on the use of telemedicine in 53 countries. The lead author is Francesc Saigí, a researcher in the Faculty of Health Sciences at the UOC, member of the Epi4Health research group, and director of the World Health Organization Collaborating Centre in eHealth, which is linked to the UOC's Faculty of Health Sciences and supported by the eHealth Center (eHC). The eHC researcher Noemí Robles and the doctoral students Keti Ivanovska and Che Riva also participated on behalf of the UOC.

Although telemedicine enables high-quality health services to be offered in a way that is accessible, cost-effective and useful in reducing morbidity and mortality, it did not become widespread until the COVID-19 pandemic, largely in order to continue providing healthcare services to patients in all the countries in European Region. In order to provide an overview of the state of telemedicine in the region (which includes the countries in Europe and some central Asian countries), the authors of the paper examined data from more than 2,000 studies of telemedicine, involving more than 20,000 patients in the WHO European Region.

"We found using digital tools in the provision of health services has a clear and significant impact on patients," said David Novillo-Ortiz, the head of the Data, Analytics and Digital Health at the WHO and a co-author of the study. "We saw better clinical outcomes, better follow-up by healthcare professionals and an overall benefit for both patients and professionals."


Better clinical results, but there are still barriers to overcome

Nevertheless, the study also identified obstacles to the use of telemedicine. In the words of Saigí, "this review highlights the main barriers and facilitators linked to the implementation of telemedicine in the European Region. That is very useful for formulating public policies, in which aspects such as leadership, governance, and legislative and economic infrastructure and regulations must be included in digital health strategies. That is why it's important to carry out studies before telemedicine is used, and to identify these predictors."

The lack of skills and knowledge related to technology, increased workloads and the lack of conclusive scientific evidence for their clinical contribution were therefore the main challenges mentioned by healthcare professionals. "We also saw that some patients are reluctant to use telemedicine tools, mainly because they prefer to have face-to-face contact with their professionals," added Novillo.

"The challenge for research is to uncover this evidence, and for public policies, the challenge is to put it into practice. This is a prerequisite for wide-spread adoption of telemedicine in any country in the European Region," concluded Saigí.


A comprehensive approach is required

The authors of the study call for the design of telemedicine programmes with a comprehensive vision. "Based on these very positive results for the effectiveness of telemedicine, policymakers should consider promoting its general implementation, while taking into account and addressing the barriers involved, in order to provide the benefits of these tools to everyone who needs them," explained Natasha Azzopardi Muscat, director of Country Health Policies and Systems at WHO/Europe and a co-author of the study.

In addition to specific barriers, the article adds that "poorer nations should also be included to benefit from emerging health technologies".


Political initiatives to implement telemedicine

WHO/Europe and the European Commission have launched several initiatives to develop and implement telemedicine techniques, especially through the Regional digital health action plan for the WHO European Region, which was approved by the ministers of health at the meeting of the WHO's Regional Committee for Europe held in September. The plan states that digital health solutions including telemedicine can make a substantial contribution to advancing universal health coverage, protecting the public in times of emergencies, and enhancing health and well-being in the region.

Other initiatives include the Horizon 2020 and Horizon Europe funding programmes and the European Reference Networks.

These projects and policies acknowledge not only the power of telemedicine to overcome geographic barriers and increase access to health services, but also the need to establish mechanisms to address the barriers and risks.


This UOC study supports Sustainable Development Goals (SDGs) 3, Good Health and Well-being; and 17, Partnerships for the Goals.

Reference article:

Saigí-Rubió, F.; Borges do Nascimento, I. J.; Robles, N.; Ivanovska, K.; Katz, C.; Azzopardi-Muscat, N.; Novillo Ortiz, D. The Current Status of Telemedicine Technology Use Across the World Health Organization European Region: An Overview of Systematic Reviews
J Med Internet Res 2022;24(10):e40877 doi: 10.2196/40877



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