Telemedicine Can Improve Access: But Access Is Not the Same as Inclusion

This blog is based on the chapter: Saatchi, A. G. (2026). The Role of Technology in Tackling

Global Health Challenges. In Addressing Global Health Challenges Through Financial Innovation and Health Technologies. IGI Global Scientific Publishing. Full chapter available here: Read the full chapter.

Telemedicine is one of the clearest examples of how technology can reshape healthcare delivery. By using digital communication tools to provide consultations, follow-up care and clinical advice remotely, telemedicine can help overcome geographic barriers that have long limited access to health services (Bashshur et al., 2016; Haleem et al., 2021).

For rural, remote, and underserved communities, this matters enormously. Distance to healthcare facilities, transport costs, workforce shortages and limited specialist availability can all delay or prevent people from receiving care. Telemedicine offers a way to bring clinical expertise closer to patients without requiring every interaction to take place in a hospital or clinic.

The chapter illustrates this through examples from several settings. India’s eSanjeevani platform is described as having served more than 100 million patients during the COVID-19 period, helping to reduce hospital overcrowding and extend access to rural communities (Lad & Padroo, 2024; Mumtaz et al., 2023). South Africa’s MomConnect initiative is discussed as an example of digital support for maternal health, while telehealth networks in the Brazilian Amazon are described as connecting Indigenous communities with medical specialists in urban centres (Tilahun et al., 2021; World Health Organization, 2021).

These examples show why telemedicine has become an important part of global health innovation. It can support continuity of care, reduce travel burdens, improve follow-up, and make specialist advice available to communities that might otherwise struggle to access it. During the COVID-19 pandemic, telehealth also helped maintain care while reducing infection exposure risks and protecting health system capacity.

But telemedicine is not automatically inclusive. A service can be technically available and still

practically inaccessible. Patients may lack digital literacy, language support, reliable internet, private space, appropriate devices, or trust in digital systems. These barriers can particularly affect older people, people experiencing homelessness, people with limited language proficiency, and those already experiencing social or economic exclusion.

The chapter discusses digital literacy barriers in rural Morocco, where poor digital confidence restricted patients’ ability to engage effectively with teleconsultation platforms, contributing to missed appointments, miscommunication and reduced trust (Alami et al., 2025). It also draws attention to the paradox that telemedicine can widen access while also reinforcing disparities if services are not designed around the needs and circumstances of different communities (Haimi, 2023).

The lesson is clear: access is not the same as inclusion. Telemedicine can reduce distance, but it can still exclude people if services are not designed around usability, literacy, culture, language, and trust. Digital care must therefore be supported by training, cultural adaptation, human support, and hybrid models that recognise that not every patient can or should be expected to engage in the same way.

For telemedicine to fulfil its promise, it needs to be part of a thoughtful service to redesign. It must be integrated into clinical workflows, referral systems, information governance, safeguarding arrangements, patient communication, and follow-up routes. Implemented well, telemedicine can make healthcare more responsive and equitable. Implemented poorly, it risks becoming another mechanism through which inequalities are reproduced.

References

Alami, H., Gagnon, M. P., Fortin, J. P., & Lehoux, P. (2025). Telemedicine in rural Morocco: A case

study of digital literacy barriers in healthcare access. Journal of Global Health Systems, 7(1), 45–58.

Bashshur, R. L., Shannon, G. W., Krupinski, E. A., & Grigsby, J. (2016). The empirical foundations of

telemedicine interventions in primary care. Telemedicine Journal and e-Health, 22(5), 342–375.

Dodoo, J. E., Al-Samarraie, H., & Alsswey, A. (2022). The development of telemedicine programmes in Sub-Saharan Africa: Progress and associated challenges. Health Technology, 12(1), 11–26.

Haimi, M. (2023). The tragic paradoxical effect of telemedicine on healthcare disparities: A time for redemption. BMC Medical Informatics and Decision Making, 23(1), 95.

Haleem, A., Javaid, M., Singh, R. P., & Suman, R. (2021). Telemedicine for healthcare: Capabilities, features, barriers, and applications. Sensors International, 2, 100117.

Lad, R. A., & Padroo, B. S. (2024). Advancements and challenges in digital health implementation in India: A comprehensive literature review. World Journal of Biology Pharmacy and Health Sciences,

18(1), 205–208.

Tilahun, B., Gashu, K. D., Mekonnen, Z. A., Endehabtu, B. F., & Angaw, D. A. (2021). Mapping the role of digital health technologies in prevention and control of the COVID-19 pandemic: Review of the literature. Yearbook of Medical Informatics, 30(1), 1–12.

World Health Organization. (2021). Global strategy on digital health 2020–2025. World Health Organization.

To explore the full argument, case studies and complete reference list, read Ameneh Ghazal

Saatchi’s chapter, The Role of Technology in Tackling Global Health Challenges, published in

Addressing Global Health Challenges Through Financial Innovation and Health Technologies

by IGI Global Scientific Publishing: Read the full chapter.