The Current Status of Telehealth and Distance Learning in Palau.

In 2017 the Republic of Palau installed fiber optic cables, allowing access to high speed internet for the first time and the capacity for growth in telehealth. Given Palau's poor access to specialists and resources, telehealth has the potential to radically change health care delivery. Currently, the status of telehealth in Palau is unknown. This study describes telehealth resources utilized at the Ministry of Health in Palau and potential future directions for telehealth. Thirty-four people, mostly health professionals at the Belau National Hospital in Palau were interviewed, including physicians, information technology personnel, public health department staff, department managers of allied health, and telehealth experts in the Pacific. Standardized questions and surveys were conducted in-person during July 2019. All departments utilized some form of telehealth. Common needs for the advancement of telehealth included: a telehealth champion, a resource facilitator, successful distance learning for auxiliary staff, dedicated telehealth space, technological help, and better telehealth communication with rural clinics. Survey respondents indicated that they would like to use some sort of distance learning, most commonly for professional betterment (86%) and upskilling of staff (86%). There are numerous distance learning and telehealth opportunities available, yet recurrent barriers to these opportunities were noted across all departments. The barriers identified in the current study and recommendations to overcome them may be applicable to other Pacific nations who face similar challenges.