article · Frontiers in Digital Health
Rural areas in Ghana face persistent gaps in healthcare access and quality. An assessment of a hub and spoke telemedicine model in Hohoe Municipality examined 1,411 patient records from October 2021 to October 2023, alongside interviews with 23 healthcare providers and 16 patients. Maternal health conditions constituted 40 percent of all telemedicine consultations. The network facilitated referrals to higher-level facilities in 89.1 percent of cases, with only 2.2 percent resulting in aborted referrals. While patients reported high satisfaction and the platform improved accessibility, case management, and care coordination, operations were hindered by systemic challenges. These obstacles included unstable network connectivity, logistical constraints, and a shortage of institutional hardware, which obliged health workers to utilise their personal mobile phones for consultations.
Rural populations often encounter severe geographical barriers to accessing quality medical care. Examining applied hub and spoke telemedicine models shows how digital consultations can effectively coordinate referrals and support maternal health. It also highlights the precise infrastructure gaps, particularly telecommunications stability and equipment provision, that health authorities must resolve to expand remote care reliably.
The findings reflect an applied and tested service delivery model within public healthcare. Potential partners include digital health platform developers, telecommunication network providers, and public health procurement bodies. Commercial and deployment opportunities lie in supplying ruggedised clinic communication hardware, dedicated referral management software, and resilient rural connectivity solutions needed to scale hub and spoke health systems into wider regional or national programmes.
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Background: Despite ongoing efforts toward achieving Universal Health Coverage in Ghana, access to healthcare in rural areas is still limited. Among the services that are accessible, there is still a gap in the quality of the services provided in rural areas. Telemedicine offers a promising solution, but evidence of its role and effectiveness is yet to be fully realized. This study, therefore, explored the role of telemedicine in bridging the healthcare gap in the Hohoe Municipality. Methods: A mixed-methods approach was employed, combining in-depth interviews with 23 health professionals and 16 patients. A retrospective chart review of telemedicine records from October 2021 to October 2023 was conducted. Descriptive analysis was performed on the quantitative data with Stata V.17, while qualitative data collected were analyzed thematically using Atlas.ti v7.5. Results: Out of 1,411 patients who used telemedicine services, 40% of the conditions were maternal and 89.1% of the consultations were referred to a higher facility with only 2.2% resulting in aborted referrals. Telemedicine plays a role in terms of accessibility (bridging geographical barriers), smoothing referrals, case management, and improving service delivery. Patients were highly satisfied with the telemedicine services. However, challenges faced included unstable network connectivity, unavailability of telephones (which made providers use their personal mobile phones), and other logistical challenges. Conclusion: Our findings highlight the role of telemedicine in bridging the healthcare access gap and its contribution to the healthcare system through the Hub and Spoke model in the Hohoe Municipality. To accelerate progress towards attainment of the Sustainable Development Goal (SDG) target 3.8 on universal health coverage, we recommend that telemedicine be extended to all health facilities in Ghana, especially the rural areas, while addressing the challenges inherent in its implementation.
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DOI: 10.3389/fdgth.2026.1864794
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