COVID 19: How Does Telemedicine Come To Aid?

With cases of COVID-19 rising rapidly, digital health and telemedicine are also rising to meet the challenge, creating a need to ensure that these care methods reach the highest standards.

Over the days, India has been battling hard with COVID-19. Despite all efforts, we haven’t managed to flatten the curve yet. In this regard, telemedicine seems to be a viable solution. How fruitful is it but?

Gairika Mitra tries to fetch details from Dr. Rishi Bhatnagar, President, Aeris Communications. Dr. Bhatnagar has recently joined the technical committee of NABH (National Accreditation Board for Hospitals and Healthcare Providers) in India.

Excerpts from the interaction:

How do you think would a concept like ‘telemedicine’ be accepted in a geography like India?

Registered Medical Practitioner (RMP) accessibility as per the WHO standards has been a persistent problem of the Indian healthcare sector. According to a report by Centre for Disease Dynamics, Economics & Policy (CDDEP) in the US, India has a shortage of around 600K doctors and 2 Mn nurses. With most of the population in India still being deprived of basic healthcare facilities, telemedicine is emerging as a life saviour. Telemedicine is a blend of information and communication technologies with medical science. In the current scenario, telemedicine and telehealth may turn out to be the cheapest, as well as the fastest, way to not only bridge the rural–urban health divide but also manage the Covid-19 crisis. India’s technology adoption rate has improved manifold, thanks to deeper penetration of smartphones and mobile apps, ubiquitous last mile connectivity, cheaper data plans and most importantly, Digital India Mission enabling wider technology adoption by Indian masses. Telemedicine helps decrease the RMP and paramedical staff’s time consumed in travel to address patient needs. This would improve the quality of healthcare services remarkably in semi-urban and rural areas. Also, the quality and effectiveness of healthcare enhances when doctors and nurses have access to more data.  

What do you think is the estimated market size like of telemedicine?

The healthcare industry has long been one of the most exciting sectors for the emerging technologies. With the emergence of 5G, IoT services and its applications, the healthcare industry are set to become more connected and readily available than ever. The quality and effectiveness of care will increase gradually when doctors and nurses have access to more data. Diagnoses will be more accurate, treatments more targeted, and serious conditions can be detected earlier. A study from Reportlinker predicts that investments for the implementation of IoT solutions in the healthcare sector will drive a 19.9% annual market growth between now and 2025, eventually reaching an estimated $534.3 billion. 

What if there is any faltering in technology during the process?

We cannot deny that there still remain challenges on the road to 100% adoption of telemedicine in our country. Though India today has 1 Bn plus mobile phones subscribers and there has been a great improvement in the last mile connectivity, still there exists pockets of population which do not have access to the internet, regular power supply and digital infrastructure to support delivery of high-end telemedicine facilities beyond mHealth. Effective delivery of telehealth services requires maintaining policy and standards with reference to national data privacy policy, user authentication, doctor-patient confidentiality, seamless connectivity through telecommunications, electronic health records, authorised access to patient’s data, encryption, guaranteed reliability, interpretability, legal obligations, multimedia applications, performance levels and security. This must be an ongoing process. In addition, system interoperability, compatibility and scalability along with constant benchmarking of equipment which meets the international DICOM standards is a must. Another aspect is that while the millennial RMPs are tech savvy, more experienced senior doctors, especially in remote areas, by large are not computer savvy, virtually lack awareness and exposure with regard to the application of information and communication technology in Medicine. With vigorous training and skill development in telemedicine for doctors, nurses and paramedical staff, such bottlenecks to the growth of Telemedicine in India can be mitigated. 

How would telemedicine pave the way for flattening the curve, especially in the state of Maharashtra, where there is a huge spike in numbers daily?

Telemedicine services can have manifold benefits. With telehealth solutions, patients can have access to improved health outcomes and quality of life with real-time support and interventions. I am happy to see the recent framework drafted by Indian government which has buoyed the use of telemedicine solutions to fight coronavirus. On March 26, 2020 the health ministry issued telemedicine guidelines enabling doctors to write prescriptions based on telephone conversations that reduce risks of transmission for medical professionals as well as patients. It also reduces the inconvenience/impact to family and caregivers and social factors. Virtual visits enabled through telemedicine would prove very effective and helpful in deciding who needs to be tested for Covid-19. For frontline physicians, telehealth is primarily a way to perform Covid-19 and other urgent-care screenings. 

In addition, this is the time for the public and private sector to work together. Our government must join hands with private healthcare players to actively encourage people to seek consultations through the telemedicine services. Taking the telemedicine route will help in bifurcating the seriousness of the patients in several aspects right from the requirement of hospitalization to home care. Doctors can check the symptoms in patients through tele-conferencing, advise them about medication, precautions as well as tests required and refer them to a healthcare facility in case their symptoms aggravate. Arrangements can also be made for pathologists to be able to collect samples from home.

How can telemedicine be reached to the masses, especially in the remote locations?

Telemedicine has made geographical boundaries redundant. Setting up telecom infrastructure in rural areas to increase reach of RMPs is easier than making available specialists physically. With 1 bn plus mobile phone connections, mBanking, mEntertainment, mCommerce and mGovernance are becoming a reality. This indicates huge potential of telemedicine in the healthcare sector too. Pilots and proof of concept studies in various sections of mHealth are abounding in India. Hundreds of thousands of messages are being sent on daily basis by government health departments, NGOs and the private sector are ensuring better adherence and compliance be it for immunisation, vaccination, ante natal counselling, or blood sugar evaluation. Medical Call centres are sharing authenticated validated health information through mobile phones. Thousands of health “apps” can now be downloaded. Video Conferences with RMPs through mobiles, using 3G, 4G and eventually 5G is on the rise. Using telemedicine in the interior parts of the country, the delivery of healthcare services can reduce the infrastructure challenges and burdens that patients encounter during transportation or while requiring specialty care.  It is also encouraging to see the government working with leading private players to establish a telemedicine network in public-private partnership mode.

Telemedicine definitely is the answer to address the poor accessibility of healthcare in rural India

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