Need to embrace telemedicine to fix critical gaps in healthcare delivery

Given the doctor-dependent, top-heavy nature of our healthcare system, creating a functional telemedicine network in rural areas by leveraging the vast spread of Community Health Centre (CHC) and PHCs will help increase access to quality medical care, writes Vikram Thaploo for South Asia Monitor

Vikram Thaploo Jul 13, 2020
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As the total COVID cases cross the 800,000 mark, most parts of India have gone into complete lockdowns till the central and state administrations can figure out a way to curb the spread. As the death toll continues to rise, the pandemic has also disrupted the economy in an unforeseen manner. The healthcare sector needs to evolve and adapt to the changing situation and needs. With the lockdowns making it difficult for patients to avail in-patient care, India’s Ministry of Health and Family Welfare has issued Telemedicine Practice Guidelines on March 25, enabling registered practitioners to provide teleconsultations to the needy patients. Providing additional relief to insured patients, the Insurance Regulatory and Development Authority of India (IRDAI) directed both health and general insurers to include telemedicine in policy claim settlements. The much-needed statutory support comes in the wake of a practical understanding as we move towards a new normal, we have to accept the fact that wide-scale acceptance of telemedicine is essential if we want to bridge critical gaps in healthcare delivery.

Safety and preventive care

Medical professionals are also falling prey to COVID-19, and if the situation gets to a point where doctors and other allied health professionals have to be quarantined, it can be quite disastrous. Telemedicine enabled visits by registered practitioners can be conducted without exposing medical professionals to the virus, which will reduce the rate of transmission, keeping both them and their patients safe. Telemedicine can also help bring down the burden on already strained healthcare systems by helping doctors filter and shortlist patients who need hospitalization. They can also check in on their patients’ symptoms via telemedicine, advise them about their medication, the precautions they need to take, the tests that are required, and make appropriate and timely referrals to the nearest facility in case their symptoms get worse. More importantly, it will enable patients to take active charge of their health.

Most patients living in urban regions use a glucometer, digital thermometer, pulse oximeter, and an electronic blood pressure monitor these days. As these are attached to a mobile app, the readings are sent to a physician directly, who can then advise them on the best course of treatment. Several apps come with attached diagnostic features. The reports are shared with the doctor directly and patients get timely advice. Many telemedicine systems use smartphones to keep track of changing health parameters. Smartphone-based logs are an elaborate and convenient way of providing immediate help to patients. In the long run, it will help reduce the frequency of outpatient visits, hospital admissions, and readmissions, and bring down medical expenses. If electronic health records are linked to the Aadhaar card, it can be used to create patient registries for big data analytics, which will allow physicians to track the health status of their patients, perform better predictive analyses, and improve health outcomes. 

Urban-rural divide

The lack of access to quality healthcare in rural areas is another serious drawback. About 75 percent of our population resides there, and although there are a lot of Primary Health Care (PHC) and rural hospitals, they are still not enough to cater to the healthcare needs of the people living in these areas. India has a shortage of 600,000 doctors and 2 million nurses, and nowhere is this more acutely felt than in rural areas. Patients often have to travel long distances just to consult a specialist. Mobile clinics and specialty hospitals make it possible for specialists to make sporadic visits to remote areas. Unfortunately, the response time is very high in both cases. Moreover, specialists often have to consult other specialists to make sure that all aspects of the case in question have been taken into consideration. The condition of patients often worsens during travel, and it ends up burning a hole in their pockets. If specialists have to travel, not only does it cost a lot of money, other patients are deprived of their services when they are unavailable. Given the doctor-dependent, top-heavy nature of our healthcare system, creating a functional telemedicine network in rural areas by leveraging the vast spread of Community Health Centre (CHC) and PHCs will help increase access to quality medical care.

However, full-scale acceptance is not going to come easily. While most millennials are comfortable with technology, senior citizens are not, and they are the ones who need telemedicine more. Some of the most experienced senior doctors are also not familiar with the information and communication technology used in telemedicine. While these are significant bottlenecks, this pandemic has created unique challenges, and adopting telemedicine will help both medical practitioners and patients overcome them. Making it mainstream is the only way to minimize the inequity and access barriers in these uncertain times. The future is contactless.

(The writer is CEO, Apollo TeleHealth, Hyderabad, and has about two decades of experience in diverse industries including healthcare, retail, and hospitality. The views expressed are personal)

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