Telemedicine amidst COVID: The Knight in Shining Armour

By Sharjeel Yunus

Telemedicine has recently garnered a lot of demand owing to the ongoing Covid-19 pandemic. Sharjeel Yunus delves into how the practice is being shaped by the crisis.

Healthcare and its delivery are at a critical point. On 25th March 2020, the Govt. of India, for the first time announced a set of guidelines for healthcare practitioners offering consultation via telecommunications. The rise in accessibility of internet connectivity, fueled by the need owing to the coronavirus pandemic, has given the telemedicine ecosystem a major boost.

It was at the launch of Fortis Hospital’s ‘Guardians of Health’ Telehealth initiative where Dr S. Narayani, Zonal Director, Fortis Hospital, Mulund, said, “While social distancing is the need of the hour, one cannot forget that healthcare needs of the community need to be met.”

The Major Talking Point of Telemedicine in India

Telemedicine is currently helping in three ways. First, it makes medical care available to patients with varying health conditions without them visiting clinics and hospitals, mitigating the risk of infection. Second, it helps suspected COVID-19 patients seek medical advice and guidance during self-quarantine. Third, it assists in the timely dissemination of verified information and dispels fake news and updates.

According to Dr. Vishal Sehgal, Medical Director, Portea Medicine, “On an average, we are receiving about 100 Covid-19 query calls per day on our helpline number. People are choosing telemedicine over home care in many cases as they are wary of stepping out or letting someone into their house.”

Dr. Vishal Sehgal, Medical Director, Portea Medicine

Saurabh Arora, Founder & CEO, Lybrate

Saurabh Arora, Founder & CEO, Lybrate added “Our platform has seen a significant jump in online consultations during this time, which of course calls for operational and technological efficiency to meet the demand. We are keeping round-the-clock checks on various processes to ensure smooth and seamless tele-health interactions, both for the doctors and the users.”

A Small Step Towards Tech, A Giant Leap To Effective Healthcare

If we are to go by the dates telehealth guidelines were first released, telemedicine is less than one month old. Over this time, Apollo Healthcare has witnessed a 100 percent  jump in demand for tele-consultation. MMHRC Consult which launched towards the end of March 2020, has registered 50 to 100 patients every day. Portea Medical and Lybrate have both seen a 60 percent increase in demand.

All this growth is made possible by an assisted system of data tools, infrastructure support and specialized administration tools. Data governance, integration, enrichment, storage and analysis for healthcare is a complicated process and a set of players in the market like Attunity, Informatica, SnapLogic and more are leading the way towards data integration.

Adding to this Dr. Sehgal says “Today we have smartphones, high speed mobile internet services etc., which facilitate real-time video conferencing through apps like WhatsApp. Patients are also able to share their diagnostic reports and images through online communication tools. The challenge of payment has been simplified by emergence of digital wallets like Paytm or UPI services.”

While some hospitals have been on the telemedicine bandwagon for a while, all healthcare providers are joining the digital realm due to this outbreak. On 28th March Project CoNTeC was conceptualized by the Ministry of Health & Family Welfare and implemented by the All India Institute of Medical Sciences, New Delhi. Union Minister of Health & Family Welfare Dr. Harsh Vardhan said, “CoNTeC has been made operational at AIIMS with a view to connect doctors across the country to AIIMS in real-time for treatment of COVID-19 patients.”

But this trend isn’t one that looks like it’ll slow down. “Now at this time, more people are resorting to Lybrate’s tele-health services to reach out to doctors as they are out of choice. Certainly, the trend would decline after the outbreak, but it would settle at a point which will be notably higher than the pre-crisis level,” says Saurabh.

Dr. Sehgal further adds, “We foresee the demand for telemedicine to only increase even after the Covid-19 pandemic is brought under control. Avoidance of commuting to medical facilities, cost-effectiveness and doctors providing quality diagnosis as well as medical advice will boost its demand in the future. Previously, the telemedicine industry was estimated to be growing at a CAGR of 16.8% globally, but now it is likely to witness faster and sustained growth.”

The Current’s Gone, What Now?

Telemedicine is not without its shortcomings. Being a purely technology-oriented service, it cannot replace hands-on treatments. “There is an operational limitation; people requiring stitches, administration of IV drugs, treatment of injuries, etc can’t use this facility. Additionally, in cases where the assessment needs touch and feel by the doctor are also not appropriate for teleconsultation.” said Saurabh.

Furthermore, scans and certain tests requiring specialised equipment would always require healthcare facilities. All these aside, there are two core challenges that telemedicine faces.

The first has nothing to do with healthcare, but its expenses. Although telemedicine is cheaper, there’s a bigger elephant in the room. India needs affordable health insurance across several economic groups and telemedicine does nothing to help the matter.

“Another drawback of telemedicine at present is lack of insurance coverage. Patients cannot get any benefits or reimbursements for their telemedicine bill. It is important for insurance companies and health authorities to work together and mainstream telemedicine which will help it become more popular and effective,” says Dr. Sehgal.

The second major barrier for telemedicine to go mainstream-- digital impersonation and cheating. Often telemedicine does not take into account concerns around trustworthiness and quality, and digital identity and record theft is more common than anyone would like to admit.

A Hypothetical Future

So what’s to say things won’t come back to the way they were if we develop a vaccine or some sort of cure which requires real-world patient-doctor interaction? How would telemedicine even help with dispensing a physical cure?

When asked, Dr. Sehgal said “The fear of infection, awareness of hand-hygiene and sanitation as well as social distancing measures, are likely to become a part of the new normal in the future. In a world when vaccines are out, telehealth can help as all the discussion will happen through teleconsultation. Doctors can be consulted and prescriptions would be given. When patients approach us, we would run a checklist/FAQ on them, post which we would send trained personnel to the patients’ homes, maintain the cold chain of the vaccines and dispense them there. So, the population at large would not be required to throng hospitals.”

While the present seems hopeful, the future of India is in a very interesting position. As a country, we do have the potential to make healthcare independent of income and affluence-- and telemedicine would be at the nexus of it all.