The Association of Physicians of India launches therapy-specific teleconsultation recommendations, for Indian physicians

The Association of Physicians of India launches therapy-specific teleconsultation recommendations, for Indian physicians.

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• Teleconsultation has considerably risen by 300% between March and November 2020[1] in India

• Currently a mainstay for accessible healthcare, teleconsultation lacks standard operating procedures, for specific therapy areas, that ensure appropriate delivery and continuity of care

• The therapy-specific teleconsultation recommendations for Indian physicians, by The Association of Physicians of India (API), aim to streamline teleconsultation and ensure quality care in line with best practices  

The Association of Physicians of India (API) has launched therapy-specific teleconsultation recommendations, in collaboration with Abbott. This robust set of recommendations outlines best practices on adopting teleconsultation across various therapeutic areas, currently catering specifically to cardiology, diabetes, gastroenterology and adult immunization with plans to cover more specialties in the future.

The Indian health ecosystem has evolved rapidly, integrating digitalization into healthcare. The adoption of telemedicine consultations or teleconsultation accelerated in 2020, with India witnessing an estimated 300% rise in teleconsultation between March and November1. This rapid growth has been attributed to multiple barriers to in-person consultations due to the pandemic, as well as limited availability of healthcare resources, lack of proximity to a clinic and other constraints2. The risk of infections has also impeded vulnerable groups, especially elderly and immunocompromised individuals, from availing in-person consultations. Additional factors contributing to the adoption of teleconsultations include approval by the Ministry of Health and Family Welfare to conduct virtual diagnosis, treatment and follow ups, bringing teleconsultation to the forefront3. 

Teleconsultation can also support a rise in routine follow-ups for disease management and monitoring. These follow-ups are crucial, especially for chronic conditions such as cardiovascular diseases and diabetes. Furthermore, with rapidly rising penetration of mobile technology and internet in India, the benefits of teleconsultation can reach underserved segments of the population, particularly in rural areas.  

Teleconsultation has therefore been established as a mainstay for accessible medical advice and care. This has prompted an urgent need for official recommendations to guide practitioners, who may be more accustomed to examining patients in-person, to deliver virtual care appropriately whilst catering to various therapeutic areas. Moreover, therapy-specific recommendations are imperative to streamline protocol and standard operating procedures to ensure consistency in the teleconsultation approaches undertaken by respective medical practitioners.   

Dr S Arul Rhaj, One of the Editor in Chief and Immediate Past President- Association of Physicians of India said, “Telemedicine consultations are now widely sought after, especially with the Government’s nod to adopt them for diagnosis and treatment. While general guidelines exist, there is a need for clear-cut and defined guidelines for specific therapy areas, which can vary significantly across symptomology, pathophysiology, diagnosis, testing, disease management and treatment steps and red flags. This necessitated therapy-specific teleconsultation recommendations to ensure structured, streamlined consultations and improved patient care.”  

The recommendations introduced by the API offer in-depth information that can equip healthcare practitioners with the knowledge necessary to adapt medical best practices for teleconsultation. For example, the recommendations for disease management in diabetes span the entire patient journey from glycemic monitoring to counselling on lifestyle. The recommendations encompass patient history, diagnosis, testing, disease management and scheduled follow ups, thereby enabling  practitioners to be cognizant of key parameters for decision-making, guided by flow charts specific to each therapy area.  

Commenting on the recommendations, Dr. Balagopal Nair, Regional Medical Director, Abbott Pharmaceuticals Division, India said, “Teleconsultation offers the possibility of overcoming geographic restrictions by increasing access and ensuring extensive reach. It has the potential to enhance the efficiency of healthcare systems by offering virtual care and making healthcare more accessible. Abbott has collaborated with the Association of Physicians in India (API) to release the first India-specific teleconsultation guidelines, to   provide a useful repository of evidence-based information to healthcare practitioners across different therapeutic areas to appropriately diagnose, treat and manage patient conditions virtually, thereby enabling them to live healthier, fuller lives.”  

The recommendations detail technological requirements, software and other practical tips to facilitate consultations. Physicians can thus make optimal use of digital tools, which paves the way for a structured and seamless patient experience. 

Furthermore, the recommendations instruct physicians on conditions to rule out across various acute conditions, such as myocardial infarctions or arrythmias, which cannot be managed virtually and may necessitate face-to-face examination or treatment with hospitalization after an initial teleconsultation. They also uphold the importance of safety, privacy, and other patient rights and safeguards by familiarizing physicians with medicolegal implications, including therapy-specific drug types that can or cannot be prescribed during teleconsultation.

 While teleconsultation cannot be adopted wholly for every therapy, it is emerging as a feasible alternative mode of delivery of healthcare across diagnosis, management and follow-ups, especially in circumstances where in-person examination may not be possible. Disease-specific teleconsultation recommendations can support the development of a standardized, high quality model of virtual care in the long-term.