Focus

Virtual OPD

Despite the promises that it made, telemedicine has not been able to live up to the expectations. Now, a company has come up with an alternative solution to telemedicine. Nancy Singh logs in to check what 'Virtual OPD' is all about

Now, even the most pessimistic of all, does not doubt the potential that healthcare industry holds in our country. This sunshine industry refused to fade away in one of the gloomiest phases of economy. But, the catch is that in spite of the phenomenal demand, one segment which remains largely untapped and under-addressed is rural healthcare (which also incidentally forms the majority).

Not that anybody is not interested, but the challenges have proven to be so many, that most of them, till date, have not been able to break this barrier yet. Enter technologists and IT companies who are endeavoring hard to provide solutions to make both these ends meet. As a result, you can see 'e-prescription' or 'e-medicine' manifesting itself in many ways, where distance is a mere figure of speech. Firstly, we heard them talking about tele-medicine, then off-late we read about a doctor who is available 24-7 through a mobile call or available online. And now the latest 'Made-for-India' solution is 'Virtual OPD' for rural patients offered by a company called Avaya Global Connect. "We looked at industry pain points before architecting communication technology based solutions to address the pain points. The landscape of consideration includes macro challenges (healthcare issues before the country) as well as micro challenges (organisational issues)," informs Samir Sayed, Director- Sales, Avaya Global Connect, Chennai. "What we found out was that every group was interested in rural healthcare, either as part of their expansion strategy or as part of their CSR. Every doctor would love to help the poorest of the poor, but eventually it all boiled down to time and space, where unfortunately even tele-medicine did not seem to be a perfect solution. Hence, we came up with Virtual OPD," continues Sayed.

What's Virtual OPD?

Coming to the point, what exactly is this new solution all about? Basically, this solution virtually simulates the OPD of hospitals with the power of internet, Unified Communications (UC) technology and video contact centre application along with the telemedicine solution. "When a patient is normally visiting to a hospital, he/ she gets a token, after which the patient waits in a queue until his/ her turn comes. Now, we are creating the same situation but 'virtually'. Doctors can access to application and provide services sitting from their homes or private clinic using a broadband connection, laptop or computer attached with web cam," explains Anil Nair, MD of Avaya Global Connect Limited. The best part is that there can be multiple rural centres whereby when a patient walks-in, clicks the button to the desired speciality and then the system understands the person's need and connects him/ her directly to the doctor of the available speciality. If the said cardiologist is busy, it isn't that much a problem as either the patient can wait or else there are multiple doctors who are online at a given particular time, who can take care of the need of the patient. As soon as the doctor is done consulting with one patient, the second one automatically gets connected.

Elaborates Nair, "With virtual OPD, any patient from remote area can go to the healthcare centre where he can request for a doctor related to his health problem. And this request is then visible on web application where the respective doctors can login to the session using webcam and start examining the patient."

Telemedicine Versus Virtual OPD

"Virtual OPD is highly scalable with many-to-many sessions" - Sameer Sayed Director- Sales Avaya Global Connect

"Patient from remote area can go to the healthcare centre and can request for a doctor" - Anil Nair Managing Director Avaya Global Connect

Telemedicine is often said to be the elixir to the problem of rural-urban divide, but creating the infrastructure at large scale, providing multiple medical speciality services simultaneously and giving doctors the flexibility to provide services within the confines of their offices or homes are some of the bottlenecks which have not allowed telemedicine to become main stream at least for rural India. There are many areas of concern regarding tele-medicine where virtual OPD plans to make a difference:

Scalability: One-to-one infrastructure inhibits rapid creation and management of infrastructure. The specialist has to be there at a particular place at a given set of time and even the patient has to be present at a given place and particular time. Sayed adds, "Virtual OPD is highly scalable with many-to-many sessions, which means many patients from different locations can simultaneously access doctors or specialists across locations. The solution is modular and the company offers it at operational costs to hospitals and healthcare centres. They are not required to make any upfront or capital investment for the virtual OPD solution. Hence, it can serve the masses with the existing healthcare facilities."

Limited Coverage: With tele-medicine, it is not possible to provide multiple specialities simultaneously at the same time. But with this solution, all the possible specialities can be available at the same time, living up to its name of 'OPD'. This increased spectrum of services available is a big relief for the provider as well as the end-user. Agrees Nair, "By marrying its video contact centre and unified communication technology portfolio, Virtual OPD provides a platform wherein patients just like in any hospital OPD, have access to various medical specialities simultaneously in a virtual world."

Infrastructure: Apart from the high capital investment required to set up a telemedicine centre in the rural region and also establish a dedicated room at the hospital, another concern with tele-medicine is that infrastructure sharing is not possible between various institutions, whereas with virtual OPD, almost 50 centres with hundreds of patients can be catered to at one instance, with doctors from institutions sitting in almost every corner of the country.

Flexibility and Freedom: This is one area where the concept of virtual OPD scores big time over the traditional form of tele-medicine, which is why, chances of doctors accepting this technology would be higher. It has to be kept in mind that speciality doctors are super-busy and with them running short of time, they cannot afford to be present to provide tele-medicine services all the time. There is a restriction of movement as well. Whereas with virtual OPD, he can move freely and provide services at his own convenience. He is not at the mercy of any infrastructural issues and free to choose the time at which he wants to log-in in the system and show himself as 'available'. This kind of flexibility and freedom is hard to think with tele-medicine.

As this system integrates with the telemedicine application, all the health records and patient's history is available to doctors. Point to be noted is that since many doctors can get online during the sessions, if a patient takes more time with a doctor, then the second patient's request which is in queue is routed to another doctor using the video contact centre programme. Hence, the application tries to utilise the pool of available doctors and provide services to more patients.

Some Projects

Launched in the month of May 2009, the response to this solution has been quite positive. As of now, the company has landed two significant pilot projects. Not revealing the identity of the groups on request, one project is a Government healthcare project in the East which plans to connect 50 rural health centres and another project involves a private healthcare provider somewhere in the South. The management also feels that low internet penetration would not be a significant trouble as with good broadband connections available in the market, this aspect can be taken care of. As for other medical equipment required, the company again feels that it is not a big headache, as there are many medical equipment providers who are providing customised solutions meant solely for rural healthcare devices market. There are enough battery-operated and portable devices available currently and the trend of diagnosis in the future will also be moving in this direction. As there are so many specialities that require high-end test, the company analysed the fact that 70 per cent of the population would get a diagnosis report from their nearest diagnosis centre which can easily be sent through a telephone or the computer to the doctor sitting to the other end. The application cost ranges from Rs 1.5 lakh to multiple lakhs, based on the kind of scalability it is providing.

Moving Forward

While it has just introduced this solution to the healthcare industry, it is far too premature to think about whether it will change the rural healthcare paradigm. But as a long-term future, the company plans to market it not only as a solution for rural healthcare, but also the urban population.

For rural population, the doctor is too hard-pressed for time, while for the people living their lives in the fast lane, they are the ones who are short of time! The kind of infrastructural changes that country-side faces, does not exist in urban landscape and with an ever-increasing mobile population that is frequently on the net, the company hopes that this solution indeed can be well-accepted. As of now, all they are taking is some baby-steps to move forward and depending on word-of-mouth, until the action speaks for itself. On the positive side, at least healthcare providers are finally given a choice instead of only tele-medicine. We have to wait and watch, as to how beautifully this system will synergise with the conventional form of medical services to actually make a difference that it promises.

nancy.singh@expressindia.com