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Telemedicine: Growing adoption amid the current crisis

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Juilee Dandekar, Sector Expert – Healthcare, Aranca shares how telemedicine is beneficial both for the healthcare sector and patients alike, how different bodies from government, private, start-ups, medtech can help better telemedicine delivery and increase penetration even into very remote areas of India

COVID–19 has taken the entire world in its grip. The highly contagious virus has claimed lakhs of lives across nations. Frontline warriors, members of the healthcare community, have been at the receiving end, with many getting infected and succumbing to the disease. With physical distancing emerging as a key precautionary measure in the fight against COVID–19, attention has turned toward virtual healthcare.

Telemedicine or remote care of patients has been around for decades. However, it is the pandemic that has made the need for its large scale adoption more pressing than ever. Medical technology, such as wearable devices to monitor vital statistics, and online services facilitating access to lab test reports have simplified virtual healthcare.

In the light of the shortage of the required healthcare infrastructure to fight COVID–19, telemedicine could well emerge as one of the solutions to overcome the crisis.

Healthcare infrastructure inadequate to deal with the COVID-19 crisis

The current pandemic has exposed the vulnerability and inadequacy of the existing healthcare infrastructure in most countries. In Italy, for instance, hospitals, especially in the city of Milan, have been struggling with acute shortage of beds. Unavailability of protective gears has also put many doctors in harm’s way.

Other European countries such as Spain, the UK and Portugal found it difficult to put up an effective fight amid shortage of testing kits, poor availability of protective clothing and equipment, and overworked healthcare staff. Consequently, the number of infections and eventually death toll climbed in these nations.

Rising number of cases has thrown a similar challenge before India. Healthcare spending in the country has been the lowest among emerging nations, at 3.6 per cent of GDP prior to the COVID–19 outbreak. Funds allocated to states for medical purposes are often unutilised or underutilised. As a result, the quality of services and amenities provided to the underprivileged in government-funded institutions are at best sub-standard and poor. Private healthcare is anyways out of the reach of this section. There is a severe shortage of primary healthcare centres and community healthcare, with government hospitals having 0.6 beds per 1,000 patients. Paucity of resources, coupled with other systemic issues, has compounded the problems in India.

To ensure care is targeted in the right direction amid the limited availability of amenities and prevent infection from spreading, medical institutions are asking patients to carry a COVID–19 negative report if they need to be admitted for any reason or even consultation. In the recent months, OPD and non-emergency services have been shut down in several hospitals so that the staff can focus on coronavirus-infected patients. Those suffering from cancer, kidney issues and TB are being turned away due to lack of facilities. Therefore, in the absence of treatment on time, many of these patients have succumbed to their respective diseases, contributing indirectly to the death toll attributed to the virus.

Telemedicine offering hope

The World Health Organisation (WHO) has recognised telemedicine as an essential service in this situation. It needs to be adopted on a large scale in countries such as India. First, from the perspective of safety of healthcare professionals who are at the forefront of providing services and, therefore, vulnerable, and second, to increase the pool of medical professionals (with geographic distance no longer a concern)—even doctors in quarantine can pitch in.

Due to the many benefits it offers, demand for telemedicine has surged and it is increasingly finding acceptance among doctors, paramedics, and consumers.

Telemedicine can be used to attend to non-COVID patients as well who are unable to get medical help due to the shortage of medical staff and equipment. Specialist care can be availed of virtually, doing away with the need to visit clinics. While this cannot help with critical illnesses that need physical examination, the idea here is to effectively manage the disease until actual care is available or a visit to the hospital is feasible.

The ecosystem

Government

The push has to begin at the helm, which it rightly has. The Indian government recognises the significance of telemedicine. The Ministry of Health and Family Welfare (MoHFW), together with NITI Aayog and Board of Governors (BoG) Medical Council of India (MCI), has issued a new set of Guidelines for doctors and caregivers pertaining to the use of telemedicine, its application, reimbursement, etc.

Start-ups

Given its immense potential, telemedicine has sparked the interest of entrepreneurs. The Indian telemedicine industry, growing in leaps and bounds, is expected to create market opportunities worth $5.4 billion by 2025.

New rules will bring clarity and systematise processes, enabling start-ups such as Practo, DocPrime, mFine, CallHealth, Lybrate, Meddo and Navia Lifecare to contribute effectively in checking the spread of coronavirus and ensuring access to quality healthcare for the rural areas in India. Teleconsultations via audio and video facilities will not only reduce the number of patients going to hospitals but also improve the doctor-patient ratio in India which is skewed. 

One of the key challenges faced by companies pushing for the adoption of telemedicine is to win the trust of people. It is difficult to replace the goodwill enjoyed by a friendly doctor in the neighbourhood or the confidence in diagnosis based on physical examination.

Medtech companies

Medtech companies stand to benefit from the opportunities presented by telemedicine. They can collaborate with healthcare service providers and develop innovative devices or technologies in line with the requirements of telemedicine services. Smart devices (such as wearables) equipped with artificial intelligence (AI) and big data analytics will help in capturing a wider set of relevant health-related information for a comprehensive diagnosis.

A robust healthcare infrastructure is the need of the hour. Amid the growing pace of digitalisation in the country, demand for telemedicine is expected to pick up in not just urban but also rural areas. It is important that the cogs in the wheel such as the government, with its favourable regulatory policies, and key stakeholders, such as physicians and medtech companies, work in sync to win the confidence of people and facilitate further adoption of telemedicine.

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