- Briefly state what is modern telemedicine.
- Present a picture of Indian telemedicine.
- Mention the effectiveness of telemedicine during Covid.
- Mention few associated challenges.
India is the 2nd most populous country in the world, with a population of around 138 crores. However, the ratio of doctor to population is not equally high. Thus, adequate and equitable distribution of healthcare services has always remained a challenge. Adding to this, the recent trend of concentration of healthcare facilities in cities & towns (including 75% doctor population) seems disturbing. The Covid-19 pandemic has added unprecedented burden on an already fragile Indian healthcare system.
Modern Telemedicine: In this context, telemedicine can be an important tool to improve healthcare service delivery, combating the mismatch, using IT technology. It can be used for information on diagnosis, treatment & prevention of disease or injury, research evaluation and continuing education of healthcare providers.
Over the past several decades, the use of wireless broadband technology has become more advanced, with cell phone-internet has become nearly indispensable. People, regardless of their status, are using these in daily lives. Further advancements in technology has resulted in transferring images of medical data and real-time audio & video consultations. Health Insurance Portability and Accountability Act 1996 guidelines, digitalizing information, have made e-Health & telemedicine stress-free & cost-effective.
Telemedicine in India: This practice have slowly gained foothold in India. The steps taken by ISRO, Dept. of Information Technology, MEA, MoH&FW and state governments have played a vital role in its development. ISRO was the pioneer of telemedicine with a Telemedicine Pilot project in 2001. To further this cause, the health ministry has undertaken projects like Integrated Disease Surveillance Project, National Cancer Network, National Rural Telemedicine Network, Digital Medical Library Network, etc. DIT has also formulated a standardized telemedicine practice guidelines. Indian telemedicine is also strategically placed in the global scenario with Pan African e-Network Project & SAARC telemedicine networks project. Private sector has too showed keen interest in this field. But till now, there is no legislation on practice of telemedicine posing risks for both doctors & patients.
How telemedicine proved beneficial in Covid times ?: the poor doctor-population ratio (0.62 1000) became daunting in the wake of Covid 19. It had delivered clinical information and discussion without the need for travel, thereby saving time, reducing medical costs and providing easier access for common man to consult specialist doctors. It reduced the burden on tertiary hospitals by providing treatments in their own geographical location and by reducing hospital visits. Simultaneously, it provided ongoing management of chronic diseases, particularly in social-distancing times. It also provided psychological support to patients & their families without getting exposed to infection. It had also provided training to health-care providers.
Challenges: it is fraught with few issues :
- Reduced liability of doctors if medical information provided is misinterpreted by patients.
- Privacy & confidentiality may get breached.
- No process for reimbursement for services provided through telemedicine.
- Specific competencies are lacking to run telemedicine program successfully, which needs technical skills to set up and use equipments. It can require extra time for equipment management & transmission of prescriptions.
Telemedicine will continue to grow and adopted by more healthcare practitioners & patients. Thus, there need to be a regulatory framework in fostering its growth. It will assist medical practitioners to pursue safe course of action to provide effective medical care based on available resources. However, telemedicine is not the answer for all problems, and cannot replace in-person consultation or emergency medicine. But its wider acceptance and implementation will help us prepare better for any future pandemics.