Telemedicine in India: Where do we stand

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Introduction

Telemedicine is a novel approach to diagnosing and treating patients using remote technology. It is most effective in providing healthcare to low-income communities around the world. The World Health Organization (WHO) defines telemedicine as “the delivery of healthcare services over long distances by healthcare professionals using information and communication technologies for the exchange of valid information and treatment, diagnosis, and prevention of disease and injuries of individuals. It is also used for research and evaluation, thereby continuing the education of healthcare providers in the interest of advancing individual health.” It is not just health care delivery but also education, research, health surveillance, and public health promotion.

The role of ISRO in enhancing telemedicine:

The Indian Space Research Organization (ISRO) began telemedicine in India with a Telemedicine Pilot Project in 2001, connecting Chennai’s Apollo Hospital with the Apollo Rural Hospital in Andhra Pradesh. ISRO, the Department of Information Technology (DIT), the Ministry of External Affairs, the Ministry of Health and Family Welfare, and state governments all made significant contributions to developing telemedicine services in India. The WHO recommends a doctor-to-population ratio of 1:1000. However, India’s current doctor-to-population ratio is merely 0.62:1000. Because training new physicians takes time and money, the doctor-to-patient ratio is likely to remain low for a long time. This shortfall is partially offset by active telemedicine services in various parts of the country.

Benefits of telemedicine:

Consider how telehealth could benefit you if you have a sickness. You could try one or more of the following:

Upload meal records, medications, and drug doses using a mobile phone or laptop for evaluation by a nurse/doctor/pharmacist who answers electronically.
Watch disease-related videos on your phone via an app.
Estimate using an app depending on your diet and degree of exercise.
To view your test results, make appointments, get prescription refills, or email your doctor, use an online patient portal.
Online ordering of testing supplies and medications is available.
Rather than making an appointment with a specialist, have a mobile photo screening performed at your doctor’s office.
Get reminders by email, text, or phone when you need a flu vaccination, a foot examination, or other preventive care.

As a family physician, telemedicine assists by providing simple access to specialized doctors and close monitoring of patients, just as mothers do. Even if telemedicine cannot solve all problems, it can undoubtedly reduce the pressure on the healthcare system to a large extent. Previously, ECG data was transferred over telephone lines. Today, telemedicine is thriving in terms of technology and healthcare services, particularly during this COVID period.

Limitations of telemedicine:

While telehealth can improve coordination of care, it also risks fragmenting health care. Care gaps, overuse of medical care, incorrect pharmaceutical use, and unnecessary or overlapping care can result from misdiagnosis.

Other considerations, such as the ability to pay for them, may restrict the potential benefits of telehealth services. Telehealth insurance reimbursement continues to vary by state and type of insurance. Furthermore, some persons who would benefit the most from increased access to care may be restricted due to regional internet availability or the expense of mobile devices.

Telemedicine relies on an optimal internet network. Hence, interrupted or inadequate connections result in programme failure. It must not be halted for succession. Expensive instruments and a shortage of service engineers in remote areas impede the adoption of teleservices, resulting in the underutilization of the services. Due to a lack of orientation in the use of tele instruments, villagers could not use tele equipment independently, resulting in privacy difficulties. Another barrier to fully adopting telemedicine services is a lack of capacity building among personnel and the community.

Conclusion

Examples of telemedicine such as Medlife, Practo, Pharmeasy, Netmeds, and 1MG provide a wide range of healthcare services while pretending to be solely technological service providers to avoid health regulatory supervision. These businesses are now governed by the Information Technology Act and the Telemedicine Guidelines, which are geared towards registered medical practitioners. Although digital healthcare is already a huge accelerating sector due to the pandemic, the guidelines speak little about online platforms.

FAQs

Q1: Does telemedicine monitor patients in emergency/critical situations? How can it be beneficial in an emergency?

A1: Yes, doctors or medical practitioners are available to the public 24 hours a day and 7 days a week. This helps you reach the best doctors, whether nearby or far away. It could prove to be life-saving, but telemedicine should be avoided as much as possible for emergency care, especially when alternative in-person care is available.

Q2: Are prescriptions obtained through teleconsultation legally valid?

A2: The standards require medical practitioners/doctors to give prescriptions in the defined format for all teleconsultations, including their digital signature and registration number. If requested, the medical practitioner’s registration can be double-checked on the websites of the respective Medical Councils.

Q3: In the event of internet connectivity issues, the resulting telephone consultation may be disconnected or of low quality. What should the patient do in this situation?

A3: If the question of connectivity arises early in the consultation, the doctor may elect not to proceed, giving the reasons. If a problem with connectivity occurs during the communication, it can be recorded and saved as proof.