By Dr Azad Moopen
India has the world’s highest number of medical colleges, and the second highest number of doctors. Yet, segments of the country’s large population of 1.3 billion remain underserviced by healthcare systems. The doctor population ratio in India is 1:1456 while the WHO guidelines recommend 1;1000. The same is true regarding the other areas of healthcare which results in high levels of infant and child mortality and very low health indices in the country. The gap between the actual demand and supply in healthcare along with attendant shortcomings in the public health system. This shortage is even worse when it comes to the rural areas where majority of the population lives. This is situation is prevalent in not only in India, but most of the developing countries in Asia, Africa and South America.
While there is no panacea to address this, one of the benefits of the technological leap that is happening across the world is likely to bridge this gap to some extent, if properly utilised. We have seen what happens in the area of telecommunication, mobile telephony leap frogging, giving accessibility to data and voice communication to billions in the poor countries at very low cost. This is an astonishing revolution that helped the world to shrink and help better and efficient communication. It is worthwhile looking at leveraging this to take healthcare to billions who do not have access to it due to physical boundaries. A patient in a remote part of the country including the hilly and tribal districts or in other countries in Africa can easily be seen by a doctor sitting in a city and a treatment prescribed. This will pen up huge opportunities increasing access to quality healthcare.
Healthcare consumers have begun to increasingly accept digital platforms as an alternative to physical access to doctors and hospitals. The pandemic has created the need for a healthcare ecosystem that is integrated digitally, to enable reach for patients and doctors who refrain from in-person visits to avoid infections.
Ayushman Bharat Health and Wellness Centres across India have started offering telemedicine services, as the health ministry too is focusing on strengthening online medical consultation services. To ensure the success of this initiative, an integrated digital healthcare ecosystem is vital, as is access to this ecosystem via uninterrupted internet bandwidth and an affordable smartphone.
In addition to providing patients in rural areas with easy access to specialist advice without having to travel long distances, telemedicine serves to decrease the in-patient load in tertiary care hospitals, as often the patients need not come back to the hospital for follow up but can do this in the comfort of their houses and get the medicines delivered.
While the pandemic may have triggered an increased adoption of telemedicine services, the ease at which people have adopted the technology makes the medical fraternity believes that it is here to stay. At Aster, within 8 months of introduction in 2020, around 800 doctors enrolled across 5 countries provided over 100,000+ consultations. Seeing the success, Aster continues to encourage people to use the model along with the option of an in-person visit to our clinics or hospitals. A hybrid telemedicine model, alternating between in-person and telehealth visits has many advantages and is sustainable in the long run. It can create continuum of care that telehealth alone cannot. While new patient appointments are virtual, follow up appointments requiring physical examination and diagnostic work can be scheduled as in-person visits. Subsequent visits can be telehealth if this seems appropriate to the patient and the doctor. This model allows for screening to prevent unnecessary contact, for observation of the patient in their home, saves travel time and cost and increases affordable accessibility to specialists.
Most non-communicable diseases (NCD) are compatible for assistance through telemedicine. During the preliminary consultations and follow-ups, patients can be trained to self-report blood pressure/blood glucose/body weight. Hence, India’s high NCD burden can be supported efficiently with hybrid models. During the pandemic, healthcare providers witnessed a sharp rise in mental health issues, and this is another area where telemedicine providers can offer counselling and therapy to patients, in the comfort of their home.
In India, this may also be beneficial in Medical Tourism. Hospitals can provide a superior patient experience and seamless transition of care to international patients by utilising a hybrid telehealth model. Through this, initial consults and doctor-patient interaction can happen days or weeks before the patient arrives in India for treatment.
Another area where Aster was one of the early movers was launching the E-ICU model wherein critical care experts from across operations were pooled into one central hub so that care for our patients doesn’t stop. This innovative and highly successful remote care strategy will help hospitals care for critically ill patients thus optimizing ICU resources.
While the benefits are numerous, telehealth does pose challenges. Healthcare workers with no training in digital skills need to be up skilled to ensure efficient and accurate usage of telehealth software. A huge section of patients continues to question the reliability of the online diagnosis and are not comfortable with the use of technology either. Digitally challenged patients do trigger the risk of miscommunication of symptoms, prognosis, or prescriptions. However, these hitches can be regarded as teething problems accompanying the adoption of any new technology or behaviour and can be expected to resolve organically, over time.
Dr Azad Moopen, Founder Chairman & Managing Director, Aster DM Healthcare
(DISCLAIMER: The views expressed are solely of the author and ETHealthworld does not necessarily subscribe to it. ETHealthworld.com shall not be responsible for any damage caused to any person / organisation directly or indirectly.)