Indian Healthcare needs to embrace Technology: COVID the 'force multiplier'
In the current scenario of COVID-19 pandemic, all businesses need to pause, see the big picture, envision the future, align their vision and mission statements with the opportunities that would open up, prioritize and finally press the reset button.
It is even more so within the healthcare systems across the globe. In the last few decades, it has been mostly traditional healthcare delivery systems that dominated across the globe. Certainly countries were not prepared to tackle the kind of pandemic that we are experiencing with COVID-19.
Though there has been an increased focus on equitable distribution of healthcare delivery, personalized care through technology-enabled solutions, the changes in the healthcare sector were not on par with other industries, rightly so due to the measured approach that is required to be followed in an industry like healthcare.
There was underutilization of technology-enabled innovative solutions in India, mainly due to the inertia in changing the status quo and challenging existing practices. Telemedicine is one such underutilized field in medicine and its advantages and benefits are brought to much-deserved focus in the current lockdown scenario.
In the wake of the COVID-19 pandemic, the Indian government released the long-awaited Telemedicine Practice Guidelines on 25th March 2020. Subsequently, several state governments proactively called doctors’ fraternity to enable telemedicine consultations.
With the doctor and patient separated by distance, absence of commute and absence of exposure of both the provider and the patient to other sick people, a person can avail a consultation with the doctor, over a telephone chat, an audio or a video call to get health counseling and prescription wherever appropriate.
India has long been battling with inadequate medical personnel in the primary care setups and inadequate hospital beds. When telemedicine is utilized to the fullest potential, there can be better primary care leading to fewer hospital admissions.
Scope of telehealth
All the wellness services, most of the primary care conditions and chronic conditions like diabetes, hypertension, etc can be tackled with syncing wearables, point of care devices and telemedicine consultations.
Screening for ophthalmological conditions, cancer follow-ups during remissions, chronic gastrointestinal problems, some acute and almost all chronic dermatological problems, reproductive health/contraception, sexual health problems, chronic urological problems, chronic respiratory ailments like asthma, COPD, certain heart conditions, rheumatological problems, chronic neurological conditions, treatment for chronic infections, palliative care services etc can all be carried out by teleconsultations. Telepsychology and psychiatry have been tried and tested and are taking off at a faster pace. Telepathology and teleradiology have already proven to be beneficial in bridging the distance barrier and overcoming capacity constraints.
Telemedicine can also be utilized for post-operative follow-ups, wound care, and rehabilitation services. With wearables and telehealth, more people can get home healthcare without exposure to the risk of hospital-acquired infections.
Owing to the COVID pandemic, most of the private hospitals, some government institutions, and many healthcare technology companies have deployed teleconsultations for free to the population of India.
Communicable diseases, especially those that are spread by respiratory droplets can be very well addressed and triaged by teleconsultations with advantages of limitation of exposure risk, better containment of infections, overcome the shortage of personal protective equipment, deploy better counseling methods and capacity utilization of medical personnel despite geographical barriers.
Non-communicable diseases can be dealt by telehealth for follow-ups, disease awareness sessions with multidisciplinary teams resulting in cost savings, uninterrupted medication delivery without the impact of local shortages, protecting the vulnerable populations from unwarranted exposure to communicable diseases.
Leadership and vision
India being a developing country with huge discrepancies in affordability of its people, always seeks cost-effective solutions. A telemedicine consultation to a remote area by a qualified medical professional leads to lowering of out of pocket expenses and is much superior in quality to a nonscientific deployment of treatments by a quack.
The current pandemic is an opportunity in disguise to test telemedicine to the fullest potential, and study medical outcomes of teleconsultations, the potential for the replacement of clinic/ hospital visits and cost savings.
With a mobile phone in every hand and a good adaptation of online grocery and apparel shopping, online ticket booking services and the likes, the time is ripe for healthcare delivery over the phone. Aarogya Setu App launched by Government of India to spread COVID-19 awareness and connect essential health services to citizens of India, is a perfect example to understand how ready India is to accept technology for healthcare. The App crossed 5 million downloads within 3 days of its launch.
Pradhan Mantri Jan Arogya Yojana (PMJAY) with the plan of opening up 1.5 lakhs wellness centers envisions telemedicine in each of these facilities. National electronic health registries with master health data of the nation with linkage across public and private health systems along with telehealth and health analytics, India can be at the forefront of medical research, track the performance of various initiatives, make better health policies, better pandemic responsiveness, and allocate budgets based on the real needs. Citizen's health record on the user’s side leads to better participation of people in taking control of their health. The National Health Stack, the visionary digital framework provides direction for all stakeholders in India’s health system for years and decades to come.
Who is going to pay?
Unfortunately, we are living in a world where diagnostics and pharmacy generate revenues to hospitals rather than the consultations by trained medical professionals. Similarly, hospitalizations are covered by insurance but not primary care. This needs to change if telemedicine has to succeed and be practiced on a large scale.
Our collective goal for both public and private health systems should be keeping the person out of the hospital by regular follow-ups, creating awareness, timely detection of worsening of a condition and enabling interventions, thereby reserving the hospitals for the sick and needy.
The US Department of Health and Human Services (HHS) had increased reimbursements for telehealth consultations after the COVID pandemic and many other countries too are changing regulations to actively promote telehealth. Teleconsultations in India by private providers need to be reimbursed by insurance companies. A strong case can be made if there is a well-planned study that can estimate the cost savings and prevent hospitalizations by the aggressive adaptation of telemedicine services.
Way forward
Some of the learnings from the COVID-19 pandemic are going to stay with us and the best practices will be continued into the next decades to come. There will be more adaptation of telemedicine by masses, better acceptance by healthcare providers, intensified deployment in various fields by hospital administrators due to realization of intangible benefits of telehealth, aggressive push and endorsements by various state governments and heightened enthusiasm of technologist entrepreneurs for coming up with disruptive solutions, and insurance companies coming up with innovative products that cover telehealth.
It is anticipated that there will be refinement and expansion of current telemedicine guidelines in the years to come and better direction on data collection, storage, and ownership leading to more professionalism and accountability from providers, shared decision making and participation from the patients and better continuity of care.
Telehealth is here to stay and is all set to make a strong impact on the health of people of India.
Opinions expressed are solely are our own and do not express the views or opinions of my organizations we are associated with.
