What is telemedicine in healthcare?

The delivery of healthcare services to patients who are separated by a distance through information technologies is referred to as telemedicine.

In this practice, physicians, and patients can share information virtually and arrive at the best course of treatment faster.

In healthcare, there are 3 types of telemedicine which are as follows :

  • Ø  Interactive medicine – This tool facilitates the communication between the physician and the patient in the virtual environment.
  • Ø  Store and Forward refer to the sharing of medical information to the physician for diagnosis and evaluation of the patient’s health.
  • Ø  Remote Patient Monitoring – It indicates the use of mobile medical devices to monitor the patient’s health condition outside clinical settings.

2. Current status of telemedicine in India :

Digital health services have helped to plug the health divide that has long since existed between rural and urban India. Since its inception, telemedicine has helped to provide clinical support to numerous citizens in India.

As of March 2021, the telemedicine platform, eSanjeevani, established by the National Telemedicine Service, completed over 3 million consultations. So far, about 1000 hubs have been set up in various states, and around 21,00,000 patients have been served through this.

This platform has been widely adopted across the country. It is being helmed as a blessing in disguise during of COVID – 19 pandemic.

Based on the current statistics, the telemedicine market in India is expected to cross US $ 5.5 billion by 2025. These clearly indicate that this area has become an integral part of the mainstream medical practice in the country.

3. What’s the difference between telemedicine and telehealth?

 Telemedicine and telehealth are often used interchangeably. Both encompass information and communication technologies to promote long-distance health care services but do not necessarily mean the same at all times.

The distinct difference between the two is that telehealth encompasses clinical and non-clinical events. 

Telemedicine is primarily involved in transmitting patient data, video consultation, and remote medical support. It is mainly restricted to service delivery to the patients by the physicians.

In contrast to this, telehealth deals with the services provided by other healthcare professionals such as nurses and pharmacists. It is often utilized to conduct administrative meetings, continuing medical education (CME), and physician training besides providing a platform for patients to consult physicians. 

According to the WHO, telehealth is a broader scope of remote healthcare services. It includes surveillance, health promotion, and public health function.

Simply put, it can be stated that telemedicine is a subset of telehealth that is solely physician-focused. 

4. What is telemedicine used for?

Telemedicine is aimed to make healthcare more accessible, cost-effective, and enhance patient engagement with physicians.

Some of the ways in which this tool is currently being used are :

a) Follow-up visits – Through the use of health software, routine follow-up visits can be done remotely without the patient having to come for an in-patient visit. This is ideal for reviewing abnormal lab results, postoperative follow-up care, and minor urgent care. 

b) Remote chronic disease management – Video visits help capture the non-verbal communication that is often lost on phone calls, which has helped improve clinical outcomes. Patients with chronic conditions have shown better compliance with the treatment plans by adopting this platform, which saves both time and money.

c) Remote post-hospitalization care – The use of smartphone applications (apps) and wearable devices such as fitness trackers have proven to be beneficial in improving recovery and reducing healthcare costs in postoperative patients.

d)Control of infectious illness – Telemedicine offers an alternative to in-person visits and allows the physicians to assess the patient’s health condition without having them come to the clinic. This practice is convenient to the patient and beneficial to society as it lowers the exposure of these germs to other patients who are visiting the clinic. This is especially helpful to pregnant women, immunocompromised, and elderly patients. They are at a greater risk of getting ill when exposed to these germs.

e)  Health assessment – Telemedicine allows patients to consult doctors in the comfort of their homes. This is particularly helpful to specialty practitioners like occupational therapists who assess the patient’s ability to take care of themselves in their homes. 

5. How does it work?

Patients residing at home can download an app specially designed for telemedicine services to get the physician’s advice.

The most common mode in which this practice is carried out is through a simple video call. The patient can set up an appointment with the physician through the online account or directly contact the toll-free phone number provided by the physician’s office.

The patient will be asked to share his health condition and medical history during this process. Following this call, the patient will either be directly connected to the physician or given an appointment schedule to consult with the physician in the future.

Besides this, several patient portals are also available to directly facilitate the communication between the patients and the physicians. These portals help the patients to raise their questions, book appointments and even get their prescriptions refilled. 

Moreover, it provides the ability to securely share the patients’ medical records and store them for future consultations.

6. Is it as effective as personal consultation?

  Telemedicine is a great way to treat patients who have ongoing medical conditions or require an initial examination about a sudden illness. In these circumstances, this platform is as effective as in-person visits.

However, research has shown that it is certainly not as effective as in-person care in diagnosing respiratory diseases and life-threatening conditions like severe bleeding, shortness of breath, or chest pain.

Despite this, it has been proven that telemedicine provides the same level of in-person care for the treatment of minor injuries, nausea, stomachache, and other such illnesses.

7. Do’s and don’ts of telemedicine :

  Dos –

a) Use a good quality camera to allow the physician to see you clearly during the consultation.

b) Check your internet speed before the appointment to avoid any glitches.

c) Try signing in a few minutes before the scheduled time. It is often advised to check-in at least 10 minutes before the appointment.

d) Keep all the prescription bottles and medical records ready with you if they need to be verified or discussed.

e) Download the telemedicine app and familiarize yourself with it well before your visit.

f) Ensure that your mobile phone or computer is charged or plugged in.

g) Keep a list of all the hospitals and physicians that have treated you since your last consultation.

h) Write down all the questions ahead of time to avoid forgetting them during the visit.

i) Always ask the physician if a follow-up visit is necessary and set up the appointment accordingly.

Don’ts –

a) Don’t hesitate to contact the physician by phone after the telemedicine visit if you have any queries regarding the discussion.

b) Don’t sit in a noisy environment for your telemedicine visit. If the space is not quiet, try using headphones.

c) Don’t shy away from asking questions if anything isn’t clear in the treatment plan provided by the physician.

8. What are the issues and challenges of telemedicine in India?

  The use of telemedicine as a mainstream healthcare service is currently gaining popularity, but this certainly has its own challenges.

Although many medical professionals have adapted to the technological advancements, some are still reluctant and consider this an existential threat. 

It is imperative to sensitize and train physicians to adopt digital health tools to avoid this issue.

Furthermore, it is also vital to create an appropriate infrastructural and regulatory environment to overcome the structural challenges of telemedicine. 

The responsibilities, benefits, and risks of all the stakeholders and the financial reimbursement mechanisms for the virtual consultations must also be adequately defined to ensure the widespread deployment of telemedicine in India.

Another major challenge for this tool is affordable broadband which is crucial to increase the ease and accessibility of digital healthcare services. High internet connection speeds are yet another major issue that needs to be addressed. This is integral for the efficient transmission of data. 

The government has been proactive in addressing these challenges. It has shown a positive attitude towards tackling them in the coming years. In short, it is evident that telemedicine is gaining a solid foothold in India and would undoubtedly help boost the country’s digital health ecosystem.

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