India is a diversified country with 60% of its population residing in the rural regions. The healthcare facilities reaching this population are inadequate and many treatable disease conditions turn out to be fatal. The first step in maintaining the good health status among the rural population is to provide a doctor to listen and look into the patient’s condition. With the brain drain to urban healthcare facilities , patient to doctor ratio is weakening every year.   Usage of telemedicine tools can be an excellent medium to serve the purpose and provide better healthcare to rural and remote places. Telemedicine is an electronic communication medium that exchanges clinical information between medical specialists and the patients. The Government of India’s Sehat telemedicine initiative in collaboration with Apollo Hospitals  which aims to connect 60,000 common service centres across the country and provide healthcare access to citizens irrespective of their geographical location is an is an example of telemedicine .

“Telemedicine can provide rural population access for basic, specialty and super specialty consultations. Since 80% of conditions do not require a doctor’s physical presence immediately, they can be dealt with through telemedicine,” Sangita Reddy, Joint Managing Director, Apollo Hospitals. “Most lifestyle and communicable diseases fall into this category.” 

 Telemedicine in India     

A critical shortage in the supply of health care providers in India demands novel approaches to deliver quality healthcare services to its wide spread geographical boundaries.    With the right usage of Information Technology and Communication , healthcare providers  can significantly improve in delivering quality healthcare by using telemedicine tool. .

Apollo hospitals are the pioneers in telemedicine in the State of Andhra Pradesh , India. 

 Usage of Telemedicine :
  • Bridge- Telemedicine can bridge the distance and can make specialty care more accessible to rural and urban populations.          
  • Live treatment- A simple video streaming through apps like Skype can enhance the treatment options available for the people staying in the rural areas.       
  • Post discharge care- Telemedicine can be a valuable tool in providing post discharge care to the patients who cannot ambulate and for the patients who stay abroad.       
  • Education and training- Telemedicine can be an excellent platform for isolated or rural health practitioners for continuing education or training and improvising their skills.
  • Economical- Telemedicine can avoid most of the unnecessary expenses spent by the patients in travel, diagnosis, delay in treatment and other emergency conditions. Thus, it is a highly cost effective and economical healthcare tool.

“When it comes to any health issue, time is of utmost importance. Timely medical intervention, diagnosis or treatment is the only thing that can cure illnesses and save lives. Telemedicine bridges this gap.” – Dr. Sunita Maheshwari, President of Telemedicine Society of India.

 Electronic consultations- an easy access to specialty care:

Electronic consultations can be defined as provider-to-provider communications within a shared electronic health record or web-based platforms. 

“A patient named Mr. Shanker Chandra was undergoing treatment in Calcutta under Dr. Tamal Bhattacharya. During the course of treatment, the patient was referred to Dr. Alok Chandan at specialty center in Hyderabad. Telemedicine allowed both the doctors to refer and communicate the patient’s reports and condition. This made a remarkable contribution in generating the treatment plan to the patient.  Electronic consultation enabled the patient to receive a better future treatment plan.”

Doctors can take the advantage of technology to provide better patient care and to improve their medical knowledge while interacting with the specialist.  The doctors can have an opportunity to virtually visualize and study the patient’s condition.

electronic-consultation

There are more than 400 telemedicine platforms located in different Medical Institutes, Medical Colleges and Corporate Hospitals in India. 

 

 

 Digital health-An intelligent strategy

“An earthquake in Gujarat on January 27, 2001 destroyed the western city of Bhuj and left many people injured  and homeless. The onlinetelemedicine research group in Gujarat established satellite telephone links to provide emergency medical care through telemedicine. This enabled tele-consultation between the district hospitals, where the victims reported and their conditions were visually shared with the doctors. Telemedicine here acted as bliss for many.”

The main aim of digital health telemedicine is to link various clinics and hospitals located in remote areas with research centers and specialty clinics. Digital health programs provide the best medical care to the remote corners of India and to the people who cannot afford the cost of treatment.

VSAT, Terrestrial and ISDN are telecommunication equipments used in India for telemedicine.

digital-health

Telemedicine– Remote patient Monitoring

A five-year-old patient, Thejas was admitted in the Aragonda Apollo hospital, located in a village in Andhra Pradesh, India. The doctors in the hospital diagnosed a murmur in the heart and kept him on a color Doppler. The Doppler images were transferred to pediatric cardiologist Prem Shekhar in Chennai, who diagnosed the case as “Sallot’s Tetrology, which is a congenital heart disease. After few hours of consultation, the child was transferred to Chennai Apollo Hospital for surgery.”

Remote patient monitoring uses digital technologies to collect health data from individuals in rural areas and electronically transmit that information securely to specialists in other locations for assessment and recommendations.

monitoring_patient1

The ISRO’s Telemedicine Network at Andaman and Nicobar Islands during post Tsunami disaster relief work was beneficial for remote population of Andaman and Nicobar Islands.

 Advancements Made in  Telemedicine

In 2012, the telemedicine market in India was valued at $7.5 million, and it is expected to rise 20 percent annually, to $18.7 million by 2017.

“Moving beyond the physical presence in medicine”-Telehealth

Telehealth is the usage of gadgets such as computers and mobile devices, to manage and maintain good health. It includes a variety of health care services including, but not limited to:

  • Online groups that talk about a particular disease or disorder.
  • Online access to health information portals and self-management techniques.
  • Texting, email and online communication with health care providers.
  • Electronic health records (Diagnostic and laboratory reports).
  • Video calling and electronic visits.

An Indian firm Call health Pvt. Ltd, which is being initiated by September 2015 is claimed to be the world’s first integrated virtual and mobility platform to give access to all healthcare products and services from the comfort of one’s home.

How people with diabetes can use tele-health to manage their health without having to leave home:-
  • Patients can use a mobile phone app where he/she can record the food consumed, medications, dosing and blood sugar levels. The applicant sends the information to a healthcare provider for review who may respond electronically.
  • Patient can communicate with a nurse or diabetes educator through email and clarify the doubts and concerns.
  • Patients can then order testing supplies and medications online.
  • Patients can research and improve their knowledge about the treatment side effects and take necessary precautions.
  • Patients can subscribe to the health websites that generate an email or text message about the preventive measures.
Benefits to healthcare professionals:healthcare-professionals
  • Improved diagnosis and better treatment management.
  • Continuous education and training.
  • Timely help and follow-up of discharged patients.
  • Access to computerized patient’s data-both online and offline.

Mobile health- The Unwired development of telemedicine

Mobile health is a term used for the practice of medicine and providing healthcare, which is supported by mobile devices. Mobile health applications are generally used in collecting community and clinical health data, delivery of healthcare information to practitioners, researchers, and patients, real-time monitoring of patient vital signs, and to directly provide care.

Mobile health technologies include:

  • Devices for patient monitoring
  • Telecare devices
  • MP3 players to educate
  •  Microcomputers
  • Data collection software
  • Mobile Operating Systems
  • Mobile applications

The launch of 4G in India can improve mobile health (mHealth) promotion in the country; it is estimated that $0.6 billion mhealth initiatives would start by 2017 

Mobile apps- Innovations that can shape healthcare’s future

Mobile telemedicine applications aim at meeting the requirements of patients and doctors by integrating wireless communications for different health care services and education. The mobile apps allow consumers to take charge of their own treatment and prevention.

Bluetooth telemedicine: An app that can measure the electrical signals from the patient’s heart and can detect the possibility of a heart attack. The application produces an electrocardiogram report and sends it through text message to the local hospitals.

Large numbers of mobile apps are created to help consumers to store health records, upload information from devices such as blood glucose monitor and blood pressure cuffs and share information with healthcare providers.

e-visits- Care that is convenient, timely, and secure

E-visits can be defined as an assessment and management service provided by a physician or health care professional to a patient using a web-based or electronic-based communication network.

Benefits of e-visits: e-visits can benefit patients and healthcare professionals.

  • Convenience: A virtual doctor can conveniently diagnose common ill
    ness like Sinusitis, flu and minor skin infections through e-visits.
  • Flexibility: Patients can have an access to healthcare on any day through e-visits.
  • Personalization: The healthcare professional can access the patient’s health record online and can personalize the treatment.

Home Health Monitoring: The home health monitoring enables patients with severe chronic diseases or conditions to monitor their blood sugar and other health factors from the comfort of their homes and share this information electronically with their physicians and other healthcare providers.            

Benefits of home health monitoring:

  • Significant reduction in hospitalizations.
  • Increased productivity of healthcare team.
  • Increased patient satisfaction and overall quality of care
  • Easy capture of healthcare data, which can be shared with healthcare professionals
  • Access to an application in tablet or computer at home.

Over the past 1bluetooth-telemedicine5years, telemedicine has witnessed a way forward in advancements, which makes it the simplest and most flexible healthcare tool available today. However, the motto of reaching the rural population is hindered due to poor broadband connectivity facilities.  An extended support from the government in providing infrastructure to the rural areas can help in resolving the concerns related to telemedicine. The recent mission of the government of India to introduce high-speed optic fiber-based broadband connectivity in all the backward areas of India can help in fulfilling the telemedicine reach to all the nook and corner of the country.

India needs an additional 1.54 million doctors and 2.4 million nurses to suffice today’s global average demand; developments in healthcare IT may alleviate the deficiencies largely. 

References:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2782224/
http://www.who.int/ehealth/resources/compendium_ehealth2013_7.pdf
https://www.telushealth.co/health-solutions/patient-and-consumer-health-platforms/products/home-health-monitoring/
http://reliantmedicalgroup.org/information-for-patients/e-visits/
http://nuviun.com/content/digital-health-in-india-the-worlds-largest-democracy
http://www.americantelemed.org/about-telemedicine/telemedicine-case-studies/case-study-full-page/mhealth-program-provides-improved-prenatal-care-for-at-risk-pregnant-women#.Vd2x9yWqqko
http://www4.ncsu.edu/~fcpayton/Telemedicine%20diffusion%20in%20a%20developing%20CountryThe%20case%20of%20India.pdf
http://www.sgpgi-telemedicine.org/Publication/peer_publication/Telemedicine%20in%20India%20Current%20Scenario%20and%20the%20Future-1.pdf
http://indiaeducationdiary.in/Shownews.asp?newsid=35732

Telemedicine-A Bliss For Providing Better Patient Care

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