Abstract
“It is not the strongest of the species that survives, nor the most intelligent, but the one most adaptable to change.”
SARS CoV-2 pandemic has changed the world completely. Things are not like before. However, there are some differences between developed and developing countries in the implementation of telemedicine. The latest trends are social distancing and travel restrictions, which have deleterious effects on every country’s economy and the health care system. The application of telemedicine services is in the hour of need. The Hon’ble Prime Minister of India Shri Narendra Modi has emphasized the development of telemedicine on June 1, 2020. In this COVID crisis, people need health care facilities as they needed before. Certain non-COVID illnesses are at stake because of this pandemic, which cannot be ignored. With this aim of continuing health care facilities, telemedicine is a requisite to break the barrier of accessing and implementation of health care services.
World Health Organization and the Centre for Disease Control have recommended telemedicine. World Health Organization defines telemedicine as the delivery of health care facilities where distance is a barrier by all health care professionals (HCP) using communication and information technology to exchange information regarding diagnosis, management, and continuing medical education for HCPs.
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American Telemedicine Association (ATA) defines telemedicine as the natural evolution of health care in the digital world.
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Ministry of Health and Family Welfare (MoHFW) Government of India has focused on an exponential increase in the use of telemedicine for providing better health care facilities to the needed.
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There are 5 types of telemedicine.
World Health Organization recommends a doctor population ratio of 1:1000. 4 India is a developing country with more than 1.21 billion population 5 and a doctor population ratio of 0.62:1000. 6 Of total, 68.84% of India’s population resides in rural region, 5 where health care facilities are distantly or not at all available. The usual practice in India is visiting the physician in-person. In this crisis period with limited personal protective equipment and social distancing, we are compelled for some mandatory changes. Awareness among the general population’s opinion has developed an interest in teleconsultations. Telemedicine has proven that distance is not an obstacle in providing health care facilities. It can be made available irrespective of time, place, and socioeconomic status.
Telemedicine in India is under the aegis of MoHFW and the Department of Information Technology. The other organizations that have helped us in telemedicine are the Indian Space Research Organization, Integrated Disease Surveillance Project, and National Cancer Network (ONCONET). 7 One such initiative of Indian Council of Medical Research, Arogyashree, 8 collaborates multiple hospitals and health care specialists.
Being a resource-constrained country, we cannot be inclined toward the trends followed by the Western world. There has to be customization of certain factors in our country—(a) Low bandwidth of the internet can be a hindrance in smooth transmission during live or synchronous telemedicine. So stored and forward will be a good option. (b) Majority of the Indian population is rural, and not everyone can afford or operate smartphones. A telemedicine application on basic phones may be a good option. The building of small kiosks/boxes in a nearby location in the village may breach the barrier. (c) The entire patient-related information, including investigations, are not kept safe in electronic medical records in India. Most patients carry hard copies to one physician to others, which has a high chance of accidentally losing data or swap of information between patients. (d) Another point of concern is malpractice by a non-authorized person. Providing health care facilities by a non-registered medical practitioner can lead to a serious offense.
“The only difference between success and failure is the ability to take action.”
This action of implementing telemedicine can prove as an essential strategy to deal with this pandemic without compromising the health care facility. Virtual visits cannot replace the in-person visits, but at these challenging times, adopting this strategy can be the need of time. In the post-COVID era, virtual visits can be made to filter patients who need in-person visits. It may prevent nosocomial infections, reduce the cost of traveling, and save health care resources.
Footnotes
Author’s Note
NS contributed to conception, preparation, and final approval of the manuscript. This manuscript is original and it, or any part of it, has not been previously published; nor is it under consideration for publication elsewhere. This manuscript is exempted from the ethical requirements as it does not contain any human or animal research.
