COVID-19 has disrupted life, compelling people to adapt to new treatment ways. When hospital visit is risky, telemedicine has come in with the right prescription. MUSBA HASHMI leads you through the medical sector’s online switch and the upgrades needed to meet the surge in the last two months

It was midnight when Abhijit Saxena, a 35-year-old Delhiite, woke up to his mother’s scream. The 60-year-old was convulsing from a sudden and acute ear ache. After self-medication failed to get her relief, the pain became so unbearable that Saxena had to rush her to hospital.

Both were denied entry at many hospitals. Saxena was advised to keep his mother away from hospitals due to the Coronavirus scare. Looking for a doctor became a Herculean task and the night became the longest one for the duo.

After hours of being a helpless witness to his mother’s suffering, it struck Saxena that he could tap a doctor online. The ENT specialist he contacted, immediately prescribed the painkillers and eardrops that worked magic on his mother.

Cooped up in their homes and with most hospitals being out of bounds due to the pandemic, many have either switched to home remedies or telemedicine, not wanting to catch an infection from a hospital. Dr Alexander Kuruvilla, Chief Healthcare Strategy Officer, Practo, tells you that about 60 per cent of the population has access to only 30 per cent healthcare facilities in India. Though telemedicine is on an all-time high, not much will change in the sector post-pandemic, he warns.

“For a patient in Arunachal Pradesh to take the opinion of a doctor in Delhi, you cannot have better technology than telemedicine. But not much will change in the telemedicine sector. We as a country, despite having the best doctors, are struggling for them in villages. The doctor-patient ratio is skewed. Therefore, telemedicine will help people in rural areas to have access to doctors and better healthcare facilities,” he says.

In urban areas, the time taken to commute to a hospital pushes many a patient to the chemist next door or self-medication, without professional advice. Under these circumstances, telemedicine is the way forward.

“Through telemedicine, the treatment starts early. Also, doctors are availabe even in off-duty hours, on weekends and holidays too. It saves patients from searching for doctors in an emergency. There are multiple ways in which telemedicine helps and will continue to help even after the pandemic is over,” he asserts.

The growth has paved way for new players in the field, and a sudden surge in users for the existing ones. However, there are chances that post-COVID-19, people will follow the traditional route of visiting a doctor and telemedicine may see a decline.

“It will not grow at such a pace as now. The growth will be slow, but it will not fade out. Take for example, the US and Canada have adopted telemedicine as a common way to address health issues. Insurance companies reimburse teleconsultation fees, realising that if a disease is addressed early, the cost of reimbursement will reduce,” Kuruvilla tells you.

He points out that though Coronavirus has made people follow social distancing seriously and avoid going to hospitals unnecessarily, visiting hospitals for minor issues is not a good option as they pose a threat of cross-infection not just for Coronavirus but for other infections as well.

Practo has grown five times since March 1, 2020 and the team is working late hours all week to respond to health needs. Many doctors are showing interest in working with the platform.

“We follow a stringent process when it comes to getting doctors registered with the app. We make sure that all their degrees and certificates are verified and available on the platform for users. We have separate sections for Ayurveda, Allopathy and Yunani medicines so that the patient can figure out what he wants to opt for. Given the surge in the last two months and the response strategy we had, we are ready to handle any situation in the near future,” he explains.

Amit Pandey, senior scriptwriter at Cosmos Maya, who writes scripts for cartoon shows, see telemedicine as a gift of technology, especially for people who can’t compromise on work.

“As the world struggles to come to terms with the outbreak, at a granular level it has brought a drastic change in life across the globe. While businesses across different sectors are reeling and people gradually getting used to the new lifestyle, the healthcare sector has emerged as a crucial part of our lives. Most people have been trying to avoid hospital visits. However, since health check-ups cannot be compromised, medical professionals have swiftly adopted telemedicine as their way to connect with their patients for virtual consultations wherever possible,” he says.

He recalls his first experience with the technology: “A few days back, I had to get in touch with a doctor virtually with the help of an app when one fine morning I noticed some allergy on my skin. I could not visit a hospital. I tried booking an appointment with a dermatologist through an app and I received a call from the doctor within 20 minutes. Soon I got a prescription on the app itself making it a seamless experience. I ordered the medicine online using another app and within an hour, I was good to go. I paid for both transactions online. Similarly, the other day when my wife complained about splitting headache, I used the same app to e-consult a doctor and got the initial medications with the help of the prescription. The best part about this was that the support team of the application regularly follows up with the patients to ensure a seamless step out of the problem. I can imagine how helpful this can be for senior citizens, a godsend. As they say, requirement is the mother of all innovations, and telemedicine is no exception,” Pandey adds.

Dr Yash Gulati, Senior Orthopaedic, Indraprastha Apollo Hospitals, tells you that telemedicine has been here for 20 years, if not more and has been occasionally used by doctors and patients. “When I say telemedicine, I refer to teleconsultation that can be through messages, voice calls or even video calls. Many hospitals around the country have been using this technology. Yes, the sector has picked up pace and is now being widely used but that doesn’t mean that it can substitute hospitals visits. That can never be the case because of the restrictions it poses when it comes to the need for a physical examination. At best, telemedicine can only be a primary introduction to the patient and a way to know more about his history. Also, it can be used to confirm a diagnosis in certain cases. If you don’t take the history of the patient, you don’t know where in the sea you will sail in and if you don’t do physical examination then you haven’t sailed at all,” Gulati says.

He adds that it is beneficial in two cases — one, when the patient lives far away from the doctor and travelling is not an option, and two, in taking a second opinion from doctors on surgeries or in general. “The technology is successful in cases where you can skip a physical examination. Like, if a patient has suffered a fracture or has undergone a knee surgery, the doctor can observe the movement via a video call and the treatment can proceed. It can also help the doctors in following up with the patients during the treatment. So it is boon for primary diagnosis and for some general ailments like the common cold, flu and allergies,” he explains.

Rajat Garg, co-founder and CEO, myUpchar, an Indian language health information platform delivering medicines nationwide and teleconsultation facility, tells you that the platform saw a 50 per cent increase in traffic in the last few months.

“Most queries were related to cold and flu symptoms, allergies and gynaecology related issues. There was no one pattern. Earlier the platform was pressed into use for seeking second opinion but in the last two months, more generic queries have poured in. We were anticipating more COVID-19 related queries, however that didn’t happen. The surprising fact was that queries related to sexual issues dropped by 50 per cent,” Garg says. The platform mostly attracts customers from Tier II and III cities. To leverage the growing demand, the platform has partnered with top doctors and organisations.

The loophole is that these platforms don’t support follow-ups with the same doctor. In case a patient wants to consult the same doctor again, there is no room for it. The app will connect you only to the doctor who is answering queries at that time.

 “Our doctors are available 24 hours a day in case of any emergency but we haven’t introduced a way in which the patient can consult the same doctor twice. We will be working on this and try to introduce the facility soon,” he says.

Though telemedicine is doing wonders for now, there are many challenges. If a patient is in a need of an injection, there is no way telemedicine can help. “In such cases, we ask the patient to visit a hospital on priority. But, for blood pressure and temperature checks, the patients are trained enough to do it by themselves. Nowadays, most of the people keep a BP monitoring machine or a glucose meter at home, so it serves the purpose. But for severe issues, we advise people to go to the hospital and get a check-up done,” Garg explains.

Dr Anand Bansal, Medical Director, Action Group of Hospitals, says that technology has always been making things easier and efficient. “When the entire country is in the grip of COVID-19, lockdown is a necessary step to curb the virus spread but, in the process, patients suffering from other diseases are having a tough time as hospitals are out of bounds. In such cases, telemedicine has emerged as a boon. Recently, the Health Ministry issued guidelines for telemedicine, considering it helps in reducing the risk of virus spread. In the past few decades, there has been a constant effort to promote telemedicine but in this pandemic, it has automatically picked up pace,” he says.

He agrees with Gulati to add that although it makes the process easier, faster and saves resources, it cannot be considered to be future of healthcare.

“Regular OPDs and physical presence are still needed for better and correct treatment. In the time of emergency, one needs to rush to the hospital. For telemedicine. one entirely depends on technology, availability of Internet which may fail at times and a major population is still not that tech-friendly, especially the weaker sections of the society,” he tells you.

The medicine delivery and sample collection from home facilities of these apps and platforms comes in handy for patients in situations like these when stepping out of the house is not an option. So, if you have developed an allergy lately or, for that matter, a cold or flu, then fret not, a doctor is just a click away.