- Types of Telemedicine
- Telemedicine in India
- Need for Telemedicine
Untapped potential of Telemedicine in India
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Telemedicine is considered to be the remote diagnosis and treatment of patients by means of telecommunications technology. Amid the COVID-19 pandemic Centre’s recent guidelines allowing for widespread use of telemedicine services came as a great push for telehealth crusaders in the country.
- As per WHO: Telemedicine is the delivery of healthcare services, where distance is a critical factor, by all healthcare professionals using information and communication technologies for the exchange of valid information for diagnosis, treatment and prevention of disease and injuries, research and evaluation, and for the continuing education of healthcare providers.
- The word “telemedicine” literally translates to ‘healing at a distance’.
- It is an umbrella term to encompass health care delivery in addition to education, research, health surveillance, and public health promotion.
Types of Telemedicine:
- Telemedicine can be classified into 5 basic types:
According to the timing of the information transmitted:
(i) Real time or synchronous telemedicine (where the sender and receiver both are online at the same point of time and ‘live’ transfer of information occurs).
(ii) Store-and-forward or asynchronous telemedicine (where the sender stores the information databases and sends it to the receiver at a convenient point of time, and the receiver can review the data according to his convenience).
(iii) Remote Monitoring type of telemedicine, also known as self-monitoring or self-testing. Remote monitoring uses a range of technological devices to monitor health and clinical signs of a patient remotely.
According to the interaction between the individuals involved:
(iv) Health professional to health professional (giving easier access to specialty care, referral and consultation services).
(v) Health professional to patient (providing healthcare to the unreached population by giving them direct access to a medical professional).
- Tele-education: A flexible and interactive long distance learning programme providing easier training and updates of the recent advances for more accurate and effective treatment methods.
- Tele-Conferencing: Discussion and interaction between doctors during workshop, conferences, seminar or continual medical education programs in a virtual room environment.
- Tele-Proctoring: Mentoring and evaluation of surgical trainees from distance with the involvement of sophisticated video-conferencing equipment.
2. Healthcare Delivery:
- School-Based Health Centers: Helps manage chronic conditions like bronchial asthma, diabetes and obesity. Telemedicine allows a school nurse, remote access to specialist medical opinion.
- Correctional Facilities: Cater to the healthcare needs of the inmates without the expense and dangers of inmate transportation or the need for a specialist doctor to enter.
- Mobile Health Clinics: Provides quick access to a remote physician or medical specialist.
- Shipping and Transportation: Helps avoid evacuations and unscheduled diversions during a medical emergency.
- Industrial Health: Provides medical management and triage advice on-site.
3. Healthcare Management & Screening of Diseases:
- Tele-health care: Use of ICTs for preventive and promotive healthcare; it is further divided into teleconsultation and tele-follow up.
- Tele-home health care: Monitor patients from a central station (Remote patient monitoring) with the help of a Computer Telephone Integrated (CTI) system for 24 hour vitals monitoring.
- Specialties like tele-ophthalmology, tele-psychiatry, tele-cardiology, and tele-surgery.
- Diagnostic services like tele-radiology and tele-endoscopy.
4. Post Disaster Relief:
- A mobile and portable telemedicine system with satellite connectivity and customized telemedicine software is ideal for a disaster stricken region where all other modes of connectivity are disrupted.
Telemedicine in India:
- Indian Space Research Organization made a modest beginning in telemedicine in India with a Telemedicine Pilot Project in 2001, linking Chennai’s Apollo Hospital with the Apollo Rural Hospital at Aragonda village of Andhra Pradesh.
- Initiatives taken by ISRO, Department of Information Technology (DIT), Ministry of External Affairs (MEA), Ministry of Health and Family Welfare (MoHFW) and the state governments played a vital role in the development of telemedicine services in India.
- Setting up of standardized telemedicine practice guidelines by the Department of Information Technology, and setting up of a National Telemedicine Task Force by the Health Ministry, in 2005, were some of the other positive steps by the government.
- Despite it, the progress has been very slow, until the COVID-19 pandemic forced the country to look for other alternatives to address the healthcare issues.
Need for Telemedicine:
- As per the government data of 2019, India has one doctor for every 1,457 citizens, which is quite low as per WHO norm of 1:1000.
- Further, the inequitable distribution of healthcare services has proven to be a major setback in public health management time and again.
- Adding to this is the concentration of healthcare facilities to the cities and towns (including 75% of the population of doctors), away from rural India, where 68.84% of the national population live.
- Taking into account the current population estimate of 1.35 billion and their healthcare needs, telemedicine can serve as a suitable means to fulfil this divide.
Significance of Telemedicine:
- Over the past several decades with improvement in internet infrastructure such as bandwidth communication speeds, information storage databases, web service backups, encryption, password protection has made telemedicine quite accessible.
- Patient education with images and videos, transfer of medical images like X-rays and scans, and real-time audio and video consultations has become a reality.
- The telemedicine practices reduce travel expenses, saves time, reduces medical costs, and provides easier access for the common man to specialist doctors without disrupting their daily responsibilities.
- It also makes the life of healthcare providers easy by decreasing the load of missed appointments and cancellations, increasing revenue and patient load and improving follow up and health outcomes.
- Telemedicine practice can prevent the transmission of infectious diseases reducing the risks to both health care workers and patients.
- However, the experts and government agencies must be mindful of the possible inadequacies of the medium, and securing sensitive medical information.
Keeping in mind the diverse healthcare needs, huge population, economic and technological divide in the country; telemedicine cannot be the only option, but can play a substantial role in addressing a vast range of problems. It is a high time to realise the potential of Telemedicine and upscale its utilization in public health.