The Rise of TeleMedicine & the Future of our Healthcare

The rise of the current pandemic has given us a few more buzzwords like Tele-Health & Tele-Medicine. After all, necessity drives any phenomenon whose time has come into mass consciousness.

Telemedicine did not have the wild success that it was expected to achieve by 2000s. Remote health-related services such as monitoring, diagnosis, prognosis & medical advice between doctors and patients online over a secure connection, held a distinct promise of being at the forefront of the medical future. It promised to make state-of-the-art healthcare more accessible and far more inexpensive.

However, the grim reality is that only a handful of countries adopted this concept in practice, and telemedicine mostly remained merely a concept for many years in even the most advanced economies.

But, then came 2020 and the COVID-19 pandemic and that has brought the field of TeleMedicine into spotlight once again, and that too quite rapidly.

Let us first delve a bit into the history of telehealth to understand the present situation and future of telemedicine. The truth is that telehealth has a long history in the medical field, & has accelerated with each new technological innovation in the field of communication. It might sound surprising to many of you, that telemedicine as we think of it is actually a century-old field. In fact, as soon as the earliest forms of telecommunications technology were invented (radio, telephone), the medical industry was tinkering with ideas on how to apply these inventions to healthcare.

In the February, 1925 issue of Science and Invention, an American inventor named Hugo Gernsback, wrote an article that combined his fascination with the future of radio communications & remote healthcare. In that article he predicted a device for the year 1975 that still sounds futuristic by all measures to me quite honestly. And needless to say, that prediction is yet to come true as such a device has not yet been invented but one we hope will happen in future.

Gernsback’s device was called the “teledactyl” and it would allow doctors to not only see their patients through a view screen, but also touch them from miles away with spindly robot arms. Quite impressively, the teledactyl was imagined as a sensory feedback device, which would allow the doctor to not only manipulate his instruments remotely, but even feel the sensation of any movement in reciprocation, by the patient. At this point several experiments were conducted for Remote Healthcare, and especially during the World War II there were many cases of remote diagnosis and consultation by doctors in some countries for their soldiers. But nothing really kicked off as revolutionary in those experiments.

After the experimentation with tele-health in the early 20th century, what really brought about rapid progress and innovation to the field was NASA's funding of telemedicine projects throughout 1960's and 1970's. Obviously this rapid progress was guided by NASA’s incentive to solve the complex problem of providing healthcare to astronauts in space. NASA also funded telemedicine projects around USA and even across the world. When the Space Age collided with the public's adoption of television, the possibilities of transmitting live video for medical consultations really opened up.

Some critics have however called it all hype and dismissed telemedicine as a mere fad. And until recently, telemedicine although was growing at a linear pace, but never became quite so common in even developed economies. But now it has hit its prime time. Research studies have projected telemedicine to be a more than $34 billion industry in 2020.

Many reasons for Tele Health to not pick up in the past was related to lack of good Hardware Infrastructure, in spite of good digital infrastructure. Over the last 5 years a lot of advancement has come across on the front of Hardware Infrastructure, which has become commercially viable. Moreover, the pandemic has fast tracked the adoption for Tele Medicine out of necessity.

At the beginning of 2020, no one could have predicted the extent of the COVID-19’s effect on society. Entire countries have gone under lockdown in a bid to limit the spread of the virus. Digital health fares as an adequate solution in these circumstances. Telemedicine started being used by doctors to connect with patients, and by mid-level provider/health workers to connect patients with doctors without patients having to physically visit a hospital or clinic. This became essential because many patients, who were not required to undergo surgeries, did not want to visit the hospitals and clinics, especially if they had non-covid related health problems. It also helped the hospitals by avoiding crowding. Even WHO is also advocating for telemedicine, to monitor patients and has issued guidelines to reduce the risk of spreading the virus by restricting their visit to hospitals.

Closer home in India, The Board of Governors in Medical Council of India (MCI) issued Telemedicine Practice Guidelines on March 25th to strengthen delivery of Telemedicine Services in a post-Covid-19 world. The focus was on Health Centers that provide preventive and primary healthcare within a 5 km radius at the grassroots level.

The COVID-19 pandemic brought telemedicine into a new light. It was also realized that medical professionals need to stay healthy and disease-free. Thus the need for remote technologies skyrocketed. Telemedicine also emerged as an alternate option to lift the burden from existing healthcare infrastructure. It’s a readily available solution that allows those patients who are following treatment for other conditions, to continue doing so with remote consultation.

So where do we go post-Covid? Is this surge in demand for Telehealth services only a bubble waiting to be burst after the severity of the pandemic gets over?

I personally do not think that this is a bubble. By looking at how past necessities created emerging trends and even solidified their place in human evolution, I am quite confident that Telemedicine is here to stay. Also the regulatory bodies are giving positive signals, because around the world they have been busy at work in creating and expediting long lasting protocols and guidelines to encourage the use of telemedicine even post-covid.

If we consider the case in India, then it is estimated that even post lockdown, it will help reduce the burden on the secondary hospitals. It will improve documentation, data-collection, diagnosis and attention to patients, without risking the safety of the patients or the health workers. It will also make healthcare accessible to all, and not just urban dwellers. Telemedicine is already being used with success in some states for reproductive & child health, as well as tuberculosis notification & outreach.

India’s public health expenditure is just 1.28% of its GDP. The rising cost of treatment has led to inequities in access, with people in under-served rural areas and urban slums among the worst hit. For people living in rural areas completely dependent on government hospitals and clinics, the government allopathic doctor-patient ratio is is at a very dismal rate of only 1 doctor for every 11,000 patients as stated in NHP 2019 data.

Imagine the boon for these people if there was more development of telemedicine infrastructure, in enabling these people with cost effective means of diagnosis and consultation.

Implementing TeleMedicine & Future Outlook

Telemedicine implementation will include using online data, telecommunication systems, and digital patient education resources in order to improve the quality of care and public health outcomes.

Some of the basic features of telehealth technology include professional videoconferencing tools, Internet-based applications, and digital imaging capabilities. Internet speeds are already up to the mark in most parts of the world, and its penetration is growing at a rapid in India. Superior quality of Video conferencing devices like those by Logitech are already available that can enable seamless patient-doctor interaction.

Many nations around the world are also learning that healthcare capacity cannot be built in an ad-hoc manner during a crisis. It takes time and investment to build a good public health system. India has failed to invest in health for decades and this must change post-Covid19. With new guidelines for telemedicine in place, and the telehealth field by itself proving to be invaluable in times of an acute crisis; I am confident that many state governments in India will now look at rapidly expanding its growth to penetrate deeper into the society. There are also a number of telemedicine startups that are investing in the telemedicine market.

The major driving force for this market is the increasing aged population, rising cost of healthcare, surging prevalence of chronic diseases, and the lack of infrastructure in hospitals to accommodate the large number of patients. These driving forces will be there even post-covid, and now with the system of telemedicine undergoing a rigorous testing, I see a bright future for this industry.