Rise of Virtual Speciality Care with Telemedicine Services

By Sourav Patra

In the quiet town of Tejpur, a boy ran barefoot with a mysterious note in his hand. He rushed towards the main bridge, connecting his village to Kasba, a central place 20 kms away. His older sister had been in pain for the past one week; and last night, she had fainted. Despite having phones, internet, and transportation, his father couldn't get a doctor. So, the boy decided to take matters into his own hands, running with his mother's old prescription - the only medical prescription in this little boy’s possession. After ten tense days of struggle and door-to-door running, the boy was handed his sister’s diagnosis - she had an ovarian cyst. No, this is not a blast from long-past. This is a true anecdote from 2020; the tough times when COVID-19 was wreaking havoc across boundaries. But as Brendon Francis has very rightly said - “The best way to escape from a problem is to solve it.” The problems which we faced throughout the nation, especially in the remote locations, led to the advent of telemedicine - changing how people got medical help.?

Telemedicine made things smoother in hospitals and clinics. It wasn't a replacement for regular visits but a support, especially for those far from hospitals; like the little boy in Tejpur. In this simple tale of the barefoot boy and his sister, we see how telemedicine brought relief in tough times. It's a story of hope and help when things seem hard.

History and Growth of Telemedicine in India:

India is in the midst of a healthcare revolution, powered by the tremendous growth of telemedicine. The collaboration between the government, private sectors, and technical ministries like MeitY and ISRO has propelled this transformation. In the era of COVID-19, telemedicine is not just a trend; it's a seismic shift, expected to skyrocket with a staggering 31% growth every year, reaching a monumental US$5.5 billion by 2025. The demand for virtual care services—tele-consultation, telepathology, teleradiology, and e-pharmacy—is surging, reshaping the healthcare landscape. The numbers paint a vivid picture: a remarkable 300% surge in online consultations, reverberating not only in bustling metros but echoing in the corridors of non-metro cities.

Looking ahead to 2025, the telemedicine landscape is poised for a radical transformation. A whopping 95% of the market is projected to be dominated by virtual consultations and e-pharmacy, while in-person appointments are expected to witness a stark 32% decline. The pulse of this revolution beats strongly in states like Jammu & Kashmir, Punjab, Uttar Pradesh, Jharkhand, Himachal Pradesh, and West Bengal, where early adoption showcases a transformative trend in healthcare delivery, magnified by the impact of the pandemic. The numbers are not just statistics; they are the heartbeat of a healthcare revolution, signalling a profound shift towards a future where telemedicine takes center stage, shaping the way we receive and deliver healthcare services in India.

Government Initiatives in Teleconsultation Healthcare Sector

Telemedicine services like eSanjeevani and the Swasth app are making it easier for people to access medical advice.?

• Connecting doctors to patients: eSanjeevani comes with two types of portals: one for doctors to communicate with each other, and another one for doctors to connect with patients directly and resolve their concerns. Since its inception in November 2019, it has already assisted in over 5.2 million consultations.?
• Making lives easier: The Swasth app, launched in June 2020, allows free telemedicine consultations through your phone. From booking tests, to buying medicines online, finding home-care providers, and even checking availability of hospital beds, this app guides users in different healthcare services. These services were particularly helpful during the COVID-19 pandemic, making it more convenient for people to get medical help without leaving their homes.
• Last-mile connectivity for defence personnel: SeHATOPD, a telemedicine portal developed for the Ministry of Defence in India, allows remote medical consultations for defence personnel and their families. Launched in May 27, 2021, by the Minister of Defence, Shri Rajnath Singh, it utilises the eSanjeevani Telemedicine Technology.

Number of teleconsultations conducted through eSanjeevni India as of February 2023 is over 7.4 million since march 2022

Exploring around the globe!

Did you know, the global revenue in the Online Doctor Consultations market amounted to US$23.75 billion in 2023? With the growing population and changing demographic curve, these solutions are falling short of catering to emerging needs. Thus, emergency care units are falling, and investment in retail clinics is declining. As per the Urgent Care Association of America, average visits per site have dropped to 12000 from 14000 between 2014–2016. Consequently, the related investments in retail clinics have been shrunk to USD 29 million (2016) from USD 160 million (2007).

North America is likely to lead the market as it is already a common practice to consult the doctor via video. According to the American Hospital Association, 65 percent of the U.S. hospitals connected with patients and consulting practitioners using video and other technology. Video consultation through a computer, tablet, or smartphone has a higher appeal among consumers. For instance, according to a survey conducted in 2015 by American Well Telemedicine Consumer, 64% of Americans were willing to have a video visit with their doctor.

In Europe, teleconsultations became the preferred mode of primary care delivery, where physicians were recommended to triage patients remotely, and face-to-face consultations were discouraged unless considered necessary by the attending doctor. In Italy, 20% of the teleconsultations carried out during the pandemic were telephone-based, 38% were conducted through web-based systems, 29% in specific platforms, and 13% via apps. By April 2020, telephone consultations in US outpatient centres accounted for 65.4% of primary care consultations and 71.6% of behavioural health visits. As nations embrace telemedicine, it not only addresses existing healthcare disparities but also emerges as a vital tool in improving accessibility, efficiency, and quality of healthcare services on a global scale.

Exploring the Diverse Application Areas of Telemedicine in Healthcare Sector:

Telemedicine plays a pivotal role in facilitating services for disabled patients, improving access for various groups, including the elderly and culturally isolated.?

1. Remote treatment, especially in highly specialised cases, becomes feasible, reducing the need for extensive travel.?
2. It proves effective in treating school-going children, addressing disorders not requiring lab examinations, and providing virtual doctor appointments, particularly relevant in the age of social distancing.?
3. Moreover, telemedicine enhances the overall healthcare system, improves patient coordination, minimises patient travel, supports tele-dentistry, and contributes to better service for both clinicians and patients.?
4. Digital health monitoring, skincare consultations, medication tracking, infection prevention, cost-effectiveness, and the reduction of face-to-face meetings further highlight the versatile applications of telemedicine in healthcare, ultimately enhancing patient care and operational efficiency.

Being in a healthcare startup which provides virtual medical care, I have seen people get the best of telemedicine services at the ease of their homes with just a gadget in their hands. Now they can connect with their trusted doctors and healthcare professionals within minutes.

Examining the Drawbacks of Telemedicine Services:

While telemedicine offers several benefits, it comes with potential drawbacks when compared to traditional healthcare approaches.?

1. It is not a substitute for the conventional system but rather complements it for specific functions.
2. Security concerns arise, particularly with the hacking risk of patients' medical data when connected through public networks or unencrypted channels.
3. Emergency situations may face delays, as remote care cannot provide immediate life-saving interventions or laboratory tests.
4. Varied state regulations may limit physicians from practicing across state boundaries, depending on licensure.?
5. Providers relying on patient self-reports during telemedicine sessions could risk missing crucial symptoms detected in-person, potentially jeopardising medication.
6. The drawbacks also include issues of availability, affordability, and communication challenges, making reliable care delivery through telemedicine a complex endeavour for some healthcare facilities.

What We Saw:

Closely collaborating with a digital health startup, SehatUp. I've witnessed firsthand the magic of teleconsulations bring in people’s lives and how we can reach our trusted doctors by the comfort of our homes!

In the realm of healthcare innovation, SehatUp stands as a beacon of transformative power. Picture this: a 55-year-old navigating the complexities of diabetes, his journey transitioning from symptomatic struggles to newfound well-being through the marvels of teleconsultation. At the heart of this narrative is SehatUp, a digital health startup weaving together the future of patient-centric care. As he embraced innovation, online consultations became the gateway to healing. Follow-up appointments unfolded seamlessly, offering real-time access to medical records, ensuring a proactive approach to health management. SehatUp's commitment shines through personalized reminders, turning a once cumbersome journey into a digitally empowered healthcare experience. This success story isn't just about managing symptoms; it's a visual symphony of innovation, where each virtual check-in and timely medicine refill reminder paints the canvas of redefined, aesthetically progressive healthcare.

Conclusion:

The future of healthcare envisions a streamlined process where patients seamlessly book appointments, providing comprehensive medical histories and documents through a user-friendly interface. This efficient system empowers doctors to create urgent care plans by accessing patients' detailed records, enabling quick mobilization of local healthcare resources for emergent and non-emergent services. The integration of video consultations in emergency departments facilitates efficient triage, reducing emergency diversion and improving overall patient conditions. Telemedicine application software is increasingly adopted by healthcare organizations, connecting specialists with patients in remote areas and enhancing follow-up care. As a transformative force, telemedicine not only alleviates the burden on medical office staff but also extends healthcare access to underserved regions, demonstrating its potential to revolutionise healthcare delivery.