Telemedicine: A New Frontier for Public Health

INTRODUCTION

Telemedicine can be defined as the use of communication and information technologies to deliver healthcare services to areas where distance is the barrier between healthcare professionals and people in need. Though the use of telemedicine was considered “experimental” the emergence of Covid-19 has fast-tracked the implementation of telemedicine in various sectors of the healthcare industry. Public Health Managers work with the goal of providing an equitable distribution of healthcare services throughout the nation. People living far off in rural and remote areas have compromised access to good-quality and timely medical care due to specialist physicians located in concentrated urban areas. Telemedicine when combined with public health can bridge this gap and facilitate healthcare access to these remote areas. Additionally, telemedicine has emerged as a successful tool for invoking the private sector to take interest in public health management.

Roles and Benefits of Telemedicine in Public Health

1. Health Management

Telehealthcare offers the opportunity for tele-follow-up and teleconsultation, ensuring that patients are monitored 24 hours a day from their homes.
In addition, it can be utilized to provide on-site triage and medical care guidance for patients with chronic illnesses like asthma, diabetes, obesity, and TB³.

2. Disease prevention and interactive health communication

Telemedicine can help public health workers in informing, influencing, and motivating the population organizations or individuals on health-related issues and ways to adopt healthy lifestyles, especially to people living in remote areas
It can also support better communication between the patients and healthcare professionals about diagnosis, prevention, or management of health conditions providing a broader decision-making choice base to the users
It also helps in promoting domiciliary and self-care practices along with existing healthcare services benefiting those living in remote areas
Healthcare services can be easily monitored and evaluated by public health workers with the help of telemedicine

3. Epidemiological Surveys

With the development of Geographical Information Systems (GISs), telemedicine has been able to provide information related to different gradients of disease incidence and prevalence in remote areas. It can help public health workers to get valuable insights into the health assessment of the targeted population area
The GIS-based epidemiological surveys differ from regular epidemiological surveys in retrieving, analyzing, and managing data. This helps the public health managers in designing the public health policies and schemes and helps in formatting public health programs
The information provided by the GIS system can be an important lead in anticipating epidemics

4. Pandemic and Disaster Management

The delivery of health facilities during a pandemic is extremely difficult in remote and hilly areas, however, telemedicine provides an effective remedy for such challenging circumstances.
Up until this point, there were no formal guidelines governing the use of telemedicine, phone, video, or internet-based platforms in India. However, on March 25, 2020, the Indian government published telemedicine-related recommendations³.
When other forms of communication are disrupted, a portable and transportable telemedicine system with good connectivity and appropriate software for remote areas may be a preferable option.

TELEMEDICINE IN INDIA

India is rapidly increasing its level of computer literacy². Healthcare professionals today view telemedicine as their newly discovered Avatar. Theoretically, it would be far simpler to install a first-rate telecommunications network in suburban and rural India than to deploy hundreds of medical specialists there². We now understand that fiber optic cables and satellite-based technology are essential for the development of communications.

The Indian government initiated the first-of-its-kind National Telemedicine Service- eSanjeevani Scheme on 13^th April 2020. The scheme was conceptualized by the Ministry of Health & Family Welfare to improve access to specialized health services, particularly in resource-deficit areas. It operates in two modes: 1. eSanjeevaniAB-HWC- under Ayushman Bharat Scheme, this is a doctor-to-doctor telemedicine system to provide specialized health services in isolated communities and rural areas; 2. eSanjeevaniOPD- this is a patient-to-doctor telemedicine system to make the outpatient services accessible to people in the confines of their homes⁴. The eSanjeevani OPD platform is available as a mobile app for both iOs and Android bases smartphones. Under this service, around 1 lakh doctors and medical specialists are currently on board to offer telemedicine consultations to people. According to the latest report of March 2022, the eSanjeevani scheme had recorded 3 crore teleconsultations⁵. At present, the eSanjeevaniHWC system is working at around 50 thousand Health & Wellness centers around the country⁵.

Among the corporate sector, in 64 health centers, the Apollo Hospital Group is playing a significant part in providing telemedicine-based medical services. The Amrita Institute of Medical Sciences in Kochi has connections to 59 domestic health facilities and 9 foreign facilities. 55 centers are connected to Bengaluru's Narayana Hrudayalaya. With 27 centers, Fortis Hospital in New Delhi is connected. Telemedicine services have also been introduced by the Sir Ganga Ram Hospital (SRGH), New Delhi, in Rajasthan and Haryana.

Certain NGOs like Public Health Technologies Trust (PHTT) a not-for-profit organization is working on large CSR projects for corporates like the organization of various medical camps in association with the local health entrepreneurs using their technology products for screening, analysis, and treatment of novel diseases in remote locations to bring a communal change to the society. The organization has partnered with different healthcare organizations for providing telemedicine facilities to people living in rural and remote areas. They have also won different awards for their telemedicine startup.

CHALLENGES

1. An optimum internet network is required for the smooth running of telemedicine programs. Hindrance in the network in hilly or remote areas results in program failure

2. The adoption of teleservices is restricted by expensive equipment and a shortage of service engineers in rural areas, which results in the underutilization of the services.

3. People who are less aware of modern technology might face difficulty in operating tele equipment independently which can possess the privacy issues

4. Utilizing telemedicine services to their full potential is being limited by the lack of staff and community capacity building.

5. Lack of qualified employees in some locations where public health facilities are still lacking makes it difficult to expand telemedicine centers in remote areas.

CONCLUSION

Imagining telemedicine as a new option to connect with a healthcare professional is not any “futuristic” idea anymore. Remote monitoring has the potential of making every minute count by providing every inch of health information thereby improving the public health services around the nation in a cost-effective way along with the assurance of good quality care. International Telemedicine schemes are bringing the world together and creating a society where distance is no longer a barrier to attaining quality healthcare service. Although in the hype, still, telemedicine has not been able to attain the heights that it should reach. Besides all the advantages, telemedicine has the biggest disadvantage of lack of data security and privacy. A smart balance is needed to be maintained between human intelligence and depending totally on electronic solutions. Attaining that balance will lead telemedicine in healthcare to its maximum potential. The level of healthcare burden is high in India, and teleconsultation platforms can fulfill healthcare needs, generating an innovative ecosystem in the healthcare industry.

REFERENCES

Related Post: Public Health in India