Record surge in telemedicine consultations as thousands seek advice online during shutdown

BG Menon, MD, ACME Consulting, said the national lockdown has opened up prospects of telemedicine in a big way. While out-patient appointments have come down, telemedicine consultations have increased considerably in the city. “During a webinar, we came to know that a 125-bed hospital in Mumbai with three consultants, typically getting 160-plus visits daily, chose online consultation to meet the healthcare needs of patients,” he told DT Next.

“In India, the number of institutions and individuals offering free teleconsultation and tele-information is doubling every few hours. The virus has helped telehealth emerge from the sidelines to the centrestage. Now, it needs a successful take-off,” noted Shivaram Malavalli, a serial entrepreneur with deep interest in the healthcare domain.

A similar view was expressed by PWC Davidar, ex-bureaucrat, who recalled the World Bank-funded Rs 600 cr TN Health Systems Project of 2006-08, as he elaborated on the various facets of improving healthcare delivery in the State. “While we invested largely on creating the hospital infrastructure and ecosystem, our endeavour was to reach healthcare to inaccessible locations,” the former health secretary told DT Next, as he pointed to the current virus outbreak that has “forcibly” put telemedicine in the limelight.

Interestingly, medical teleconsultancy start-up Practo claims that the volume of users on its platform has increased by an average of more than 100 per cent since March 1 and more than 50 per cent of all general practitioner e-consults were related to COVID-19, Malavalli told DT Next. It is therefore not surprising that the US government has earmarked $500 million exclusively for telemedicine in the fight against COVID-19. Scores of countries like China, Japan, Australia and Hong Kong are now providing virtual care on a war footing. Health insurance companies in the US have even approved reimbursements for COVID-19 teleconsults.

Consider the case of Dr R Guhan, a consultant neurologist and assistant professor of neurology, Rajiv Gandhi Government General Hospital. He started offering teleconsultation free of charge for those with neurological problems during the lockdown. Dr A Suresh, a pulmonologist at SIMS, too, is among several doctors in the city, who have been reaching out to patients to offer their services. Dr Guhan’s message reads, “Persons with neurological complaints can message over WhatsApp for queries and consultation and I shall call back at the earliest till May 3,” while Suresh’s forwarded message goes like this: “For online consultation… SIMS Hospital is now taking appointments for video consultation.” A hospital in Tiruchendur that Guhan also serves along with his doctor-father, has benefited immensely. “There is a big competition for good video facilities. Nobody seemed to understand in the past the import of telemedicine. But, the situation has changed. Telemedicine has come to stay and one can’t wish it away,” said Davidar, as he added that online consultation is becoming the norm. The clinical work done by the medical fraternity is acting as a facilitator during the COVID-19 crisis as follow up by the doctor or serving out-patients is possible with telemedicine.

Davidar also highlights some worrisome aspects involving the patients’ who are not honest when it comes to declaring their actual medical conditions. “Fever and a few other symptoms can prepare the doctor using telemedicine to route such patients directly to the COVID centres as a precautionary measure. But, there are patients in a denial mode,” he said, citing the example of a case that led to police intervention to “fish out” a patient in suburban TN.

Telemedicine, he added, is a good filter option and the State is strong in this area. Doctors, who were reluctant in the past to use this channel, are increasingly embracing the advancement. This highlights the cases where patients from far-off locations travel to cities in search of medical care and expertise. The cost of reaching is far more than the fee of the doctor. In chronic cases, a mandatory physical visit is necessary, which can then be complemented by telemedicine.

If prohibitive costs impeded the adoption of telemedicine, the pandemic will drive down the price by 25 per cent, Menon said, as he argued that the savings that hospitals generate in the form of overheads (staff cost in the form of front office, AC, waiting area), manpower and transportation (parking space) can be passed on to the patients. “A specialist charging Rs 1,000 per visit, can bring it down to Rs 750 under the telemedicine framework,” he pointed out.

However, he has a word of caution. Though the lack of credibility or quality of care can be addressed by accessing accredited healthcare professionals, the platform to offer telemedicine had to be robust and adhering to the stringent guidelines prescribed by the Board of Governors of in supersession to Medical Council of India (BoG-MCI).