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As the Covid-19 pandemic disrupted the continuum of care, it did come as a booster shot for widespread use of telemedicine forced by the pandemic led restrictions and fear of infection transmission.

Telehealth practices deliver clinical information and permit consultation and discussion between healthcare professionals and patients regardless of where the patient is located. It is effective in reducing travel expenses, save time, reduce medical costs, and provide easier access for the common man to specialist doctors without disrupting their daily responsibilities.

“Telehealth has emerged as an effective and sustainable solution for precaution, prevention and treatment to stem the spread of COVID-19. It is bridging the gap between people, physicians and health systems, enabling everyone, especially symptomatic patients, to stay at home and communicate with physicians through virtual channels, helping to reduce the spread of the virus to mass populations and the medical staff on the frontlines,” said Telemedicine Society of India (TSI), President, Colonel (Dr) Ashvini Goel.

With simple video calls, mobile calls and even chat, telehealth has been able to address not only the non-COVID related healthcare issues of the general public but also treat patients with mild covid symptoms at home along with providing follow-up care.

Now with over a year since the pandemic affected India and the world, we speak to doctors’ who have been providing care through teleconsultations and through Telehealth to get their experiences.

Dr K Ganapathy, member of the board of directors of Apollo Telemedicine Foundation, calls the COVID-19 pandemic the Global Chief Transformation Officer for Telehealth adoption in India.

As the COVID-19 pandemic brought upon uncertain times, the Board of Governor of Medical Council of India (MCI) adopted the Telemedicine Practice Guidelines in March 2020, which provided a practical framework for the practice of telemedicine even though it existed before but was surrounded by many concern and doubts.

According to Dr K Ganapathy, the Telemedicine Practice Guidelines, 2020 made all the difference as thousands of doctors were unwilling to give teleconsultations, they were unsure, even though there was no law saying that telemedicine was illegal neither was there a ruling that telemedicine can be done.

“As the pandemic has increased the use of telemedicine multifold in the past 15 months, the authorities must update or modify the telemedicine with the new learnings so they are more useful to the patients. One of the modifications are prescriptions of drugs, the regulations prohibit us from prescribing several drugs but we need to relook at this. There is no point of a doctor being able to make a diagnosis unless he is able to treat the patient,” he said.

Highlighting how teleconsultations are helpful for patients with mild COVID symptoms and who have been recovering at home, Dr
Avi Kumar, Consultant Pulmonology at Fortis Escorts Heart Institute, said, “Teleconsulations are manageable for us and even the patients as they can get healthcare advice without putting the doctors at the risk of infection transmission. With the advent of teleconsultations, we have been able to instil the warning signs in the COVID patients.”

However, he also stated that with telehealth there is a fear about missing some important symptoms which could endanger the life of the patient rapid especially since these are COVID patients.

Commenting on the trust deficit faced by doctors in virtual consultation, Dr Ketan Parikh, Paediatric Surgeon and Founder at PyraMed, said, ” Teleconsultations works very well with follow-up patients as they already trust the doctor and even the patient’s medical history is already known. The problem happens for new patients as the adequate connect has not formed and due to trust issues patients are not comfortable in sharing the images and videos of areas of concern,” he said.

He also stated that with telehealth there is a feeling of inadequate or partial consultation done because we are not able to adequately examine the patient.

Dr Parikh also stressed the importance of maintaining records from a medicolegal point of view. “I would have a justification on why I wrote a particular medicine or did a particular investigation. Maintaining records protects as you have written down your thought process, your justification for your clinical decision,” he added.

Dr Rajesh Bhardwaj, Pediatric Otorhinolaryngologist who has been providing care virtually through the teleconsultation platform, Practo, supported its use saying that many health conditions can be treated with telemedicine and that the platform has been very beneficial especially during the time of the pandemic to protect people transmission.

Though telemedicine has shown to be very effective in the delivery of non-emergency care, there still isn’t enough awareness and training of doctors to conduct the same, shared Dr Manoj Kumar, Consultant – General Physician, Internal Medicine at Manipal Hospital. He urged on the importance of two-way consent in telemedicine and sharing of medical history.

Elucidating on the tips to ace teleconsultation, Dr Ganapathy said, “Today telemedicine has become so vast that you can’t learn how to do telemedicine by switching on your video camera. You need formal training and exposure to telehealth. To practice telemedicine, the body language of the doctor is very critical. The doctor should be able to answer the patients’ doubts clearly and make the patients’ feel that you are empathizing with them.”

He reiterated that the hospital information systems are terrific, but a doctor with all the technology in the world must still practice tender loving care.

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