By: Shobhit Rastogi,
MHA-Health, (2011-13)
According to a recent data, 71% of Indian
population resides in rural areas whereas only 2-3% of specialists are present
in those areas to take care of their health. The condition of ambulance
transportation of patients, connectivity of roads and referral coordination
between hospitals is still very bad. Ultimately, it’s the poor patient who is
still suffering the brunt of inefficiency of governance and planning.
Telemedicine:
Telemedicine mainly focuses on two aspects of
connectivity: physician to physician (primary care to speciality care) and
physician to patient (homecare). Other than the real time patient care, another
aspect is pre-recorded data collection and data transfer. Electronic Health
Record (EHR) and Cloud Computing along with Telepathology and Teleradiology can
prove to be revolutionary concepts for fulfilling the indigenous requirements
of our healthcare system. Cloud Computing is used to put EHR and other relevant
database on a common platform so as to be accessed as and when required
anywhere in the world. Telepathology and Teleradiology virtually brings
Pathology lab to the patient’s doorstep, thereby reducing the burden of
visiting the lab again and again for submission and collection of reports and
also revolutionising the way in which these reports are processed by physicians
and specialists.
Stage is set for TeleMedicine to
flourish:
Department of Information Technology has
announced the establishment of 100,000 Telecentres across the nation as part of
it’s E-Governance initiative, which will be connected with fast internet and
will be a resource centre for all governmental activities, Telemedicine would
also be an integral part of this initiative. In the next five year plan,
government plans to spend Rs 20,000 Crores for creating a Optical Fibre network
across the country and they also have a proposal to give ‘Right to Broadband’
as a basic right in coming future.
Another very important boon to growth of
telemedicine in India is the very high penetration of mobile usage in the
country. According to a recent estimate, there are more than 900 million
working mobile numbers in our country right now, which is an enormous resource with more reach and more
potential than any other means of communication. We can use this huge network
of mobile telephony for betterment of health services, management of chronic
diseases, increasing health awareness and to provide follow up care along with
various newer and more innovative models of interventions.
Barriers
for TeleMedicine
The
biggest barrier is the mindset of both physicians and patients. Physicians have
their own reservation about different legalities associated with Telemedicine, about
Consumer Protection Act and about how to administer care without actually
meeting and touching the patients. In more than 80% of cases encountered in
primary health care settings, actually touching the patients is not required
and with all the available high end technical devices for real time
auscultation, ECG, Fundoscopy, skin examinations, autoscopy and pulse oximetry;
they can make even better diagnosis than the physicians in the field with the
traditional equipments.
As
far as patients are concerned it has been seen that the ease of usage and
quality of care has been instrumental in winning the confidence of the people
world over and the initiatives have picked up speed through mouth publicity
only. Similar response has also been observed in different pilot projects of
telemedicine carried out in various parts of the country.
Another
very important barrier is lack of connectivity and proper network of internet
services, that is why any organisation who wants to render services through
Telemedicine has to first create their
own network, than by using that network they provide their telehealth
services, which leads to sky rocketing of costs and makes the entire project
commercially non viable. The required model is where a service provider (has to
be the government) creates a network for telemedicine and opens it for usage by
different organisation and charge them on the basis of amount of usage by each
of them. With the recent announcement of DoT & IT of ‘right to broadband’
and nationwide optical fibre network, this model is very soon going to be a
reality.
