The Covid 19 outbreak has created many challenges on traditional healthcare systems, as citizens have not been able to consult with the doctors physically. The telemedicine industry is expected to create more than $5.4 billion market opportunity by 2025. Practo and DocPrime, mFine, CallHealth and Lybrate are some of the leading startups in India’s telemedicine market. This situation has led to the government to change the regulations around remote delivery of healthcare services and allow telemedicine via video, audio or text.
Telemedicine will not only help these startups address the spread of coronavirus but also improve access to healthcare among the rural areas. Innovative technologies are allowing health organizations to enhance the access and reduce the burden on hospitals through real time consultation with doctors through smartphones tablets, laptops or PCs. Many startup companies are looking to make a make in the industry that is currently on rise. Which is why, India has seen a tremendous increase in demand of telemedicine for healthcare services.
The consumers’ expectations for the convenient healthcare system is evolving while the healthcare industry is continuously striving to meet people needs with the help of technology. The telemedicine market in India is expected to reach $5.4 Billion by 2025 with a CAGR of 31%. Telemedicine will reduce the time of consultations and improve the quality of healthcare services in rural areas, removing many of infrastructural challenges. According to Statista, the industry is bound to touch $280 billion by the end of 2020.
The current scenario of telemedicine in India
The World Health Organization (WHO) recommends a doctor to population ratio of 1: 1000, while the current doctor population ratio in India is only 0.62:1000. Training of new physicians is time consuming and expensive, hence the doctor to patient ratio can be expected to remain low for a long time to come. This is because the active telemedicine services in various parts of the country. Telemedicine services in the country come under the combined jurisdiction of Ministry of Health and Family Welfare and the Department of Information Technology.
Telemedicine division of MoHFW, the National Telemedicine portal for implementing a green field project on e-health establishing a National Medical College Network (NMCN) for interlinking the medical colleges across the country with the purpose of e-education and a national rural telemedicine network for e healthcare delivery. Another one is the Village Resource Center (VRC) which has been developed by ISRO to provide a variety of services such as tele-education, telemedicine, online-decision support, interactive farmers’ advisory services, e-governance services, weather services and water management.
Arogya is another internet-based mobile telemedicine conglomerate that integrates multiple hospitals, mobile medical specialists and rural mobile units/clinics. The project is an initiative of Indian Council of Medical Research (ICMR). They have collaborated with a team of scientists from University of Karlsruhe, Germany who are working on the design of an ECG jacket which can be used for the continuous monitoring of a patient's ECG without hospitalization. Telemedicine practices in India have slowly and steadily gained foothold.
The steps taken by ISRO, Department of Information Technology (DIT), Ministry of External Affairs, Ministry of Health and Family Welfare, and the state governments played a vital role in the development of telemedicine services in India. ISRO (Indian Space Research Organization) was the pioneer of telemedicine in India with a Telemedicine Pilot Project in 2001, linking Chennai's Apollo Hospital with the Apollo Rural Hospital at Aragonda village in the Chittoor district of Andhra Pradesh. In the past few years, ISRO's telemedicine network has come a long way. It has expanded to connect 45 remote and rural hospitals and 15 super specialty hospitals.
Types and applications of telemedicine
Telemedicine can be classified into 5 types:
- Real time or synchronous telemedicine - where the sender and receiver both are online at the same point of time and live transfer of information occurs.
- Store and forward or asynchronous telemedicine - where the sender stores the information databases and sends it to the receiver at a convenient point of time and the receiver can review the data according to his convenience.
- Remote Monitoring- this is the type of telemedicine –which is also known as self-monitoring or self-testing. Remote monitoring uses a range of technological devices to monitor health and clinical signs of a patient remotely.
- Health Professional to health professional – which gives easier access to specialty care, referral and consultation services.
- Health professional to patient – providing health care to the unreached population by giving them direct access to a medical professional.
The target audience of Telemedicine industry are:
- People who are willing to try telemedicine
- Application developers and network operators
- Third party suppliers and healthcare service providers
- Potential Investors
- Government organizations
- Research Institutes
Telemedicine in India during Covid 19 Pandemic
In today’s times, when the world is facing the pandemic of Covid 19, the affliction of which I highly contagious and exponentially increasing numbers of cases worldwide poses unprecedented challenge to even the world best health care systems. In India, till now, there was no legislation or guidelines on the practice of telemedicine and the gaps in legislation and the uncertainty of rules posed a risk for both the doctors and their patients. However, in view of COVID-19 outbreak, the topic of telemedicine has suddenly taken a front seat.
In the wake of the ongoing pandemic, telemedicine proves to be an added boon providing the following added benefits to the health-care provider as well as the patients. Telemedicine can be used for ongoing management of chronic diseases such as bronchial asthma and hypertension during a time when social distancing is encouraged. Individual with these conditions are particularly susceptible to Covid-19 and medication compliance and disease optimization are important ways to mitigate severity.
Telemedicine is a safe and effective alternative to in person care. Telemedicine can also be used for providing psychological support to patients and their family members without getting exposed to the infection. During COVID-19 pandemic, telemedicine can also help in reducing the burden on the tertiary hospitals by providing diagnosis and treatment to patients in their own geographical location and reducing chances of patient's exposure due to hospital visits. Telemedicine can also help in providing training to the care providers of sick and disabled children and elderly.
Challenges faced by the Telemedicine in India
- Telemedicine is plagued by a question of liability when information provided by telemedicine is misinterpreted.
- Acceptance for both doctors and patients will be a challenge.
- Maintaining the privacy and confidentiality of telemedicine services is crucial to acceptance by consumers.
- The healthcare professional these providers must adhere to all data privacy and confidentiality guidelines.
- Language and communication barriers are another main issue.
- There is a need to develop process for reimbursement of the services provided through telemedicine by the health-care providers
- Lack of regulations made by the government for the sector.
- Protection of information and computer systems is of top priority.
- Telemedicine visits can require extra time for equipment management and transmittal of prescriptions.
- Rural India lacks basic infrastructure, ignorance and lack of awareness.
Benefits of Telemedicine in India
Telemedicine has made it possible for a health care provider to virtually visit a patient.
Benefits for of telemedicine for patients are:
- Immediate access to health care specialists.
- Convenient to the patient because it saves time traveling and no need to take leave form work.
- Good patient engagement and improved quality of care delivery.
- Discussion between health-care professionals and patients regardless of where the patient is located, reduce travel expenses, reduce medical costs.
- Telemedicine is cost effective.
- Provide easier access for the common man to specialist doctors without disrupting their daily responsibilities.
- Good for immunity fewer chances to catch an infection from the hospital visit.
- Telemedicine also allows likelihood of better maintenance of records and documentation.
Benefits for service provides (physicians) are:
Overall, Telemedicine is emerging as a promising tool for better health delivery for primary care and secondary care.
- Better decision making.
- Analysis of stored data increases the practice efficiency.
- Better follow up with a patient.
- The doctors or physicians can also get a second opinion immediately for better. diagnosis and management.
- The revenue is also increased by reaching out to many patients.
- Saves time for the physicians.
- As physician can see many patients.
- Can make informed decisions if the in-clinic visit is required or not.