In Telehealth, Scaling Up The Indian Advantage

Context: India’s cheap data plans provide a conducive environment to scale up its telehealth advantages.

Impact of COVID-19 Pandemic on Healthcare

• Disruptions in healthcare services: According to World Health Organization (WHO) - 
  • About 45% of low-income countries incurred at least partial disruption of over 75% of services and 60% of services in South East Asian countries relative to only 4% of high-income countries. 
  • Adverse effects on diagnosis and treatment of other communicable diseases:
    • Low detection of tuberculosis cases in India.
    • Lower antenatal care visits in India.
    • Adverse events in diabetic patients and Cancer care

• Exacerbated inequalities: People living in rural and remote areas are the most affected.

Measures taken in India: in the field of telehealth

• eSanjeevani platform: offers both provider-to-patient interactions and provider-to-provider interactions.
• Private providers and non­governmental organisations have also expanded virtual access to underserved populations.

Way Forward: Expanding digital health services as envisaged by Global Strategy on Digital Health, adopted by the World Health Assembly, brings an opportunity for India to leapfrog into a reality of ‘Health for All’.

• Increase the efficiency and effectiveness: of every minute spent in virtual care interactions.
• Virtualise in-person shared medical appointments (SMAs) – A new care model- Remote-shared medical appointments;  Advantages of In-person SMAs - 
  • Patients get more time with clinician.
  • Enable peer support and peer-to-peer learning.
  • Improve both productivity and outcomes for many conditions: e.g. Aravind Eye Hospital in Puducherry has successfully trialled in-person SMAs for patients with glaucoma.
  • Can be offered through existing platforms: e.g. eSanjeevani.
  • Can help clear misinformation about testing and vaccine adoption by engaging in real-time.
  • Amplify the impact of health systems: both during the pandemic and beyond.
  • Way to accelerate the adoption of virtual in-person SMAs: Rigorous testing combined with mentoring, training and behaviour change for both patients and providers.
    • E.g. Training platforms like Extension for Community Healthcare Outcomes (ECHO) can accelerate its adoption.