Med Tech

Telemedicine and critical care amid COVID-19

Telemedicine, which literally means “healing at a distance”, can be traced back to the mid to late 19th century with one of the first published accounts occurring in the early 20th century when electrocardiograph data were transmitted over telephone wires. Telemedicine has evolved a lot over the years as it incorporated advancements in technology considering the constantly changing health requirements of society. WHO defines Telemedicine as “The delivery of health care services, where distance is a critical factor, by all health care professionals using information and communication technologies for the exchange of valid information for the diagnosis, treatment and prevention of disease and injuries, research and evaluation, and for the continuing education of health care providers, all in the interests of advancing the health of individuals and their communities”.

In India, nearly 75% of the population of doctors lives in towns as compared to the rural areas where 68.84% of the national population live. Telemedicine plays a vital role in this scenario where the equitable distribution of healthcare services has proven to be a major goal in public health management. 

Telemedicine and ‘medical distancing’ during the pandemic

The role of telehealth services in preventing, diagnosing, treating, and controlling diseases during the COVID-19 outbreak has increased manifold. In the present time, social distancing (keeping people discrete) and medical distancing (keeping healthcare staffs discrete from patients and other providers) are being emphasised heavily. Patients, who were used to visiting doctors now have to resort to telemedicine to get themselves diagnosed. As far as doctors are concerned, their clinical acumen plays a vital role in the telemedicine platforms. “It’s not easy, particularly for us pulmonologists. In order to understand the patients’ conditions better, in-person diagnosis is important. If your clinical acumen is really good, then you can ask some leading questions and find out the diagnosis through Telemedicine,” said senior physician Dr GS Kailash. 

Critical care

Critical care services require intense resources and process control. When we consider parameters like structure, operations, outcomes and costs, Tele-ICU seems to have a lot of potential. Tele-ICU platforms offer various services including remote video visualization of patients and biomedical devices, access to electronic medical records (EMR), scrutinize patient data, combining physiological parameters with clinical risk factors to predict deterioration and provide decision support. The platforms also embed risk-prediction algorithms to facilitate more efficient interventions to reduce ICU risk. 

“Telemedicine will really help in ICU because you don’t have to rush every time to the hospital. For example, they say their heart rate has gone up. What do I do? Then I can suggest one medicine to come down. That’s all, I don’t have to come all the way to the hospital to do this. You have to use the technology to avoid too much of a running around,” Dr Kailash added.

How does a Tele-ICU facility look like?

The operational structure of a Tele-ICU

 

Benefits of Tele-ICU

  • Promotes evidence-based best practices through checklists and prompting
  • Enhanced monitoring, early identification and treatment
  • Better coordination of care
  • Increased night-time vigilance

Concerns of Tele-ICU

  • Diffusion of responsibility
  • Underutilization of Tele-ICU (e.g, insufficient authority)
  • Insufficient contact between Tele-ICU hub and ICU
  • Scepticism of Tele-ICU
  • Increased fixed and variable costs

Advantages of Telemedicine

For patients

  • Cost-effective
  • Convenient
  • Easy access to specialists
  • Satisfaction
  • Getting email or text reminders
  • Social distancing

For healthcare providers

  • Less overhead expenses
  • Social distancing
  • Additional revenue source
  • Easy availability of e-health records

Disadvantages

For patients

  • Protection of medical data
  • Emergency care delays
  • Technological barriers

For healthcare providers

  • Licensing issues
  • Technological issues
  • Lack of in-person diagnosis satisfaction

Conclusion

Telemedicine has shown a lot of potential in addressing a vast range of problems in the field of healthcare but the lack of awareness and acceptance of new technology by both the public and the professionals have held it back from attaining its true potential. The Indian government has started taking interest in Telemedicine to include it in the public health system which has resulted in its rise. The market size for telemedicine in India was around USD 830 Million in 2019. It is projected to increase to USD 5.5 Billion by 2025 growing at a CAGR of 31% during 2020-25.

India’s Telemedicine Market Size 2010-2019, with estimates till 2025

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