During COVID-19 pandemic, terms like telehealth, telemedicine,
remote-patient monitoring, virtual care and digital health are
thrown around very commonly, though these terms have been around for years, but
the recent situation is accelerating patient awareness and physician adoption
of these technologies.
With a growing need for social isolation, healthcare
organizations are actively seeking ways to provide health services to patients
with both COVID-19 and other conditions remotely.
Start-up investing is not a new phenomenon in the
financial world, but one sector, in particular, has seen a veritable boom in
investors since the beginning of the COVID-19 pandemic. While many industries
plummeted in the first quarter of the year, digital health companies closed the
first quarter of 2020 with unprecedented levels of funding. Private equity
and venture capital financing of digital health start-ups reached an all-time
high of just over $3 billion in Q1 2020.
Digital health seeks to enhance administrative tools,
clinical tools and patient interaction to make the healthcare experience more
effective, efficient, and positive for patients. Healthcare is far behind in
technology, and this industry is looking to fill that gap. Those of us who work
in the digital health space want to take current healthcare experience, which
is something like Blockbuster Video in the early 2000s and turn it into Netflix.
The Board of
Governors in supersession of the Medical Council of India (MCI) issued Telemedicine
Practice Guidelines on March 25 to strengthen delivery in a post-Covid-19
world, with a focus on Health and Wellness Centres (HWCs) that provide
preventive and primary healthcare within a 5 km radius at the grassroots level.
Telemedicine
is being used by doctors to connect with patients, and by mid-level
provider/health workers to connect patients with doctors without patients
having to physically visit a hospital or clinic. Even post
lockdown, it will help reduce the burden on the secondary hospitals and improve
documentation, data-collection, diagnosis and care without risking the safety
of the patients or the health workers. It is already being used with success in
some states for reproductive and child health and tuberculosis notification and
outreach.
There is a
persistent shortage of doctors, health workers and hospital beds in the
country, especially in rural areas and densely populated underserved states.
India has 1.1 million allopathic doctors registered with the Board of
Governors/State Medical Councils in December 2019, according to the National
Health Profile 2019.
India’s
public health expenditure is just 1.28% of its GDP, with the per capita public
health expenditure being Rs 1,657 in 2017-18. The rising cost of treatment has
led to inequities in access, with people in under-served rural areas and urban
slums among the worst hit. For people living in rural areas completely
dependent on government hospitals and clinics, the government allopathic
doctor-patient ratio is 1:10,926, shows NHP 2019 data.
For a population of 1.36 billion, this makes the doctor-population ratio
1:1,457, which is lower than the WHO recommended norm of 1:1,000. In addition
to doctors, India has a little more than two million registered nurses and
midwives, many of whom need infection control training to care for patients
with communicable diseases, such as Covid-19 and tuberculosis. The WHO estimates there is a deficit
of 6 lakh doctors and 20 lakh nurses in India. Further, doctors often have to
perform many routine tasks like data entry, patient management; pharmacy
interfacing, ensuring the right gear and equipment are present in the required
quantities at the point-of-need, and so on—over and above their medical and
caregiving duties.
Before Telemedicine
Practice Guidelines, there was no legislation or guidelines on the practice of
telemedicine through video, phone, and online platforms, which include the web,
apps, chats, etc. The existing provisions under the MCI Act, 1956, MCI
Regulations 2002, Drugs & Cosmetics Act, 1940 and Rules 1945, Clinical
Establishment Act, 2010, Information Technology Act, 2000 and the Information
Technology Rules 2011 primarily governed only the practice of medicine and
information technology.
