Telemedicine gained ground in India during the pandemic and while the momentum slowed down to an extent, remote healthcare delivery is here to stay. Bhavya Bagga of CXO News and APAC News Network explores different facets of telemedicine and how it democratizes healthcare.
Telemedicine, the remote delivery of healthcare services, has emerged as a crucial tool in India, a country facing challenges in providing equitable healthcare to its vast population of over 1.4 billion people. Despite facing obstacles like insufficient technological infrastructure, the potential of telemedicine to bridge the rural-urban healthcare divide is significant. The ability to offer consultations and medical diagnostics over telecommunications infrastructure enables patients to access medical care without the need to travel physically, making healthcare more accessible and cost-effective.
In India, many people face challenges in accessing healthcare, especially in remote areas. Telemedicine has emerged as a valuable solution to this problem. The Covid-19 pandemic in 2020 showed just how important telemedicine can be. It gave hospitals and doctors a chance to use it more widely. Before the pandemic, telemedicine was used only occasionally, but the crisis pushed many healthcare providers to adopt it quickly. Telemedicine has proven to be effective in helping doctors reach patients without the need for them to visit a hospital. This has not only made healthcare more accessible but also eased the pressure on traditional healthcare facilities.
Dr. Ashok Seth, Chairman of Fortis Escorts Heart Institute, highlighted the crucial role telemedicine plays in revolutionizing healthcare delivery in India. According to Dr. Seth, telemedicine flourished during the COVID-19 pandemic and must continue as an integral part of healthcare services. He emphasized that digital technologies, including telemedicine, help make healthcare more accessible, affordable, and personalized, particularly for patients in remote areas.
Telemedicine empowers patients by enabling them to connect with doctors from their homes, reducing hospital visits, and lowering treatment costs. Dr. Seth also mentioned how wearable devices are being used to monitor patients’ health remotely, allowing doctors to intervene early if complications arise. This not only improves patient outcomes but also reduces emergency hospital admissions. He pointed out that virtual consultations, rehabilitation services, and continuous monitoring can help patients recover at home while still receiving quality care.
Dr. Seth stressed that digital technology is essential for India’s 1.4 billion population and could play a pivotal role in preventive healthcare, ensuring that patients are treated in their own environments and stay out of hospitals.
Despite the challenges faced, the potential benefits of telemedicine in India are immense. By leveraging technology to provide virtual consultations and medical services, telemedicine can revolutionize the healthcare landscape, particularly in remote and underserved areas. Through cost-effective and easily accessible services, telemedicine has the capacity to transform healthcare delivery, ensuring that all individuals, regardless of their geographical location, can receive quality medical
Background and Evolution
Telemedicine in India started with significant contributions from various entities such as ISRO, the Department of Information Technology, Ministry of External Affairs, Ministry of Health and Family Welfare, and state governments. These collaborations played a crucial role in developing telemedicine services in India. One notable early initiative was ISRO’s telemedicine network, which aimed to provide healthcare services in rural areas using telecommunications infrastructure. Additionally, the introduction of official guidelines in 2019 and initiatives like the “e-Sanjeevani” national teleconsultation portal further accelerated the adoption of telemedicine in India.
COVID-19 accelerated telemedicine adoption across India by addressing critical barriers, such as inadequate medicolegal considerations, through the issuance of guidelines by the Ministry of Health & Family Welfare. The sudden rise in internet use during the pandemic led to increased data consumption at homes by at least 15%, facilitating the expansion of telemedicine services. Successful collaborations between government and private healthcare institutions further promoted telemedicine as a crucial tool in bridging the healthcare gap between rural and urban India, positioning Indian telemedicine on a global scale.
Praveen Bist, Chief Information Officer (CIO) at Amrita Hospitals, highlighted their focus on integrating telemedicine into the hospital’s digital strategy. Amrita Hospitals has emphasized teleconsultation and remote care services, particularly during the Covid-19 pandemic. Telemedicine has helped patients access healthcare without needing to visit the hospital physically, allowing for seamless follow-up care and consultations.
Bist noted that Amrita Hospitals’ robust digital infrastructure, including their Electronic Medical Records (EMR) system, has been pivotal in delivering telemedicine services effectively. With a fully Wi-Fi-enabled campus and mobile devices provided to clinicians, the hospital ensures that healthcare providers can access patient information anytime and anywhere. This integration enables clinicians to provide real-time consultations and support remotely.
The Telemedicine Practice Guidelines (2020) in India play a crucial role in regulating and expanding teleconsultation services nationwide. These guidelines address various aspects such as eligibility for practicing telemedicine, types of teleconsultations, doctor-patient relationship, consent, management protocols, and data security and privacy. They are essential as they facilitate timely access to healthcare services and provide access to interventions that may not be readily available otherwise.
Neeraj Lal, COO of Apollo Hospitals (Gujarat region), emphasized the increasing role of cloud technology in healthcare, particularly in telemedicine and remote monitoring services in India. He pointed out that Apollo Hospitals has been actively improving its cloud computing capabilities to meet diverse client needs. One key development in this area is the Apollo 24/7 digital platform, which integrates Google Cloud’s Vertex AI to enhance telemedicine services and patient care through innovations like the Clinical Intelligence Engine.
This partnership enables Apollo to leverage data-driven insights for better clinical decision-making. Moreover, Neeraj highlighted Apollo’s expansion into hybrid and multi-cloud solutions, positioning the hospital to provide more flexible and scalable telemedicine services. He also mentioned that cloud-based innovations like the patient transportation management application, akin to ride-hailing services, are improving patient access to healthcare facilities, thus enhancing the overall telehealth experience in India.
The guidelines draw insights from global professional organizations, the European Union, and international literature, emphasizing emerging ethics, policies, and considerations, with a focus on the experience in the United States.
Current State of Telemedicine in IndiaÂ
Telemedicine has shown a notable variance in its adoption between urban and rural areas, indicating a need for tailored resources and training to cater to the distinct needs of these populations. Telehealth serves as an alternative healthcare delivery model that enhances treatment accessibility and diminishes barriers to care primarily in underserved and rural regions. While telehealth holds potential to revolutionize healthcare services in rural and underserved urban communities, challenges still hinder its widespread implementation.
Dr. Chandrasekar Chikkamuniyappa, CEO of DHEE Hospitals, highlighted the significant role of telemedicine in India’s healthcare landscape, particularly during and after the pandemic. He emphasized that DHEE Hospitals rapidly expanded its telemedicine infrastructure to ensure uninterrupted care while minimizing physical interactions. Through their advanced telemedicine platform, patients can consult with healthcare providers remotely, receive timely medical advice, refill prescriptions, and access follow-up care, all from the comfort of their homes.
Chikkamuniyappa noted that remote health monitoring services have also become essential for managing patients with chronic conditions, enabling continuous tracking of vital signs and symptoms. These services not only enhance convenience but also improve patient outcomes by facilitating early intervention and timely care. By integrating telemedicine and remote health monitoring into their healthcare model, DHEE Hospitals has adapted to the evolving needs of the healthcare sector, providing high-quality, patient-centric care while embracing digital transformation.
Major platforms and companies driving telemedicineÂ
- Practo: Practo launched its telemedicine product in 2015, offering audio, video, and chat capabilities for patients and doctors to connect. In 2016, Practo expanded its telehealth services to democratize quality healthcare in India, leading to millions of teleconsultations and significant growth, especially during the pandemic.
- HealthTap: HealthTap provides an AI-driven telemedicine platform that enables virtual consultations, medical advice, and personalized health information. Users can ask medical questions, receive advice from licensed doctors, and access various health resources.
These companies, along with others in the telemedicine industry, play a crucial role in advancing healthcare accessibility and delivery through innovative technologies and services. Additionally, government initiatives like eSanjeevani also contribute to the promotion and adoption of telemedicine practices to enhance healthcare services for the population.
The impact of AI and digital infrastructure on telemedicine in India
AI, mobile apps, and digital infrastructure play crucial roles in the growth of telemedicine in India. Integrating artificial intelligence (AI) into telemedicine enhances its capabilities by enabling patient monitoring, intelligent diagnosis, and healthcare IT assistance.
Dr. Sachin Jhawar, Director of Apex Hospital, highlighted the growing importance of telemedicine in India. He stated that the Government of India has initiated substantial projects to expand telemedicine services, not only within the country but also to neighboring nations in South Asia and Africa.
Jhawar emphasized that telemedicine is a critical solution to address healthcare disparities, particularly between urban and rural areas. He expressed confidence in its potential to enhance access to affordable healthcare services in underserved regions. Dr. Jhawar also pointed out that the Medical Council of India has established guidelines to support telemedicine implementation, providing a practical framework for healthcare providers. He recognized the role of digital technology and artificial intelligence (AI) in strengthening India’s public health infrastructure, noting how mobile technology was effectively utilized during the COVID-19 pandemic to facilitate remote patient monitoring.
AI-powered wearable devices for continuous monitoring, virtual nursing assistants, and AI’s role in telemedicine and remote patient engagement are transforming patient care delivery. Modern mobile health apps support telemedicine by providing interactive clinical interfaces for treating patients with minor diseases, exchanging data, and sharing imaging findings. The shift towards telemedicine, facilitated by mobile apps and digital infrastructure, is predicted to increase significantly, with nearly two-thirds of patients accessing healthcare through digital platforms by 2023.
Bhoopendra Solanki, CIO of Sakra World Hospital, highlighted that Sakra began exploring virtual consultations long before the Covid pandemic, focusing on follow-up care for patients. During the pandemic, they expanded their digital offerings by introducing home-collection of RT PCR samples and launching a mobile app at the start of the lockdown. Sakra also enabled Hospital Information System (HIS) integration and put the Unique Health Identification (UHID) under patient control, paving the way for online payments, E-POS, and QR-code-based systems.
With innovations like touchless check-in, kiosks, and automated billing, they aim to streamline and automate the entire patient journey. By minimizing data silos and integrating systems through APIs, Sakra is striving for a seamless, data-driven healthcare experience. This approach reflects a broader trend in India’s healthcare sector, where telemedicine and digital health solutions are becoming essential for improving access and efficiency.
Benefits and ImpactÂ
Telemedicine in India has significantly improved patient care through follow-ups, consultations, and easy access to specialists. By utilizing digital technologies, telemedicine enhances patient access. Health apps facilitate scheduled follow-up visits, making doctors and patients more effective, reducing missed appointments, and optimizing patient outcomes. Telemedicine has also improved access to care for various clinical conditions such as stroke and pregnancy, demonstrating enhanced health outcomes in select circumstances. It addresses geographical barriers and has the potential to benefit patients across different medical domains by providing easy access to specialist consultations and follow-ups, ultimately enhancing overall healthcare delivery in India.
Sudeep Dey, Chief Information Officer (CIO) of HCG Hospitals, highlighted key advancements in telemedicine within India, especially at HCG. He emphasized that HCG Hospitals made teleconsultation available across all centers in 2023, enhancing patient access to healthcare services remotely. Additionally, HCG introduced tele-radiology capabilities at select centers, allowing for the remote analysis of diagnostic imaging, which has proven instrumental in providing faster and more accurate diagnoses.
Dey noted that while telemedicine has progressed significantly, especially in terms of consultations and radiology, there is still work to be done in scaling these services to offer comprehensive remote monitoring and care for patients, particularly those with chronic conditions. This reflects India’s broader trend in healthcare, where telemedicine adoption is rapidly increasing, driven by the need for more accessible and efficient healthcare solutions across the country.
Challenges Facing Telemedicine in IndiaÂ
The challenges facing telemedicine in India include insufficient technological infrastructure, barriers due to virtual consultations, limited digital literacy, particularly among older adults and rural populations, health literacy issues, and the need to overcome these challenges for successful implementation to bridge the rural-urban healthcare divide with cost-effective and easily accessible services.  “Access to timely and accurate health information is a real challenge in India. Looking at this scenario, our partnership with Google Cloud is poised to address this challenge through various collaborations,†opines Shobana Kamineni, Executive Vice Chairperson, Apollo Hospitals. AskApollo embodies the fusion of technology and compassion to revolutionize patient care, Kamineni added further.
Many healthcare providers and patients are hesitant to fully embrace telemedicine for several reasons. Although telemedicine has advantages like better access to doctors, effective follow-up visits, and improved healthcare availability, there are challenges that prevent it from being widely used.
One important issue is that healthcare providers and patients may need extra support or encouragement to start using telemedicine more often. Some doctors and patients worry that virtual appointments might not be as effective as traditional in-person visits. Additionally, problems with technology, concerns about privacy, and unclear payment policies also make people reluctant to adopt telemedicine fully.
Overall, while telemedicine offers significant advantages in terms of convenience and accessibility, addressing these barriers and increasing awareness about the benefits of telemedicine are crucial steps towards its broader adoption in healthcare practices.
Future ProspectsÂ
Upcoming innovations in telemedicine in India include the integration of AI-driven diagnostics, wearables, and remote monitoring. These advancements aim to enhance healthcare by improving diagnostic accuracy, enabling earlier disease detection, and providing expert-level diagnostics to individuals in remote or underserved areas. The collaboration among AI engineers, data scientists, domain experts, and stakeholders is crucial for developing effective and ethical AI solutions in healthcare. The global market for AI in healthcare is projected to grow significantly, reaching US$ 148.4 billion by 2029, driven by factors like increasing collaborations within the healthcare sector.
The Indian government has been actively working on expanding telemedicine infrastructure and regulations. In FY 2021, the Indian Telemedicine Market was valued at USD 1314.83 million, with a predicted Compound Annual Growth Rate (CAGR).
In response to the COVID-19 outbreak, India’s government introduced new telemedicine guidelines to facilitate the provision of medical services during lockdowns. The government’s ongoing initiatives aim to enhance telemedicine usage, exemplified by the eSanjeevani project, which has shown promise in addressing healthcare limitations in India.
The Ayushman Bharat Digital Mission also uses cloud-based solutions to host a database of citizens’ health records identifiable with a unique digital ID that can be shared with all service providers on the platform. “Following the success of the Co-WIN app and digital ID initiatives, the overall demand for cloud-native solutions has increased significantly,†reveals Ram Deshpande, Partner for Digital Advisory & Technology Transformation, EY India.
The Government of India has initiated and completed major projects to expand telemedicine services, even reaching out to countries in South Asia and Africa. These efforts show a strong commitment to using telemedicine to improve healthcare access and delivery, not just during the pandemic but also afterward. Telemedicine has great growth potential in India. It is becoming a key solution to help fill the gaps in healthcare access. As part of the government’s Digital India mission, telemedicine is expected to grow, helping to address the uneven doctor-to-patient ratio. Although there are challenges like limited technology infrastructure, telemedicine can help reduce the healthcare gap between rural and urban areas by offering cost-effective and easily accessible services. To support this growth, the Medical Council of India has introduced Telemedicine Practice Guidelines, providing clear principles and a practical framework for implementing telemedicine.
Conclusion
In conclusion, telemedicine can greatly change how healthcare is delivered in India by making it easier, cheaper, and better, especially for people in areas that lack services. The use of AI and digital technology is helping this change, allowing patients to consult with doctors remotely, get continuous health monitoring, and manage their care more efficiently. Although there are still challenges like limited technology and digital skills, the efforts of healthcare providers, government support, and new technology show a bright future for telemedicine. By adopting these innovations, India can close the healthcare gap and ensure everyone has access to quality medical services, no matter where they live.
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