Teleconsultation in the wake of COVID-19 Pandemic – Chirag Gupta

By Chirag Gupta(6st Sem)

Author Note

Chirag Gupta is now a student of 6th semester KMC, Manipal, Udupi, Karnataka. Correspondence concerning the article should be addressed to Chirag Gupta, Nehru Hostel B&C, Eshwar Nagar, Manipal, Karnataka 576401. Email:[email protected]

Abstract

In the wake of COVID-19 pandemic teleconsultation has emerged out. It has been proven to be a great tool for providing medical care without risking the clinician or patient for covid-19 infection7. It sure comes with its benefit like convenience, easy to accessible to those who have resources, to maintain proper follow up. But it also has its restrictions in the form of lacking proper infrastructure and knowledge. In this article there is discussion about the advantage and disadvantage of Teleconsultation and its feasibility in future.

Teleconsultation in the wake of COVID-19 Pandemic

On 31st Dec, 2019 WHO picked up a media statement by the Wuhan Municipal Health Commission from their website on cases of ‘viral pneumonia’ in Wuhan, China and on 11th March, 2020 WHO declared the novel coronavirus outbreak a pandemic1. During the ongoing pandemic, the WHO suggested that communities should embrace a non-pharmaceutical intervention, namely, physical distancing2. That leads us towards the idea of teleconsultation.

Teleconsultation is defined as synchronous or asynchronous medical consultation using information and communication technology to omit geographical and functional distance3. Some study shows that the patients have been found to be satisfied with the teleconsultation5. But the system to support teleconsultation has not been established properly yet for the long-term aspect. The lack of proper technology and its knowledge itself in rural areas or semiurban areas and the chances of malpractice has been found to be challenging6. Following is the discussion of benefits and challenges of Teleconsultation.

Advantages of Teleconsultation in Pandemic

In the current pandemic scenario teleconsultation has been proven to be a great tool to provide basic care. Studies has been done suggesting that teleconsultations for diabetes care are feasible, cost-effective, and reliable4. A study showed that telemedicine can enhance learning skills, case handling strategies8. The utilisation of telemedicine has been rapidly increasing in the USA. From 2010 to 2017, the percentage of US hospitals that connect with patients using video and other technology has increased from 35% to 76%9 . In India, Social Endeavor for Health and Telemedicine (SEHAT) launched on 25 August 2015. It is a

telemedicine health initiative by government. Benefits of teleconsultation does not get limited to pandemic scenario only. Other benefits10 are mentioned below.

  • Reduce the inconvenience and price of patient transfers.
  • Remove distance barriers and improve access to quality health services.
  • Privacy Assurance – Telemedicine complies with HIPAA laws that aim to stop personal or secure medical documents from being leaked.

Disadvantages of Teleconsultation

Teleconsultation presents with a lot of benefits but without the proper system established there are shortcomings of the teleconsultation. As we know that more than sixty percentage of Indian population are living in rural areas, so they lack proper infrastructure and knowledge of computer11-13. Various other problems10 are –

  • People are hesitating for using technology and even not aware of technology too.
  • People are thinking that the technology is very costly.
  • Not every medical staffs is aware of such technology very well.
  • Communication gap is another problem. In Indian rural areas few people know English.
  • Limited Access to High-Speed Internet14.
  • In a study conducted in Saudi on 25 physicians the main disadvantages of telemedicine noted by respondents is that it was difficult to make a diagnosis throughout the virtual clinic due to the lack of physical examination and inability to use their hands-on expertise8.

Discussion

The pandemic has forced us towards teleconsultation, and it is compelling us to make it more feasible. The benefits it presents are numerous when its perfect. Even studies have shown that telemedicine appointments can be equal to in-patient visits in a variety of specialties15. There is need of campaigns for more awareness towards teleconsultation. Providing easily accessible guidance is a first step but will need cultural change to implement as well15. There should be more studies towards the remote monitoring devices for patients17.

Conclusion

Teleconsultations is a helpful tool for many medical and surgical conditions, in the psychological field, medical reports, laboratory follow ups, prescription, and communication with other facilities and other specialties. But it cannot replace where the physician’s hands-on expertise is needed8. We need to start to view teleconsultation not just as a replacement but as a parallel and complementary form of delivering therapy. A combination or hybrid approach can be the most successful approach in the new world of health post-COVID-19, and guidance will need to expand to encompass the use of teleconsultation in conjunction with other in-person and digital technologies16.

References

  1. Who.int. 2020. Listings of WHO’s response to COVID-19. [online] Availablet:<https://www.who.int/news/item/29-06-2020-covidtimeline> [Accessed 10 June 2021].
  2. World Health Organization. Regional Office for the Western P. Role of primary care in the COVID-19 response. Manila (PH): WHO Regional Office for the Western Pacific; 2020
  3. Deldar, K., Bahaadinbeigy, K., & Tara, S. M. (2016). Teleconsultation and Clinical Decision Making: a Systematic Review. Acta informatica medica : AIM : journal of the Society for Medical Informatics of Bosnia & Herzegovina : casopis Drustva za medicinsku informatiku BiH, 24(4), 286–292. https://doi.org/10.5455/aim.2016.24.286-292
  4.   Verhoeven, F., Tanja-Dijkstra, K., Nijland, N., Eysenbach, G., & van Gemert-Pijnen, L. (2010). Asynchronous and Synchronous Teleconsultation for Diabetes Care: A Systematic Literature Review. Journal of Diabetes Science and Technology, 4(3), 666–684. https://doi.org/10.1177/193229681000400323
  5. Dias, L, Martins, B, Pinto, MJ, Rocha, AL, Pinto, M, Costa, A. Headache teleconsultation in the era of COVID-19: Patients’ evaluation and future directions. Eur J Neurol. 2021; 00: 1– https://doi.org/10.1111/ene.14915
  6. Ruralhealthinfo.org. 2021. Telehealth Use in Rural Healthcare Introduction – Rural Health Information Hub. [online] Available at: <https://www.ruralhealthinfo.org/topics/telehealth> [Accessed 10 June 2021].
  7. Raffaele Galiero, Pia Clara Pafundi, Riccardo Nevola, Luca Rinaldi, Carlo Acierno, Alfredo Caturano, Teresa Salvatore, Luigi Elio Adinolfi, Ciro Costagliola, Ferdinando, Carlo Sasso, “The Importance of Telemedicine during COVID-19 Pandemic: A Focus on Diabetic”
  8. Mubaraki AA, Alrabie AD, Sibyani AK, Aljuaid RS, Bajaber AS, Mubaraki MA. Advantages and disadvantages of telemedicine during the COVID-19 pandemic era among physicians in Taif, Saudi Arabia. Saudi Med J. 2021;42(1):110-115. doi:10.15537/smj.2021.1.25610
  9.  American Hospital Association. Fact sheet: telehealth, 2019. Available: https://www.aha.org/system/files/2019-02/fact-sheet-telehealth-2-4-19.pdf
  10. Brindha, G., 2013. Emerging Trends of Telemedicine in India. Indian Journal of Science and Technology, 6(sp5), pp.1-7.
  11. Sanjeev A, Thornton K et al. (2011). Outcomes of treatment for Hepatitis C Virus infection by primary care providers, The New England Journal of Medicine, vol 364(23), 2199–2207, Doi: 10.1056/NEJMoa1009370.
  12.  Chang B L, Bakken S et al. (2004). Bridging the digital divide: reaching vulnerable populations, Journal of the American Medical Informatics Association, vol 11(6), 448–457.
  13. Nelson A (2002). Unequal treatment: confronting racial and ethnic disparities in health care, Journal of the National Medical Association, vol 94 (8), 666–668.
  14. 33 FCC Rcd 1660 (2)
  15. Kichloo A, Albosta M, Dettloff K, et alTelemedicine, the current COVID-19 pandemic and the future: a narrative review and perspectives moving forward in the USA Family Medicine and Community Health 2020;8:e000530. doi: 10.1136/fmch-2020-000530
  16. Smith K, Ostinelli E, Macdonald O, Cipriani A. COVID-19 and Telepsychiatry: Development of Evidence-Based Guidance for Clinicians. JMIR Ment Health. 2020 Aug 28;7(8):e21108. doi: 10.2196/21108. PMID: 32658857; PMCID: PMC7485934.
  17. Cheung CC, Deyell MW. Remote Monitoring of Cardiac Implantable Electronic Devices. Can J Cardiol. 2018 Jul;34(7):941-944. doi: 10.1016/j.cjca.2018.01.003. Epub 2018 Jan 8. PMID: 29691097.

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