In the Union Budget speech of 2017-18, Indian Finance Minister articulated his intent, among several others, to launch a new initiative named ‘Digi Gaon’, which would extend the broadband digital technology in rural India. Besides education and skills, ‘Digi Gaon’ would facilitate affordable access to e-healthcare in the in the hinterland of the country.
“Under the Bharat Net, optical fiber has been laid in 1,55,000 km. I have stepped up the allocation for Bharat Net projects to Rs 10,000 crore in 2017-18 and by the end of 2017-18, high speed broadband on optical fiber will be available in more than 1.5 lakh gram Panchayats with hotspots and access to digital services at low tariff,” the Finance Minister said.
“This will give a major fillip to mobilizing broadband and Digital India, for the benefit of people living in rural areas,” he further added.
Increased penetration of ‘Telemedicine’, per se, in the country has the potential to improving time, cost and the quality of access to affordable health care in rural India, as confirmed by several important studies.
A broad perspective:
A report of the World Health Organization (W.H.O), titled “Telemedicine – Opportunities and developments in the Member States”, states that the term ‘Telemedicine’, was coined in the 1970s, which literally means “healing at a distance”. It signifies the use of modern Information and Communication Technologies (ICTs), such as computers, the Internet, and cell phones, to improve patient outcomes by increasing access to care and medical information.
Recognizing that there is no one definitive definition of ‘Telemedicine’ – a 2007 W.H.O study, after reviewing 104 peer-reviewed definitions of this word, adopted the following broad description:
“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 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”
‘Telemedicine’ in India:
Before I get into other relevant details in this area, let me briefly explore in which segments of the three important areas – Market, Services and Providers, ‘Telemedicine’ has already started working in India, though with a varying degree of success.
Market segments:
‘Telemedicine Market’ in India can broadly be segmented into nine key categories. A recent research report on “India E-Health Services Market Outlook to 2020” by Ken Research captures the top three of these segments as follows:
- Tele-radiology: The top segment in India that involves the electronic transmission of radiographic images of patients, such as, X-Ray, CT scan or MRI from one location to another location for an expert interpretation by a radiologist sitting there to quickly facilitate appropriate treatment.
- Tele-consultation: Ranked second in terms of revenue earning of the Indian telemedicine industry in 2015. It involves establishing a clear audio and video communication link between the patient and doctors of different disciplines, as required. Patients’ demand for online consultations with the doctors is fast increasing as it helps to get disease specific medical advice from the different experts located anywhere in the world.
- Tele-ICU: Was ranked as the third largest segment. It involves the use of an off-site command center in which a critical care team (intensivists and critical care nurses) connects with patients in distant ICUs to exchange health information through real-time audio, visual, and electronic means.
The following are the other six segments, which I am presenting below with a brief definition of each, for convenience:
- Tele-ophthalmology: It delivers eye care through digital medical equipment and on telecommunications technology platforms.
- Tele-dermatology: It involves communication technology to connect patients with dermatologists to improve skin health. The technology allows the patient to be examined and even treated without making a physical trip to a dermatologist.
- Tele-surgery: It is the ability for a doctor to help perform surgery on a patient even though they are not physically in the same location. It is a form of telepresence.
- Tele-pathology: It involves the practice of pathology at a distance using telecommunications technology to facilitate the transfer of image-rich pathology data between distant locations for the purposes of diagnosis, education, and research.
- Tele-psychiatry: it is the application of telemedicine to the specialty field of psychiatry. The term typically describes the delivery of psychiatric assessment and care through telecommunications technology, usually video-conferencing.
- Tele-Home Care and Nursing: This is primarily meant for patients who prefer receiving various health care services at home, such as those suffering from serious chronic diseases, post-surgery, and to cater to the critical regular heath needs of elderly persons.
Service segments:
Similarly, various international literature has segmented the ‘Telemedicine services’ into two broad types, as hereunder:
- Real Time telemedicine services: These services include telephonic call or video-conferencing where both the doctors and the patients need to be present at the same time, and real time interaction happens between them.
- Store and Forward telemedicine services: These do not require both the doctor and the patient be present at the same time and transmission and assessment of the medical records can be done at any convenient time.
Types of Providers:
Ken Research Report categorized the ‘Telemedicine Providers’ available in India into the following three groups:............
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