By Siddharth Mala
New Delhi: Over the past few years, online doctor consultations have gained significant popularity in India. The advent of technology and increased internet penetration has made it more convenient for people to seek medical advice remotely.
According to a study conducted by Lybrate last year, there was a substantial increase of 87 per cent in online medical consultations in tier II-III cities in 2022. This surge in virtual doctor consultations was attributed to the rising popularity of telemedicine over the past couple of years. Notably, cities such as Jaipur, Ahmedabad, and Lucknow experienced this significant growth in online consultations, whereas metros witnessed a 75 per cent increase during the same period.
On the occasion of National Doctors’ Day, ETHealthworld interacted with experts to understand how online medical consultations have resulted in significant transformations and enhanced convenience for both doctors and patients in the health sector.
Based on an analysis conducted by Statista, the telemedicine market in India exhibited a value of approximately 830 million $ in 2019, a notable increase from 647 million $ in the previous year. This market has witnessed steady growth since 2010 and is projected to expand at a Compound Annual Growth Rate (CAGR) of 31 per cent until 2025.
Commenting on the pace of growth in the number of online consultations for patients, Dr Vaibhav Kapoor, Co-founder, Pristyn Care, stated that the number of online consultations for patients has experienced remarkable growth because of advancements in technology and the increasing accessibility of internet connectivity. The COVID-19 pandemic played a significant role in accelerating this growth, with the past two years witnessing a surge in online consultations that surpasses the numbers seen in the previous decade. The implementation of social distancing measures and the imperative to minimise face-to-face interactions prompted a rapid increase in the utilisation of telemedicine services.
As per Practo, the digital healthcare platform’s recent study on online consultations showcased that doctors spent over six hours a day on average consulting patients. In a positive shift post-COVID, doctors continued to embrace digital technologies and spent an additional 62 per cent of their time beyond the committed hours.
While emphasising on the rise of online medical consultations impacting the accessibility of healthcare for individuals in remote areas, Dr Abhijit Paul, Medical Director, Practo, said, “Telehealth can help healthcare providers and organisations in expanding the access to quality healthcare in rural areas. It is also proven to be extremely helpful with monitoring and communication within the healthcare system. Increasing accessibility and convenience, cost-effectiveness, and continuity of care are some innumerable benefits of taking online consultations with doctors.”
Online consultation vs in-person visit
Although online is helpful for providing easy access to healthcare, it may not be suitable for all medical conditions or situations. Certain conditions may require in-person assessments, such as examining a wound. In such cases, telemedicine consultations may be supplemented with in-person visits to ensure a comprehensive evaluation, inform doctors. Apart from it, internet penetration is a challenge in some remote or rural areas. The absence of consistent internet access makes it challenging to implement telehealth solutions that depend on video conferencing or remote monitoring. Then, there is a lack of digital infrastructure, such as electronic health records and remote monitoring devices. This can make it difficult to integrate telehealth into existing healthcare systems and workflows. Also, technology literacy is not something many are aware of.- This can make it difficult for patients to access telehealth services and for healthcare providers to effectively communicate with patients using technology.
Informing that telemedicine consultations are not a full replacement for in-person appointments, nor are they appropriate for all patients or clinical settings, Dr Aniket Mule, consultant- internal medicine, Wockhardt Hospitals, Mira Road, said, “Technology may not always function well and it might act as a barrier in care delivery. The inability to conduct an in-person physical examination is a barrier and inaccurate information about the patient can be a cause of concern.”
While speaking on challenges faced by healthcare professionals Dr Mule emphasised that during any treatment, doctors normally follow a four-step approach that includes history-taking, clinical diagnosis, therapeutic consultation, and follow-up.
During the history-taking process, clinicians ask individual- and disease-specific questions. The former is about the patient’s previous diseases, family status, previous therapies, allergies, and so on, while the latter are concerning the disease’s origin, duration, and progression. According to medical practice, history-taking accounts for 70 per cent of diagnoses, making it a critical duty.
History-taking becomes even more critical in telemedicine because the patient is not physically present. Doctors may have been unable to view the patients’ facial expressions or measure their anxiety levels. Sometimes, connectivity troubles make it difficult to hear patients clearly. There also exists linguistic challenges, with patients speaking in their native language making it tough for the doctor to understand things properly.
According to NITI Aayog, the Indian telemedicine market is expected to witness substantial growth, with its market size projected to escalate from $830 million to $5.5 billion by 2025. This growth is anticipated to be driven by a CAGR of 31 per cent over the same period. Several key factors contribute to the growth of the telemedicine industry including an increase in healthcare demand, technological advancements, diagnosis convenience for patients, and enhanced patient retention.
With the increase in the rate of growth in online consultations from doctors, a few barriers exist which pull behind few on equal access to telemedicine. On this Vikram Thaploo, CEO-Telehealth, Apollo Hospitals, suggested a few measures to bridge the technological divide and ensure equal access to online medical consultations for all individuals.
He stated foremost focus should be on implementing digital literacy programs aimed at educating individuals, particularly those who are less tech-savvy, about the basics of using digital devices, accessing the internet, and utilising online platforms for healthcare. These programs can be conducted through community centers, libraries, or local healthcare organisations. He also emphasized to development of user-friendly online platforms and applications for medical consultations that prioritise simplicity and ease of use.
“Design interfaces that are intuitive and require minimal technical knowledge and consider the needs and limitations of individuals with varying levels of technological proficiency,” he added.
Stressing on Public-Private Partnerships, Thaploo said initiatives such as improving broadband connectivity, setting up community Wi-Fi networks, or exploring innovative solutions like satellite internet is of utmost importance.
Pointing out that ethical concerns are a major issue in telemedicine and in medical practice, Dr Sharad Kumar Agarwal, President, Indian Medical Association (IMA) stated that for the follow-up process of patients with chronic diseases, the telemedicine mode of consultation can be preferred. However, for diagnosing the disease and reviewing the condition, it is always advisable to have a physical consultation.
Dr Agarwal further added that in medical teaching and ethics, it is always advisable to first see the patient, as a patient. Unless the patient has been examined physically, it is not advisable to prescribe the medicine and that is the basic fundamental of medical science. He also advised not to take digital consultation just for the sake of it and can take it up only in case of emergency of those patients who are on the regular follow up of the same disease element with the doctor or in case of chronic diseases telemedicine should be considered.
Although there is a lot of enthusiasm about this shift to digital healthcare and there’s definitely momentum, which is building, the doctors inform us that there is a need for the proper guidelines for online consultation.
