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By: Atibhi Mehra and Anirban Panda

Over the years, the healthcare sector has made considerable efforts to shift from a reactive to a proactive approach by placing the patient at the heart of the care delivery model. While it takes decades to bring about a meaningful change in a slow-moving industry such as healthcare, , sometimes things can become upended in a matter of weeks. The phenomenon management scholar Rita McGrath calls this an “inflection point.”

With the COVID-19 pandemic, we are navigating through one such inflection points with regard to the healthcare delivery landscape.

In India, in the pre COVID-19 scenario, there was a movement towards the adoption of virtual care; however, it was relatively slow, unplanned and lacked strategic planning. It was fueled by the adoption of smartphones and new technologies such an Artificial Intelligence (AI) and Machine Learning (ML).

However, the real push came with the pandemic-induced lockdown.  Today, with an aim to enable seamless and convenient patient-provider interaction, the virtual care landscape is witnessing acceleration in adoption, growth and innovation.

According to a report by the digital health platform, Practo, online consultations in India went up by 500% between March 1 and May 31, 2020. Around 80% were first-time telemedicine users, of which 44% were from non-metro cities. Additionally, the number of doctors joining Practo has gone up by almost 50%.

These numbers indicate that tech-enabled healthcare is making the distribution of health-related services over long distances possible without actual physical contact between the patient and the doctor, thereby making the health system work better for everyone.

Mapping the virtual care landscape

Quite often the term virtual care is misunderstood for telemedicine or Telehealth. While telemedicine specifically refers to treatment of patients’ medical conditions without seeing them in person, virtual care is a broader term.

Virtual care typically comprises of telemedicine, mobile health (mHealth), remote patient monitoring (RPM) and personal emergency response systems (PERS). While telemedicine is helping patients get doctor consultations from the safety and comfort of their home mHealth, RPM and PERM are helping the providers to make better informed decisions, leading to effective and efficient consulting.

Add to this the rise in availability of biosensing wearables (blood pressure, oxygen level, glucose level etc.), use of smartphones as activity or physiology tracking sensors and application of AI/ML to provide physicians with insights for decision making related to treatments and procedures. With all this, we are looking at a complete transformation of the care delivery paradigm.

Establishing a virtual care delivery model

During the pandemic, providers, especially big hospital groups, are reduced to providing only core services.

Ancillary services like primary care, lab testing, and chronic care have been decoupled. In such a scenario, establishing virtual care capabilities could prove vital to streamline operations. However, virtual health delivery requires an enterprise approach, mandating capabilities such as:

  • A robust strategy and governance structure for virtual health offerings, delivered through a financially viable care model compliant with all regulatory requirements
  • scalable and interoperable technology infrastructure that support the requirements of virtually enabled care models
  • Cognitive and analytics tools to generate insights on virtual health usage and outcomes
  • An agile operational structure that can easily be integrated into virtual health workflows
  • An engaged workforce of clinicians and other enabling staff aligned to support virtual health offerings, keeping patient experience at the center

In India, there is a large population base that is not exposed to these technologies and does not have access to primary health centers. Thus, to enable a virtual care delivery model in addition to the above capabilities, a virtual or cross-geography model of care delivery must be established. Virtual care services must be integrated into a seamless delivery process with coordinated planning across services, settings and patient populations to make optimum allocation of provider time.

Roadblocks to a virtual care delivery model

To realize the change envisioned, the industry will traverse multiple challenges. The general concerns would be regarding connectivity of basic infrastructure, lack of technology skills among the population at large as well as the need for privacy and security.

Additionally, provisions will have to be made to upskill medical staff and make them adept at working with advanced technologies. There is also a lack of confidence that the senior medical staff has concerning the application of ICT in patient care and the hesitation to adopt the latest advancements, work as bottlenecks in the growth of virtual care.

However, the replacement of in-person examinations is a practical challenge as it involves making patients aware of conducting self-examination and reporting deviance to their primary healthcare provider. The rapid digitization calls for physicians to don multiple hats, such as doctors, technicians and counselors, while connecting virtually with their patients. For this, in addition to medical and digital streams, caregivers will need to be trained in empathy and behavioral skills.

Conclusion

The coronavirus outbreak has served as a significant inflection point for organizations and consumers or patients, accelerating investment, and helping them to break structural barriers in the adoption of virtual care. Many people are trying virtual platforms for the first time. Only good reliable service can replace physical delivery and hook people to this mode, as it offers a fair amount of flexibility and convenience. The pandemic provided the stimuli to try out the virtual care and now what is important is to convince the patients that it is as good, if not better than the conventional mode of care delivery.

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