TELEMEDICINE: A solution to the burgeoning healthcare needs to bridge the demand supply gap of patients and healthcare professionals

 

TELEMEDICINE: A solution to the burgeoning healthcare needs to bridge the demand supply gap of patients and healthcare professionals

By: Sanjeeb Kumar Samal

Recently I had been to villages remote to Bhubaneswar, the capital of Odisha to conduct health camps free of cost under the Corporate Social Responsibility (CSR) scheme of our company. We moved with a team of general practitioners and with medicines. The dates were announced in advance in order to get a good attendance. Normally 100 to 500 patients turned up in each of the health camp. Some familiar patterns of disease prevalence were observed among the patients who attended the health camps. Aged persons with complaints of knee pain would be common phenomena in all the health camps. In one of the camps I was surprised by one observation. The measure of blood pressure of some female patients showed very high value, which to me was unlikely. On seeking a reason for that the doctors told me that the village folks take lot of water dipped rice with high salt in their diet (in eastern part of India intake of watered rice is common by the poor section of populace)  and the salt is causing the elevated blood pressure.  The doctors accompanying used say that lot of patients will be found malaria positive in the health camps considering the environmental conditions of our venues, but so was not the case. I wish this had a correlation with the ongoing National Vector Borne Disease Control Programme (NVBDCP) under National Rural Health Mission (NRHM) which has given clear cut guidelines and tools to eradicate vector borne diseases like malaria, dengue, filariasis and kala-azar. It was a pleasure to see that the pathology technicians in our team would bring along rapid test kit lots from public hospital to detect the vector borne diseases.

I used to think that non communicable diseases (NCDs) are absent in the rural areas in comparison to urban areas. But, the observation I had in that health camp and interaction with doctors did change my perception. The NCDs of cancer, cardiovascular diseases and diabetes have found their ways into rural heartlands due to urbanization, tobacco consumption, alcohol consumption and physical inactivity. An epidemiological transition is taking place in the rural areas as well. In fact the Government of India has taken cognizance of the fact and has recently launched the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) in the year 2010.

It’s well known that the NCDs are fast grappling the urban Indian population and simultaneously undeniable that the NCD monster is steadily raising its head in the rural mass as well. This calls for deployment of specialists in the rural areas treat the rising numbers of NCD patients.

The Government led initiatives are slow and usually takes too long time in addressing the disease prevalence and very likely that the status quo will continue in the future. If the Year-2011 reports are any indicator of how things are placed in current scenario, the following table elucidates, out of 19,236 specialist posts 12,301 are in shortfall in the 4,809 total CHCs (Community Health Centre: Secondary health care centers for rural population) of our country

Table: Requirement Vs. Deployment of specialist doctors in CHCs

States

Total CHCs functioning

Required (4 specialists per CHC)

Sanctioned

In Position

Vacant (sanctioned-in position)

Shortfall (required- in position)

Himachal Pradesh

76

304

NA

9

NA

295

Bihar

70

280

280

151

129

129

Assam

108

432

NA

216

NA

216

Orissa

377

1,508

812

438

374

1,070

Uttar Pradesh

515

2,060

2,060

1,894

166

166

Chhattisgarh

148

592

592

82

510

510

Jharkhand

188

752

124

66

58

686

Rajasthan

376

1504

1068

569

499

935

Madhya Pradesh

333

1,332

778

227

551

1,105

Uttarakhand

55

220

210

78

132

142

All India

4,809

19,236

9,831

6,935

3,880

12,301

 

 

 

 

 

 

 

 

 

Source: http://www.indiaspend.com/sectors/rural-india-faces-60-shortage-of-doctors

There are seemingly two options to combat the menace.  One is to increase the postings  of medical/paramedical professionals and second is to apply Information & Communication Technology (ICT) to bridge the distance between the doctor and patient in the existing set up.

Telemedicine is considered as the next game changer in healthcare by leveraging electronic & telecommunication advancement to connect the patients and doctors separated by distance. Treatments is possible over video calls, conferencing calls from consultation to tertiary treatments in mental health, dermatology etc. Telemedicine will also be useful in seeking second opinion and providing continued medical education to health care professionals.

Source: ISRO Site

With innovations in the logistics associated around the telemedicine system, issues like lack of awareness, non –affordability, distance from the healthcare centre and fear of falling into the trap of moneymaking private hospitals, which prevent the villagers from seeking quality healthcare can effectively be addressed.

Telemedicine is in a much nascent stage in India. Organizations such as ISRO, SPGIMR Lucknow , PGIMER Chandigarh , Govt. Medical Colleges of Orissa,  Apollo Telemedicine Network Foundation, Telemedicine Society of India and some private tertiary care organizations are taking pioneering steps in promoting telemedicine. Suitable policies by the Government and entry of entrepreneurs will make Telemedicine an acceptable medium of providing healthcare services to larger and underprivileged section of the society.

About the author: Sanjeeb Kumar Samal, an engineer by profession, a healthcare enthusiast and an aspiring healthcare entrepreneur. The author can be reached sk_samal@yahoo.com

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