In Part 1 (view here), we started to explore whether Telemedicine will just be a flash in the pan or will it be sustainable. I shared my thoughts on the real value of Telemedicine being for the beneficiaries living in Tier 2 cities & beyond and also that the Telemedicine approach is not about just technology and aggregation of Doctors. Let us now look at two more aspects before I share my concluding thoughts
- Carpenter coming to your home without his toolkit to build your table!
In its current form, majority of the Telemedicine models and implementation end up being a video conference between a Doctor and the Patient with some ability for the Doctor to manage the Electronic Medical Records. It is also not surprising to note that several Telemedicine service providers (I have seen this more in South East Asia than in India) do clearly state on their websites – the areas where the Patients are encouraged to use Telemedicine and areas where this model will not work and hence patients should abstain. In summary, most of them recommend this model for returning chronic care Patients with whom the Doctors/Physicians have a certain amount of familiarity and case history.
Before we try and dig deeper, lets look at another absolute fact. Telemedicine’s adoption is far greater in the case of homeopathy and in mental health. Why is that? Simply because in these two streams of medical science, a simple conversation between a Doctor and a Patient is good enough (in most cases) for the Doctor to start a well-informed course of treatment.
Looking at the two aforementioned facts together would tell us that allopathic treatment would certainly require the Doctors to know the Patient’s vitals and other Clinical data for the Doctor to decide the course of treatment. This is more pronounced in case of acute illnesses. Going back to my second point of making the core constituents believe in this model, they should get absolute confidence that the Doctor has diagnosed enough before they start to prescribe. Else, the Patients and the Doctors will not be able to use this model as the first line of defense and yet receive/deliver good clinical outcomes. So integrating a sufficient amount of diagnostics and devices is an absolute must to make this model really sustainable over a large range of use cases – both for Acute and Chronic cases
- How can I cross the last mile without a road to connect?
Healing touch is often a term associated with good healthcare professionals. I certainly believe that Telemedicine must try and integrate some form of human touch for the Patients in order for this model to be scalable and sustainable. While it is a given, that the very essence of Telemedicine is to support a remote Doctor-Patient interaction and by default the Doctor cannot provide that human touch, the model must incorporate a human touch at the Patients end through the involvement of either Paramedics/Healthworkers/ASHA Workers (in case of India) in order to do two things
- Act as a bridge between the Doctors and the Patients &
- To provide the much needed human touch to the Patients
But for this to happen in a scalable way, one must think of developing scalable operating models and protocols along with training and enablement of such healthworkers – staffed closer to the Patients and at the Point of care.
Multiple operating models could be enabled to reach to every district, every village and even every home/hutments
Almost 3 billion people live in this world without good access to Primary care. 70% of the Doctors live in places where 25% of the Population live. These two facts alone make us clearly agree that enabling remote access to Doctors is the ONLY way to solve this “access” problem and nothing else. However, Telemedicine in its current form has to go through holistic evolution and transform itself into “Smarthealth” to emerge as a great enabler to making this happen. To me, Smarthealth is an integrated approach that combines Technology, Operating Protocols and Human Touch in the right way underpinned by a sustainable operating model. Here are my concluding thoughts:
- The Smarthealth model must focus on reaching out to the last home in the last village (As long as there is an internet connection) and not just focus on major cities
- The Smarthealth model must enable a very effective model for delivering high clinical outcomes for a wide range of Primary Care use cases (both Acute and Chronic) rather than restricting its use to a few specific areas. This would immensely help to build the trust in its “Core” constituents
- The Smarthealth model must integrate as much examination and diagnostics options as possible for the Doctors to remotely diagnose the Patients and thereby improving the quality of clinical outcomes
- The Smarthealth model must combine a sustainable operating model, human touch, world class operating protocols to ensure that the last mile reach out is effectively done
This is exactly is the journey we have started with our company, Axon Smarthealth
Would be very glad to receive your comments
Authored by Sivakumar Thulasidoss
Co-founder, Axon Smarthealth Pte Ltd