Telemedicine fails to take off in AI age
Hyderabad:At the critical juncture where medicine is about to meet Artificial Intelligence and bring revolutionary changes in healthcare, the popularity for video consultations through telemedicine services still remains low. The patient-doctor relationship continues to be dominated by various factors other than mere exchange of information.
While doctors acknowledge an increase in the number of patients opting for video consultations from pre-Covid years, they are not as high as during the Covid years. “During the Covid years, I was in the United Kingdom and about 98 per cent of my consultations happened online,” said Dr Sreekanth Yerram, consultant cardiologist.
“While certain specialties and illnesses can be worked out online, cardiac issues need to be dealt with enhanced precision and certainty. While telemedicine has its own advantages, I prefer meeting patients in person. At least the first visit to the doctor must be an in-person visit. It helps establish trust between doctor and patients,” he added.
He said that video consultations are helpful when patients need follow-up visits or in getting second opinions. “Two groups of people find teleconsultation convenient: elderly people who have difficulty travelling to the hospital and younger people who are working professionals with time constraints. While the former group still essentially believes in physical consultation, the latter group prefers video or phone consultation over physical visits as it is part of their all-pervasive engagement with technology. It is just an extension of how they interact in general,” Dr Yerram explained.
Overtime, especially post-Covid, the telemedicine services have continued to expand. The central government launched its eSanjeevani app and many private organisations offer both specialised and general outpatient services through video consultation. Certain image-based specialties such as dermatology, radiology, microbiology, and ophthalmology are more conducive to using telemedicine, as per studies. Other various services include tele-education, tele-support, tele-monitoring, and tele-training.
“We had great difficulty during Covid as we prefer to visit the doctor even for minor issues,” said S. Swathi, a communications professional. “We do not take our health for granted. We believe a physical visit is always better,” she added.
However, it works for patients who live in remote areas and travel to the facilities adds to the cost of healthcare. “There is a huge difference in socio-economic backgrounds of people who prefer video consultations. Those from lower and marginalised backgrounds are more frequent visitors to the hospital,” shared Dr Yerram.
While a visit to the doctor is often a collective decision, where family decides together, people also prefer making personal online consultations when it comes to opting for psychological support and therapy. “I’ve taken therapy online. The therapist was good, and the treatment was affordable. I didn’t have to put in too much effort to find someone, and honestly, I wasn’t very comfortable discussing it with my family,” said Mridula Banerjee, an artist.
“I always prefer my patients to visit the hospital as there are several parameters that a doctor checks that the patient cannot gauge themselves,” said Dr Dilip Gude, senior general physician and diabetologist.
“For example, weight is a major factor in diabetes patients. In virtual interaction they may try to hide their actual weight but in a physical consultation, the doctor checks weight, blood pressure, height, heart rate and various other things that add to the diagnosis. Many times obese patients may be asked to lose weight and they might be able to improve their diabetic condition because of that as well,” Dr Gude added.
According to Dr Gude, a lot of things might also be lost in translation, patients and families might not be able to understand the gravity of the situation. “At times, what feels like acidity could also be an impending heart attack. Hence, physical consultation always helps,” he said.
Having said this, doctors believe telemedicine helps patients who are not from the city to be in touch with them, or those who migrate to other cities. Even the lustre of side money-making doesn’t motivate doctors to entertain patients solely on virtual mode. “Even now we are bombarded with so many patient details on WhatsApp and it doesn’t help,” he added.
There is also a factor of how aware people are about available services, which adds to the decision making process. “Virtual patient-doctor interaction is not as good as physical mode. However, there has been a reasonable and acceptable increase in people opting for it. Many parents prefer to talk over the phone or video calls for clarifications, small queries and follow-ups. With change in lifestyles, people appreciate that there is another option available,” said Dr Vijayanand Jamalpuri, neonatologist and paediatrician.
“Some knowledge of technology and operating smartphones is needed for availing that option,” he added, responding to whether people from lower economic backgrounds use telemedicine. He mentioned that there are healthcare-to-healthcare services called Cloud Critical Care where smaller facilities can connect with bigger hospitals and take opinions on critical matters. However, the same limitations of point of access exist here as well. “Discretion is recommended while attending patients online. If someone is having difficulty breathing, one would always recommend going to a nearby physician immediately,” he added.
Even in emergency cases, some hospitals have initiated telemedicine support to provide timely aid. “If a patient is in an emergency, a paramedic or a family member can contact the hospital and be on a video call with a doctor, who can guide what can be done immediately and be in touch till the time help arrives and while the patient reaches the hospital. This is where telemedicine has its greatest advantage in emergency response,” said Dr Yerram.
