Telemedicine during COVID-19: A nationwide pilot in a real-time situation

Many believe that telemedicine can have a direct impact on flattening the demand curve for health systems across the country during the COVID-19 pandemic, slowing its spread and transmission over an extended period. Telemedicine providers inform that they have experienced a demand tsunami that can best be described as a nation-wide pilot in a real-time situation. Vikram Thaploo, CEO, Apollo TeleHealth shares experiences from their tele-health project during the COVID-19 pandemic in an interview with Raelene Kambli

How did Apollo TeleHealth manage its Urban Primary Healthcare Centres in Andhra Pradesh, as the frontline warrior against COVID-19?

Following are the measures that have been taken:

* Apollo TeleHealth’s managed Urban Primary Healthcare Centres in Andhra Pradesh emerge as the frontline warriors against COVID-19 as community screening begins. Primary healthcare workers conduct door-to-door screenings of international travellers and suspected cases in hotspot zones across the state.

* Community-level screening has also been started in select areas to gauge the real extent of community transmission.

* Apollo TeleHealth’s 183 Urban Primary Healthcare Centres (UPHCs) in the urban municipalities across nine districts are aggressively working with the state government supporting both grassroots level efforts as well as providing IT-enabled services.

* Monitoring of all the patients is done on daily basis by UPHC doctors with effective support from ANM’s, ward ANMs and ASHA workers in urban areas.

* Monitoring calls are initiated by the centre teams from morning 6.00 am to 11.00 pm to gather updates on screening and reporting symptomatic people in the allotted population on the government portals.

* This data is then diligently updated online by all the Center ITs. Over 60,000 telehealth services have been provided by Apollo Remote Healthcare through different initiatives and projects during the lockdown; 90 per cent of teleconsultations are being provided from home through secure connections and EMR applications.

* Free COVID-19 teleconsultations have been enabled at over 150,000 CSCs across India at Gram Panchayat level through the Digital India initiative. Recently, Apollo Telehealth with the initiative of MP Government has enabled Sanjeevani Telehealth Seva for non-COVID patients for the people of Bhopal and Indore.

Our logistics were firmly in place when we started. We were the first to provide PPE to our healthcare workers and conduct extensive training exercises to ensure their safety and preparedness in the fight against COVID-19. We made sure our UPHCs were well-equipped to screen symptomatic patients and enforced safety protocols that everyone is mandated to follow. We also implemented operating procedures to ensure smooth functioning, testing, data collection and sharing.

How have you been able to perform community-level screening using telehealth in areas to gauge the real extent of community transmission?

We marshalled the resources of telehealth facilities to gather real-time information on symptomatic patients and collate them with the help of field workers. Our IT team ensures that the information is up-to-date, which is promptly shared with the state health department.

How many telehealth services have you been able to provide during this lockdown and crisis?

Our telehealth clinics offer specialist consultations in up to nine specialities. We have established a tele-emergency hotline with a call centre team to cater not just to general healthcare, but also assist with critical emergency care. Apart from that, we are also in the process of launching smart health kiosks which can be installed at any location, including malls, metro stations, corporate offices, etc. These kiosks are compact digital clinics that will enable the screening and diagnosis of various health parameters with the help of smart tech, connected devices and integrated technologies like patient health records, electronic medical records and cloud-based services. We have successfully provided over 60,000 consultations through our different initiatives and projects during the lockdown.

Recently, Apollo Telehealth, with the initiative of  Government of Madhya Pradesh, has enabled Sanjeevani Telehealth Seva for non-COVID patients for the people of Bhopal and Indore. Please elaborate on the same, and what are the core functions that Apollo TeleHealth actually does under this partnership? 

With the COVID-19 outbreak hindering the conventional doctor-patient consultations, a large number of patients have been left in the lurch. Many patients living with serious conditions such as cardiovascular disease, diabetes, etc need ongoing treatment and regular medical consultation. As part of the  CSR initiative of BFIL and IndusInd Bank, we launched Sanjeevani Telehealth Seva, which was met with an enthusiastic response. The project initially kickstarted in Bhopal and Indore, and was later extended to the entire state of Madhya Pradesh. Our offerings address all non-COVID 19-related consultations including both general physician and specialist services. The telehealth service will offer specialist consultations under nine specialities namely general medicine, gynaecology, dermatology, orthopaedics, endocrinology, ENT, pediatrics, ophthalmology and cardiology. The patients who call the toll-free number will first be attended by a general physician for clinical assessment. The general physician will then triage for the need of a specialist and a specialist consultation will be separately conducted. Patients receive the prescription on their mobile phone through SMS as well as email. We hope to scale up these services nationwide in a phased manner.

What are the outcomes so far?

Our telehealth Seva, launched as a CSR project for BFIL and IndusInd Bank and backing of the state government in Madhya Pradesh, has received over 10,000 consultation calls in quite a short span of time, demonstrating that people are more than welcome to embrace telemedicine once they understand how convenient and effective it is. On the PPP front, our UPHCs have been at the forefront of the COVID-19 battle, and have effectively helped recognise, track and contain COVID-19 cases with the help of ANMs, ASHA workers and medical officers. Our projects and initiatives have garnered over 2,50,000 patient touchpoints across the country, we plan to scale up our operations with the help of various state governments. So far, the response to our initiatives has been overwhelmingly positive, and all indicators suggest that scaling up telehealth services will help bridge many of the gaps in healthcare delivery. The recent gazette notification by the central government to standardise the practice of telemedicine will help lay down guidelines and improve the rapid access to medical practitioners who may not be available in person. If we can launch awareness campaigns to educate people on telemedicine, it will greatly help to popularise the notion and usher in greater cultural acceptance.