Currently a mainstay for accessible healthcare, teleconsultation lacks standard operating procedures, for specific therapy areas, that ensure appropriate delivery and continuity of care
The Association of Physicians of India (API) has launched therapy-specific teleconsultation recommendations, in collaboration with Abbott. This robust set of recommendations outlines the best practices on adopting teleconsultation across various therapeutic areas, currently catering specifically to cardiology, diabetes, gastroenterology and adult immunisation with plans to cover more specialties in the future, a statement said.
It also said that the Indian health ecosystem has evolved rapidly, integrating digitalisation into healthcare. The adoption of telemedicine consultations or teleconsultation accelerated in 2020, with India witnessing an estimated 300 per cent rise in the process between March and November. This rapid growth has been attributed to multiple barriers to in-person consultations due to the pandemic, as well as limited availability of healthcare resources, lack of proximity to a clinic and other constraints. The risk of infections has also impeded vulnerable groups, especially elderly and immuno-compromised individuals, from availing in-person consultations. Additional factors contributing to the adoption of teleconsultations include approval by the Ministry of Health and Family Welfare (MoH&FW) to conduct virtual diagnosis, treatment and follow ups, bringing teleconsultation to the forefront.
According to the statement, teleconsultation can also support a rise in routine follow-ups for disease management and monitoring. These follow-ups are crucial, especially for chronic conditions such as cardiovascular diseases and diabetes. Furthermore, with rapidly rising penetration of mobile technology and internet in India, the benefits of teleconsultation can reach underserved segments of the population, particularly in rural areas.
Teleconsultation has, therefore, been established as a mainstay for accessible medical advice and care. This has prompted an urgent need for official recommendations to guide practitioners, who may be more accustomed to examining patients in-person, to deliver virtual care appropriately whilst catering to various therapeutic areas. Moreover, therapy-specific recommendations are imperative to streamline protocol and standard operating procedures to ensure consistency in the teleconsultation approaches undertaken by respective medical practitioners, it added.
Dr S Arul Rhaj, One of the Editors in Chief and Immediate Past President- Association of Physicians of India, said, “Telemedicine consultations are now widely sought after, especially with the government’s nod to adopt them for diagnosis and treatment. While general guidelines exist, there is a need for clear-cut and defined guidelines for specific therapy areas, which can vary significantly across symptomology, pathophysiology, diagnosis, testing, disease management and treatment steps and red flags. This necessitated therapy-specific teleconsultation recommendations ensure structured, streamlined consultations and improved patient care.”
The statement also mentioned that the recommendations introduced by the API offer in-depth information that can equip healthcare practitioners with the knowledge necessary to adapt medical best practices for teleconsultation. For example, the recommendations for disease management in diabetes span the entire patient journey from glycemic monitoring to counselling on lifestyle. The recommendations encompass patient history, diagnosis, testing, disease management and scheduled follow ups, thereby enabling practitioners to be cognizant of key parameters for decision-making, guided by flow charts specific to each therapy area.
Commenting on the recommendations, Dr Balagopal Nair, Regional Medical Director, Abbott Pharmaceuticals Division, India, said, “Teleconsultation offers the possibility of overcoming geographic restrictions by increasing access and ensuring extensive reach. It has the potential to enhance the efficiency of healthcare systems by offering virtual care and making healthcare more accessible. Abbott has collaborated with the Association of Physicians in India (API) to release the first India-specific teleconsultation guidelines, to provide a useful repository of evidence-based information to healthcare practitioners across different therapeutic areas to appropriately diagnose, treat and manage patient conditions virtually, thereby enabling them to live healthier, fuller lives.”
The recommendations detail technological requirements, software and other practical tips to facilitate consultations. Physicians can thus make optimal use of digital tools, which paves the way for a structured and seamless patient experience, said the statement.
Furthermore, it said that the recommendations instruct physicians on conditions to rule out across various acute conditions, such as myocardial infarctions or arrythmias, which cannot be managed virtually and may necessitate face-to-face examination or treatment with hospitalisation after an initial teleconsultation. They also uphold the importance of safety, privacy and other patient rights and safeguards by familiarising physicians with medicolegal implications, including therapy-specific drug types that can or cannot be prescribed during teleconsultation.