The telemedicine guidelines issued by the government last week are timely and constitute a step forward. They are a major break from past practices of medical consultation and treatment. The guidelines allow online medical consultation, enabling patients to reach registered medical practitioners through WhatsApp, Skype or phone calls and get prescriptions for ailments. The prescriptions, by e-mail or WhatsApp, will be accepted by pharmacies except in the case of classified drugs and narcotic substances. Doctors will have to protect the privacy and personal medical data of the patients. A limited use of artificial intelligence and machine learning has also been allowed. The guidelines also cover radiology, pathology and ophthalmology. They were issued now probably because of the crisis in the healthcare system created by the coronavirus pandemic. Crisis situations usually lead to changes in policy. There have been persistent demands for a positive policy on telemedicine but the government was unsure of it. There was a lack of legal clarity also on the matter. It has, however, taken a decision now, and that should be welcomed.
The decision will hopefully make a difference because many patients who are unable to personally consult doctors will now be able to do so by virtual contact. Though the WHO has recommended that there should be one doctor for every 1,000 people, India has only one for every 1,445 people, and there is only one primary health centre for every 64,800 persons. Medical services are poor in many rural areas, especially in many backward states. This situation might change with the telemedicine system. The problem of doctors refusing to work in villages may also be addressed to some extent. It will take some time for the system to stabilise and for people to become familiar with it. Even then not all the people who need essential medical services may be able to access it. It is also possible that the system may expand its scope and services when technology and its processes improve. Improvement in the educational and awareness levels of people will also help.
A McKinsey report has estimated that India could save up to $10 billion if 30-40% of direct in-person consultation by patients with doctors can be replaced with telemedicine. It also projected that more than 50% of outpatient consultations could be done by telemedicine by 2025 if the system is implemented efficiently. The most important lesson from the present Covid-19 crisis is that the public healthcare system needs vast improvement in many ways. The telemedicine system can be part of that improvement, and that should receive attention and encouragement even after the crisis passes.
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