CHEARS

As the Covid-19 cases are on the rise, the availability of healthcare is found to be on the decline. Patients hesitate to visit the doctor in fear of contracting the virus and transportation is also relatively scarce. Although it has managed to curb the number of hypochondriacs visiting the hospital, the patients who really need help are also discouraged from getting regular checkups and treatments. While this particular situation has improved when compared to the initial days of lockdown, another alarming situation has been on the rise – more and more healthcare workers have been testing positive for Covid-19. As we know, when each healthcare professional tests positive, the members of their healthcare team and their colleagues all have to be quarantined. This means that there is a huge decrease in the healthcare workforce. In a country like India where the patient burden to each physician is already high, such a situation can really cripple the existing system. Telemedicine, the practice of caring for patients remotely when the provider and patient are not physically present with each other, could be a partial solution to this problem. While it was originally started to help the patients living in rural areas to enable them to get access to healthcare, it can be adapted to suite the present need.

A central strategy for health care surge control is “forward triage” - the sorting of patients before they arrive in the hospital, which can easily be achieved using telemedicine. Communication with patients can be done over the phone and details regarding the patient can be collected. For example in case the patient suspects Covid-19 infection, the symptoms experienced by the patient as well as their travel history can easily be obtained. Then it can be determined if the patient actually requires treatment or can be cured by self-isolation. If patient has to be brought in to the hospital, this method can help the hospital to prepare in advance to accept the patient while minimizing exposure. In case of other diseases, the need of visit to physician’s office can be determined. If the situation can be handled by the patients themselves, appropriate advice to manage their condition can be given over the phone and they can be asked not to visit the hospital. If hospital visit is deemed necessary, an appointment can be booked. This decreases the exposure and protects the patients, the healthcare workers as well as the community. While this cannot be implemented for all patients, filtration of at least a few patients is possible.

In case of hospitals where more advanced technology is available, remote monitoring of patients in hospital is also encouraged. For example, large hospitals may have Electronic Intensive Care Unit (e-ICU) programs. This allows remote monitoring of a large number of the sicker patients simultaneously and can be useful in the case of Covid-19 patients.

It is understood that Telemedicine programs cannot be implemented overnight. Lack of staff and lack of sufficient technology could be potential barriers. However, hospitals can slowly or even partially implement such measures to protect their staff as well as the patients. In fact, few hospitals already have stared telemedicine departments following the rise in Covid-19 cases. It would be much easier to contain the spread of the virus if more hospitals were to implement this system.