Healthcare experts, Dr. Budhaditya Gupta, and Indian School of Business (ISB) professor D.V.R Seshadri opined that well-designed teleconsultation models can make a substantial contribution to tackle the healthcare equity dilemma for rural/semi-urban India.
Since the COVID 19 pandemic, there has been a significant increase in the telemedicine as lockdowns have induced people to take up teleconsultations. Various significant institutional stakeholders of India like the Ministry of Health and Family Welfare, Media Council of India, and the Insurance Regulatory and Development have recognized and encouraged telemedicine.
The rural area accounts for 70% of India’s population, which makes the accessibility of telemedicine to them a big challenge. According to World Health Organization (WHO) recommendations, the doctor to population ratio must be 1:1000, but the sad reality is that there is a vast shortage of almost 600,000 doctors in the rural areas and the biggest reason for this is that a large number of doctors prefer to be based in urban areas rather than rural areas.
Telemedicine models for rural/semi-urban India
In the past two decades, many for-profits and not-for-profit organizations have been promoting development and helping to launch services based on telemedicine for the rural and semi-urban population. Uncertain clinical and regulatory guidelines, low digital literacy, poor network connectivity and capacity, and a lack of (or insufficient) rigorous efficacy studies are just a few examples. Anyhow, the underlying challenge is to provide an accurate assessment and effectual care given through teleconsultation. Let us now look at some of the factors that will help us to better understand this challenge.
- City-based doctors are completely different compared to doctors and patients living in rural or semi-urban places. The doctors have little or no experience with the rural/semi-urban context due to which effective communication is hampered. With India being a diverse nation, it is difficult for doctors to adapt and tune in to the local actuality of the patients living there.
- Language is also one of the barriers due to which doctors and patients are not able to communicate. The city doctors are not very well versed with the local dialect. Furthermore, it is also difficult when it comes to understanding the values, ethics, norms, diets, etc., of the rural and semi-rural populations. They also lack health literacy and the confidence to communicate with city-based doctors effectively.
Even though there is huge excitement about the future opportunities that telemedicine brings for people living in rural and semi-urban areas, still the existing staff-assisted telemedicine structure is not perfect for the required doctor-patient communication, resulting in an unsatisfactory experience between the two.
The Future
Teleconsultation models that are well thought out, with appropriate context can definitely bring a significant change when it comes to the healthcare equity challenge in rural and semi-urban areas of India. With the help of a human-centered design approach, many entrepreneurs and NGOs can establish telemedicine care models in various parts of rural/semi-urban India that can help overcome the challenges discussed above. Besides this, the following factors will improve the design of these models.
Near-remote doctors
The most important advantage of telemedicine is that doctors can provide care to patients from remote places, which means that geographic distance cannot stop a patient from getting the right care they deserve with the bestest of doctors. For example, Australian-trained medical practitioners residing in countries such as Canada employ telemedicine to treat rural and regional patients in Australia, because their environments are similar. In India, tele-health doctors should ideally be located near or in the same state or territory. This will help in improving the doctor’s understanding towards the language, cultural norms, diets, etc., of the patients.
Intelligent matching algorithms
The model for telemedicine for rural and semi-urban areas in India keeps on developing through time. The embedded algorithms in these models which help in determining which doctor needs to watch over a particular rural/semi-urban area can be improved for a more smooth functioning. These algorithms should do more than just deciding the appropriate consultation doctor with the patient’s clinical conditions. Not just on the basis of clinical conditions, these algorithms should match doctors and patients on the basis of various factors like language, religion, gender, location proximity, etc.
Author- Toshank Bhardwaj, AI and Telemedicine Content Creator
