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Venkataraman A, Fatma N, Edirippulige S, Ramamohan V. Facilitators and Barriers for Telemedicine Systems in India from Multiple Stakeholder Perspectives and Settings: A Systematic Review. Telemed J E Health 2024; 30:1341-1356. [PMID: 38206654 DOI: 10.1089/tmj.2023.0297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024] Open
Abstract
Background: Telemedicine is viewed as a crucial tool for addressing the challenges of limited medical resources at health care facilities. However, its adoption in health care is not entirely realized due to perceived barriers. This systematic review outlines the critical facilitators and barriers that influence the implementation of telemedicine in the Indian health care system, observed at the infrastructural, sociocultural, regulatory, and financial levels, from the perspectives of health care providers, patients, patient caregivers, society, health organizations, and the government. Methods: This review complies with the current Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols 2015. A total of 2,706 peer-reviewed studies published from December 2016 to September 2023 in the PubMed, Cochrane, Scopus, Web of Science, CINAHL, MEDLINE, and PsycInfo databases were considered for the title and abstract screening, after which 334 articles were chosen for the full-text review. In the end, 46 studies were selected for data synthesis. Results: Analysis of the literature revealed key barriers such as data privacy and security concerns, doctor and patient resistance to information and communications technology (ICT), infrastructure issues, and ICT training gaps. Facilitators included reduced health care delivery costs, enhanced patient access to health care in remote areas, and shorter patient wait times. The real-world experiences of Indian telemedicine practitioners and pioneers are also explored to complement literature-based perspectives on telemedicine implementation. Both stress the need for reliable internet connectivity, technological adoption, comprehensive ICT training, positive sociocultural attitudes, stringent data privacy measures, and viable business models as crucial for effective telemedicine adoption, with experts emphasizing practical adaptability alongside the literature-recognized facilitators.
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Affiliation(s)
- Aparna Venkataraman
- Department of Mechanical Engineering, Faculty of Medicine, UQ-IITD Academy of Research, Indian Institute of Technology Delhi, Hauz Khas, New Delhi, India
| | - Najiya Fatma
- Department of Mechanical Engineering, Indian Institute of Technology Delhi, Hauz Khas, New Delhi, India
| | - Sisira Edirippulige
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, St Lucia, Queensland, Australia
| | - Varun Ramamohan
- Department of Mechanical Engineering, Indian Institute of Technology Delhi, Hauz Khas, New Delhi, India
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Islam MT, Bruce M, Alam K. Patterns and determinants of healthcare utilization and medication use before and during the COVID-19 crisis in Afghanistan, Bangladesh, and India. BMC Health Serv Res 2024; 24:416. [PMID: 38570763 PMCID: PMC10988829 DOI: 10.1186/s12913-024-10789-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 02/27/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND COVID-19 rapidly spread through South Asian countries and overwhelmed the health systems that were unprepared for such an outbreak. Evidence from high-income countries showed that COVID-19 impacted healthcare utilization, including medication use, but empirical evidence is lacking in South Asia. This study aimed to investigate the effect of COVID-19 on healthcare utilization and medication use in South Asia. METHOD The current study used longitudinal data from the 'Premise Health Service Disruption Survey' 2020 and 2021. The countries of interest were limited to Afghanistan, Bangladesh, and India. In these surveys, data related to healthcare utilization and medication use were collected for three-time points; 'Pre-COVID phase', 'Initial phase of COVID-19 outbreak', and 'One year of COVID-19 outbreak'. Generalized estimating equation (GEE) along with McNemar's test, Kruskal-Wallis test and χ2 test were applied in this study following the conceptualization of Andersen's healthcare utilization model. RESULT The use of healthcare and medication was unevenly impacted by the COVID-19 epidemic in Afghanistan, Bangladesh, and India. Immediately after the COVID-19 outbreak, respondents in Bangladesh reported around four times higher incomplete healthcare utilization compared to pre-COVID phase. In contrast, respondents in Afghanistan reported lower incomplete utilization of healthcare in a similar context. In the post COVID-19 outbreak, non-adherence to medication use was significantly higher in Afghanistan (OR:1.7; 95%CI:1.6,1.9) and India (OR:1.3; 95%CI:1.1,1.7) compared to pre-COVID phase. Respondents of all three countries who sought assistance to manage non-communicable diseases (NCDs) had higher odds (Afghanistan: OR:1.5; 95%CI:1.3,1.8; Bangladesh: OR: 3.7; 95%CI:1.9,7.3; India: OR: 2.3; 95% CI: 1.4,3.6) of non-adherence to medication use after the COVID-19 outbreak compared to pre-COVID phase. CONCLUSION The present study documented important evidence of the influence of COVID-19 epidemic on healthcare utilization and medication use in three countries of South Asia. Lessons learned from this study can feed into policy responses to the crisis and preparedness for future pandemics.
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Affiliation(s)
- Md Tauhidul Islam
- Murdoch Business School, Murdoch University, 6150, Perth, WA, Australia.
| | - Mieghan Bruce
- School of Veterinary Medicine and Centre for Biosecurity and One Health, Harry Butler Institute, Murdoch University, 6150, Perth, WA, Australia
| | - Khurshid Alam
- Murdoch Business School, Murdoch University, 6150, Perth, WA, Australia
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Yankappa N, Kumar A, Prasad A, Tiwari L, Kumar P. Clinicodemographic Profile and Clinical Outcome of Children Presenting to Telemedicine Center at Institute of National Importance of India: A Prospective Observational Study. Int J Telemed Appl 2024; 2024:5341988. [PMID: 38327874 PMCID: PMC10849814 DOI: 10.1155/2024/5341988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 01/16/2024] [Accepted: 01/18/2024] [Indexed: 02/09/2024] Open
Abstract
Background There is a global shortage of healthcare professionals, especially in developing countries, leading to disparities in access to healthcare, worsened by the pandemic. Telemedicine is emerging as a solution, with growing adoption worldwide due to advancements in technology and increased awareness. Research Problem. The establishment of telemedicine depends on resources, infrastructure, and knowledge about healthcare needs. Further studies are needed to monitor and address evolving issues in telemedicine. The Overall Purpose of the Study. Rural health disparities stem from multiple factors, like limited healthcare access, workforce shortages, lifestyle choices, and lower socioeconomic status, leading to higher mortality and chronic diseases. Addressing these challenges is vital for rural community well-being. Telemedicine centers present a promising solution, bridging gaps, and improving healthcare outcomes for underserved remote populations. Methodology. Objective: This study assessed the clinicodemographic profile and clinical outcome of children presenting to the telemedicine center at the Institute of National Importance in India. Design: Prospective observational study. Setting: A single-center tertiary care level. Participants: This study included 79 children aged up to 18 years. Major Findings and Summary of Interpretations. In our study, 79 children using telemedicine found a near-equal gender distribution. 8.9% needed emergency care, with common complaints being respiratory issues, fever, abdominal pain, and vomiting. After two weeks, 83.5% showed improvement, emphasizing telemedicine's effectiveness in pediatric care. Conclusion Our study underscores telemedicine's positive impact on pediatric healthcare, emphasizing its potential to enhance access, outcomes, and cost-efficiency. Wider telemedicine adoption can reduce morbidity and mortality, support preventive care, and streamline posttreatment services, alleviating pressure on specialized facilities. While our focus was pediatrics, the telemedicine model is adaptable to various age groups and conditions, but it should be seen as a valuable supplement to, not a total substitute for, in-person healthcare visits.
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Affiliation(s)
- N. Yankappa
- Department of Paediatrics, All India Institute of Medical Sciences, Patna, India
| | - Anil Kumar
- Department of Trauma Surgery & Critical Care, All India Institute of Medical Sciences, Patna, India
| | - Arun Prasad
- Department of Paediatrics, All India Institute of Medical Sciences, Patna, India
| | - Lokesh Tiwari
- Department of Paediatrics, All India Institute of Medical Sciences, Patna, India
| | - Pradeep Kumar
- Department of Paediatrics, All India Institute of Medical Sciences, Patna, India
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Ansarian M, Baharlouei Z. Applications and Challenges of Telemedicine: Privacy-Preservation as a Case Study. ARCHIVES OF IRANIAN MEDICINE 2023; 26:654-661. [PMID: 38310426 PMCID: PMC10864944 DOI: 10.34172/aim.2023.96] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 10/02/2023] [Indexed: 02/05/2024]
Abstract
Today, technology has an important impact on the development of medical services, especially during the outbreak of COVID-19. Telemedicine, known by terms such as telehealth and digital health, refers to the utilization of technology to provide health care services at a distance that leads to improved monitoring, detecting and treatment of disease, and provision of individual care. It has been considered in various fields such as radiology, cardiology, pulmonology, psychiatry, emergency care and surgery. The most important advantages of using telemedicine are saving time for the doctor and the patient, reducing the cost of multiple visits to the doctor, reducing the spread of contagious diseases and caring for patients who cannot see a doctor, such as the elderly. In this paper, we review the research in the field of applying telemedicine, as well as its advantages and disadvantages. Next, we discuss the challenges in the field of using telemedicine which are privacy preserving, data security, cost of infrastructures, lack of physical examination and responsibility for patients' compensation. One of the most important challenges is privacy preserving of patients' information during transmission and process. We categorize and compare the various methods that have been proposed to protect peoples' privacy.
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Affiliation(s)
- Maryam Ansarian
- Medical Image and Signal Processing Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Baharlouei
- Medical Image and Signal Processing Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Prakash J, Samudra M, Ali T, Chaudhury S, Srivastava K. The COVID-19 pandemic: Lessons learned. Ind Psychiatry J 2023; 32:S1-S5. [PMID: 38370927 PMCID: PMC10871432 DOI: 10.4103/ipj.ipj_248_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 09/23/2023] [Accepted: 09/28/2023] [Indexed: 02/20/2024] Open
Affiliation(s)
- Jyoti Prakash
- Department of Psychiatry, Armed Forces Medical College, Pune, Maharashtra, India
| | - Madhura Samudra
- Department of Psychiatry, Dr. D. Y. Patil Medical College Hospital and Research Centre, Dr. D. Y. Patil University, Pune, Maharashtra, India
| | - Tahoora Ali
- Department of Psychiatry, Dr. D. Y. Patil Medical College Hospital and Research Centre, Dr. D. Y. Patil University, Pune, Maharashtra, India
| | - Suprakash Chaudhury
- Department of Psychiatry, Dr. D. Y. Patil Medical College Hospital and Research Centre, Dr. D. Y. Patil University, Pune, Maharashtra, India
| | - Kalpana Srivastava
- Department of Psychiatry, Armed Forces Medical College, Pune, Maharashtra, India
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Surve S, Chauhan S, Kulkarni R, Salvi N, Nadkarni A, Madkaikar M, Chaudhary K, Chavan A, Suryavanshi D, Thorat A, Kaur H. Challenges in screening for sickle cell disease among newborns from the tribal region of Palghar, Maharashtra during the COVID-19 pandemic. Indian J Med Res 2023; 158:378-383. [PMID: 38006343 DOI: 10.4103/ijmr.ijmr_3220_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Indexed: 11/27/2023] Open
Abstract
BACKGROUND OBJECTIVES Despite several adversities imposed by the COVID-19 pandemic, it was crucial to sustain research having public health relevance such as investigations around sickle cell disease (SCD). Against this background, an ongoing ICMR-multicentric study for newborn screening of SCD in the tribal population at Model Rural Health Research Unit (MRHRU-Dahanu) in Palghar District, Maharashtra constituted the current study setting. This was a descriptive study wherein, certain measures were undertaken and strategies were developed in view of the challenges in newborn screening for SCD due to the COVID-19 pandemic during December 2019-September 2021 at Sub District Hospital, MRHRU-Dahanu. METHODS During the onset of the pandemic, (December 2019-March 2020), the follow up was possible in 26.7 per cent (20/75) of the newborns. Subsequently, challenges such as travel restrictions, fear of COVID-19, shortage of staff were experienced with respect to enrolment and follow up visits. RESULTS After implementing certain pragmatic strategies (ASHA involvement, usage of virtual platform and flexible visits), follow up rate increased to 47.5 per cent (66/139) between July 2020-April 2021 (post first lockdown) and to 66 per cent (65/98) during the second wave (May 2021-August 2021). INTERPRETATION CONCLUSIONS The study emphasizes the importance of network building, use of virtual platform and engaging health workers in tribal settings. Such pragmatic approaches have the potential to pave a path for further implementation research involving specific interventions to improve health outcomes in tribal settings.
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Affiliation(s)
- Suchitra Surve
- Department of Child Health Research, ICMR-National Institute for Research in Reproductive & Child Health, Mumbai, India
| | - Sanjay Chauhan
- Department of Operational & Implementation Research, ICMR-National Institute for Research in Reproductive & Child Health, Mumbai, India
| | - Ragini Kulkarni
- Department of Operational & Implementation Research, ICMR-National Institute for Research in Reproductive & Child Health, Mumbai, India
| | - Neha Salvi
- Model Rural Health Research Unit, Dahanu, Maharashtra, India
| | - Anita Nadkarni
- ICMR-National Institute for Immunohaematology, KEM Hospital Campus, Mumbai, India
| | - Manisha Madkaikar
- ICMR-National Institute for Immunohaematology, KEM Hospital Campus, Mumbai, India
| | | | | | | | - Anil Thorat
- Civil Surgeon Office, Palghar District, Maharashtra, India
| | - Harpreet Kaur
- Division of Epidemiology & Communicable Diseases, Indian Council of Medical Research, Ansari Nagar, New Delhi, India
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Nanda M, Sharma R. A comprehensive examination of the economic impact of out-of-pocket health expenditures in India. Health Policy Plan 2023; 38:926-938. [PMID: 37409740 DOI: 10.1093/heapol/czad050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 03/27/2023] [Accepted: 07/04/2023] [Indexed: 07/07/2023] Open
Abstract
More than 50% of health expenditure is financed through out-of-pocket payments in India, imposing a colossal financial burden on households. Amidst the rising incidence of non-communicable diseases, injuries, and an unfinished agenda of infectious diseases, this study examines comprehensively the economic impact of out-of-pocket health expenditure (OOPE) across 17 disease categories in India. Data from the latest round of the National Sample Survey (2017-18), titled 'Household Social Consumption: Health', were employed. Outcomes, namely, catastrophic health expenditure (CHE), poverty headcount ratio, distressed financing, foregone care, and loss of household earnings, were estimated. Results showed that 49% of households that sought hospitalization and/or outpatient care experienced CHE and 15% of households fell below the poverty line due to OOPE. Notably, outpatient care was more burdensome (CHE: 47.8% and impoverishment: 15.0%) than hospitalization (CHE: 43.1% and impoverishment: 10.7%). Nearly 16% of households used distressed sources to finance hospitalization-related OOPE. Cancer, genitourinary disorders, psychiatric and neurological disorders, obstetric conditions, and injuries imposed a substantial economic burden on households. OOPE and associated financial burden were higher among households where members sought care in private healthcare facilities compared with those treated in public facilities across most disease categories. The high burden of OOPE necessitates the need to increase health insurance uptake and consider outpatient services under the purview of health insurance. Concerted efforts to strengthen the public health sector, improved regulation of private healthcare providers, and prioritizing health promotion and disease prevention strategies are crucial to augment financial risk protection.
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Affiliation(s)
- Mehak Nanda
- University School of Management and Entrepreneurship, Delhi Technological University, Vivek Vihar Phase 2, Delhi 110095, India
| | - Rajesh Sharma
- University School of Management and Entrepreneurship, Delhi Technological University, Vivek Vihar Phase 2, Delhi 110095, India
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Gupta A, Suresh A, Suparna PN. Gynecomastia: The Impact of COVID-19 Pandemic on its Awareness. Aesthetic Plast Surg 2023; 47:37-38. [PMID: 35441236 PMCID: PMC9017735 DOI: 10.1007/s00266-022-02884-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 03/24/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Arunesh Gupta
- Department of Plastic and Reconstructive Surgery, Topiwala National Medical College, BYL Nair Hospital, Mumbai, India
| | - Aneesh Suresh
- Department of Plastic and Reconstructive Surgery, Topiwala National Medical College, BYL Nair Hospital, Mumbai, India
| | - P. N. Suparna
- Department of Plastic and Reconstructive Surgery, Topiwala National Medical College, BYL Nair Hospital, Mumbai, India
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Dey J, Bhowmik A. Concurring of Neural Machines for Robust Session Key Generation and Validation in Telecare Health System During COVID-19 Pandemic. WIRELESS PERSONAL COMMUNICATIONS 2023; 130:1885-1904. [PMID: 37206633 PMCID: PMC10067522 DOI: 10.1007/s11277-023-10362-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/25/2023] [Indexed: 05/21/2023]
Abstract
In this technique, it has been proposed to agree the session keys that have been generated through dual artificial neural networks based on the Telecare Health COVID-19 domain. Electronic health enables secure and protected communication between the patients and physicians, especially during this COVID-19 pandemic. Telecare was the main component which served the remote and non-invasive patients in the crisis period of COVID-19. Neural cryptographic engineering support in terms of data security and privacy is the main theme for Tree Parity Machine (TPM) synchronization in this paper. The session key has been generated on different key lengths and key validation done on the proposed set of robust session keys. A neural TPM network receives a vector designed through same random seed and producing a single output bit. Duo neural TPM networks' intermediate keys would be partially shared between the patient and doctor for the purpose neural synchronization. Higher magnitude of co-existence has been observed at the duo neural networks at the Telecare Health Systems in COVID-19. This proposed technique has been highly protective against several data attacks in the public networks. Partial transmission of the session key disables the intruders to guess the exact pattern, and highly randomized through different tests. The average p-values of different session key lengths of 40 bits, 60 bits, 160 bits, and 256 bits were observed to be 221.9, 259.3, 242, and 262.8 (taken under multiplicative of 1000) respectively.
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Affiliation(s)
- Joydeep Dey
- Department of Computer Science, M.U.C. Women’s College, Burdwan, India
| | - Anirban Bhowmik
- Department of Computer Science, M.U.C. Women’s College, Burdwan, India
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Dey J. State-of-the-art session key generation on priority-based adaptive neural machine (PANM) in telemedicine. Neural Comput Appl 2023; 35:9517-9533. [PMID: 37077617 PMCID: PMC10032630 DOI: 10.1007/s00521-022-08169-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 12/06/2022] [Indexed: 03/24/2023]
Abstract
Telemedicine is one of the safest methods to provide healthcare facilities to the remote patients with the help of digitization. In this paper, state-of-the-art session key has been proposed based on the priority oriented neural machines followed by its validation. State-of-the-art technique can be mentioned as newer scientific method. Soft computing has been extensively used and modified here under the ANN domain. Telemedicine facilitates secure data communication between the patients and the doctors regarding their treatments. The best fitted hidden neuron can contribute only in the formation of the neural output. Minimum correlation was taken into consideration under this study. Hebbian learning rule was applied on both the patient’s neural machine and the doctor’s neural machine. Lesser iterations were needed in the patient’s machine and the doctor’s machine for the synchronization. Thus, the key generation time has been shortened here which were 4.011 ms, 4.324 ms, 5.338 ms, 5.691 ms, and 6.105 ms for 56 bits, 128 bits, 256 bits, 512 bits, and 1024 bits of state-of-the-art session keys, respectively. Statistically, different key sizes of the state-of-the-art session keys were tested and accepted. Derived value-based function had yielded successful outcomes too. Partial validations with different mathematical hardness had been imposed here too. Thus, the proposed technique is suitable for the session key generation and authentication in the telemedicine in order to preserve the patients’ data privacy. This proposed method has been highly protective against numerous data attacks inside the public networks. Partial transmission of the state-of-the-art session key disables the intruders to decode the same bit patterns of the proposed set of keys.
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Affiliation(s)
- Joydeep Dey
- Department of Computer Science, M.U.C. Women’s College, Burdwan, India
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Winkie MJ, Nambudiri VE. A tale of two applications: lessons learned from national LMIC COVID applications. J Am Med Inform Assoc 2023; 30:781-786. [PMID: 36040186 PMCID: PMC9452142 DOI: 10.1093/jamia/ocac146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 08/09/2022] [Accepted: 08/21/2022] [Indexed: 11/14/2022] Open
Abstract
Mobile health (mHealth) technologies in low- and middle-income countries (LMICs) have received increased attention for the significant potential benefits they can bring to underserved populations. As smartphones are becoming increasingly accessible, many stakeholders in the mHealth space have begun exploring smartphone applications as a means to impact individuals living within LMICs. With the COVID-19 pandemic straining healthcare systems around the world, many governments in LMICs turned to use smartphone applications to help support and manage their pandemic responses. By analyzing national COVID-19 applications created and launched by the Indian and Vietnamese governments, we highlight effective application functions and strategies, summarizing best practices for future LMIC application development.
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Affiliation(s)
- Mitchell J Winkie
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Vinod E Nambudiri
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
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Maroju RG, Choudhari SG, Shaikh MK, Borkar SK, Mendhe H. Role of Telemedicine and Digital Technology in Public Health in India: A Narrative Review. Cureus 2023; 15:e35986. [PMID: 37050980 PMCID: PMC10085457 DOI: 10.7759/cureus.35986] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 03/10/2023] [Indexed: 03/12/2023] Open
Abstract
There are still many areas of India without proper medical facilities. In such a setting, technology can play a facilitating role, particularly in reaching out to remote locations and offering a greater standard of care at a lower cost. The method of treating and diagnosing patients remotely through communication networks is known as telemedicine. When more patients get access to telemedicine, payers take more notice of how much less expensive it is than traditional medicine, and doctors are aware of its benefits. Telemedicine is a more beneficial technology that can expand access to preventive treatment and may lead to long-term health. Telemedicine has the potential to greatly affect public health. This paper reviews the current state of the art of telemedicine in India. Nearly 50 years ago, telemedicine was shrugged off as a complicated, expensive, and inefficient technology. Because of how quickly the information technology and telecommunications disciplines are advancing, telemedicine is today a viable, dependable, and useful technique. Practitioners and medical experts from a variety of fields have experienced success with telemedicine. The COVID-19 pandemic highlighted the need for strong primary healthcare networks for a more effective public health response during health emergencies and exposed the fragmentation of healthcare delivery systems. Although primary care is the first point of contact between the general public and the healthcare system, it has not recently grown much focus or funding. Even in the post-COVID-19 environment, telemedicine offers the potential to get through enduring barriers to primary care in India, such as a shortage of qualified medical professionals, issues with access, and the cost of in-person care. Telemedicine has the power to speed up the delivery of universal health coverage while strengthening primary care. There is a widening gap between people and those who offer basic health services as the population in India has grown, and the average lifespan has increased. Telemedicine helps with palliative care, early identification, a better cure, prevention, and rehabilitation in the treatment of cancer. Due to a shortage of primary care delivery networks and referral units, secondary and tertiary care facilities' health systems are overworked. To successfully use telemedicine, proper planning and operating processes are required. Thus, the development and implementation of telemedicine will improve patient care and India's primary healthcare system in the future. Finally, telemedicine's cost-effectiveness will likely be its most significant outcome.
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Gupta N, Gupta MK, Joshi NK, Mantri N, Sridevi G, Patel M, Goel AD, Singh K, Garg MK, Bhardwaj P. Is telemedicine a holy grail in healthcare policy: clinicians' and patients' perspectives from an Apex Institution in Western India. BMC Health Serv Res 2023; 23:161. [PMID: 36793030 PMCID: PMC9930698 DOI: 10.1186/s12913-022-09013-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 12/27/2022] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND This study aimed to explore the perception of doctors regarding telemedicine consultations and the level of patient satisfaction with the services received through teleconsultations. METHODS This cross-sectional study was conducted on clinicians who provided teleconsultations and patients who received teleconsultations in an Apex healthcare institution in Western India. Semi-structured interview schedules were used to record the quantitative and qualitative information. Clinicians' perceptions and patients' satisfaction were assessed using two different 5-point Likert scales. Data were analyzed using SPSS v.23 using non-parametric tests (Kruskal Wallis and Mann-Whitney U). RESULTS A total of 52 clinicians who delivered teleconsultations and 134 patients who received teleconsultations from those doctors were interviewed in this study. For 69% of doctors, telemedicine was feasible to implement, and for the rest, it was challenging. Doctors believe telemedicine is convenient for patients (77%) and prevents the transmission of infection (94.2%). Difficulty in clinical evaluation (73%), communication (55.7%), network connectivity (34%), diagnosis and investigations (32%), and patients' e-illiteracy (32%) were the most common challenges faced by clinicians. Patients' experiences were positive in terms of ease of registration (82.1%), audio quality (100%), freedom to discuss medicine (94.8%), and comprehension of the diagnoses (88.1%). Patients expressed satisfaction with the length of the teleconsultation (81.4%), the advice and care they received (78.4%), and the manner and communication of the clinicians (78.4%). CONCLUSIONS Though there were some challenges in the implementation of telemedicine, the clinicians perceived it quite helpful. The majority of the patients were satisfied with teleconsultation services. Difficulty in registration, lack of communication, and a deep-rooted mindset of physical consultations were the primary concerns from the patient side.
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Affiliation(s)
- Nainsi Gupta
- grid.463267.20000 0004 4681 1140School of Public Health, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan India
| | - Manoj Kumar Gupta
- School of Public Health, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan, India. .,Department of Community Medicine & Family Medicine, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan, India.
| | - Nitin Kumar Joshi
- grid.463267.20000 0004 4681 1140School of Public Health, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan India
| | - Neha Mantri
- grid.463267.20000 0004 4681 1140School of Public Health, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan India
| | - G. Sridevi
- grid.463267.20000 0004 4681 1140Department of Community Medicine & Family Medicine, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan India
| | - Mamta Patel
- grid.463267.20000 0004 4681 1140School of Public Health, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan India
| | - Akhil Dhanesh Goel
- grid.463267.20000 0004 4681 1140Department of Community Medicine & Family Medicine, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan India
| | - Kuldeep Singh
- grid.463267.20000 0004 4681 1140Department of Pediatrics, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan India
| | - M. K. Garg
- grid.463267.20000 0004 4681 1140Department of Medicine, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan India
| | - Pankaj Bhardwaj
- grid.463267.20000 0004 4681 1140School of Public Health, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan India ,grid.463267.20000 0004 4681 1140Department of Community Medicine & Family Medicine, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan India
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14
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The COVID-19 pandemic: an opportunity to strengthen telemedicine in low and middle-income countries. Pediatr Res 2023; 93:463-464. [PMID: 35729216 PMCID: PMC9210331 DOI: 10.1038/s41390-022-02167-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 05/27/2022] [Accepted: 06/04/2022] [Indexed: 11/08/2022]
Abstract
IMPACT During the peak of the COVID-19 pandemic the healthcare systems of several countries came under strain and were even crippled, especially in LMICs, necessitating the exploration of alternate mechanisms for scaling-up healthcare services. Telemedicine can be an invaluable modality for complementing standard modes of pediatric healthcare delivery, not only during crises like the COVID-19 pandemic, but also for reducing the inequities that exist in access and delivery of pediatric healthcare in LMICs. A well-coordinated approach in health policy, development of infrastructure, and effective community participation is required for effective integration of pediatric telemedicine in LMICs healthcare systems.
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15
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Kumar S, Pranathi G. Telemedicine in India: COVID-19 and beyond? ANNALS OF INDIAN PSYCHIATRY 2023. [DOI: 10.4103/aip.aip_73_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
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16
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Upadhyay N, Kamble A, Navare A. Virtual healthcare in the new normal: Indian healthcare consumers adoption of electronic government telemedicine service. GOVERNMENT INFORMATION QUARTERLY 2023. [DOI: 10.1016/j.giq.2022.101800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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17
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Kasoju N, Remya NS, Sasi R, Sujesh S, Soman B, Kesavadas C, Muraleedharan CV, Varma PRH, Behari S. Digital health: trends, opportunities and challenges in medical devices, pharma and bio-technology. CSI TRANSACTIONS ON ICT 2023; 11:11-30. [PMCID: PMC10089382 DOI: 10.1007/s40012-023-00380-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 03/27/2023] [Indexed: 04/12/2024]
Abstract
Digital health interventions refer to the use of digital technology and connected devices to improve health outcomes and healthcare delivery. This includes telemedicine, electronic health records, wearable devices, mobile health applications, and other forms of digital health technology. To this end, several research and developmental activities in various fields are gaining momentum. For instance, in the medical devices sector, several smart biomedical materials and medical devices that are digitally enabled are rapidly being developed and introduced into clinical settings. In the pharma and allied sectors, digital health-focused technologies are widely being used through various stages of drug development, viz. computer-aided drug design, computational modeling for predictive toxicology, and big data analytics for clinical trial management. In the biotechnology and bioengineering fields, investigations are rapidly growing focus on digital health, such as omics biology, synthetic biology, systems biology, big data and personalized medicine. Though digital health-focused innovations are expanding the horizons of health in diverse ways, here the development in the fields of medical devices, pharmaceutical technologies and biotech sectors, with emphasis on trends, opportunities and challenges are reviewed. A perspective on the use of digital health in the Indian context is also included.
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Affiliation(s)
- Naresh Kasoju
- Sree Chitra Tirunal Institute for Medical Science and Technology, Thiruvananthapuram, 695011 Kerala India
| | - N. S. Remya
- Sree Chitra Tirunal Institute for Medical Science and Technology, Thiruvananthapuram, 695011 Kerala India
| | - Renjith Sasi
- Sree Chitra Tirunal Institute for Medical Science and Technology, Thiruvananthapuram, 695011 Kerala India
| | - S. Sujesh
- Sree Chitra Tirunal Institute for Medical Science and Technology, Thiruvananthapuram, 695011 Kerala India
| | - Biju Soman
- Sree Chitra Tirunal Institute for Medical Science and Technology, Thiruvananthapuram, 695011 Kerala India
| | - C. Kesavadas
- Sree Chitra Tirunal Institute for Medical Science and Technology, Thiruvananthapuram, 695011 Kerala India
| | - C. V. Muraleedharan
- Sree Chitra Tirunal Institute for Medical Science and Technology, Thiruvananthapuram, 695011 Kerala India
| | - P. R. Harikrishna Varma
- Sree Chitra Tirunal Institute for Medical Science and Technology, Thiruvananthapuram, 695011 Kerala India
| | - Sanjay Behari
- Sree Chitra Tirunal Institute for Medical Science and Technology, Thiruvananthapuram, 695011 Kerala India
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18
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Ramesh PV, Paul A, Ramesh SV, Kumar NKS. Commentary: What the eye sees, Let's make the world see - Smart evolution of teleophthalmology. Indian J Ophthalmol 2022; 70:4243-4244. [PMID: 36453324 PMCID: PMC9940584 DOI: 10.4103/ijo.ijo_2116_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Prasanna Venkatesh Ramesh
- Medical Officer, Department of Glaucoma and Research, Mahathma Eye Hospital Private Limited, Trichy, Tamil Nadu, India,Correspondence to: Dr. Prasanna Venkatesh Ramesh, Mahathma Eye Hospital Private Limited, No. 6, Seshapuram, Tennur, Trichy – 620 017, Tamil Nadu, India. E-mail:
| | - Anujeet Paul
- Fellow, B B Eye Foundation, Kolkata, West Bengal, India
| | - Shruthy Vaishali Ramesh
- Medical Officer, Department of Cataract and Refractive Surgery, Mahathma Eye Hospital Private Limited, Trichy, Tamil Nadu, India
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19
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Markan A, Kishore A, Agarwal A, Akella M, Singh A, Goyal S, Roy M, Singh M, Singh M. Demographic profile of patients seeking teleophthalmology consultations through e-Sanjeevani: Retrospective analysis of 5138 patients from North India. Indian J Ophthalmol 2022; 70:4238-4243. [PMID: 36453323 PMCID: PMC9940582 DOI: 10.4103/ijo.ijo_781_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Purpose To report the demographic profile of patients registered through e-Sanjeevani OPD seeking teleophthalmology services. Methods This was a cross-sectional data analysis of patients with ocular complaints registered through the e-Sanjeevani platform at a tertiary care center. It was a doctor-to-doctor consultation, where teleophthalmology consultants provided teleconsultation services at subcenters (SCs), primary health centers (PHCs), and community health centers (CHCs). Data regarding the patient's age, gender, residential address, provisional diagnosis, and treatment prescribed were recorded from May 2021 to February 2022 (9 months). Results In total, 5138 patients were teleconsulted from the mean age of the patients was 37.64 ± 19.34 years. Among these patients, 44% were males and 56% were females. Most of the teleconsultation calls were made from Palwal district (19.8%), followed by Hisar (14.5%) and Sonipat. The most common provisional diagnosis was dry eyes (21%), followed by allergic conjunctivitis (18%), refractive error (15%), and cataract (14%). These constituted approximately 70% of the diagnosis made through teleconsultations. The rest of the eye problems were diagnosed as stye, blepharitis, nasolacrimal duct obstruction, pterygium, subconjunctival hemorrhage, etc., The majority of the patients were managed medically (56.6%) and approximately 11.6% of the patients were referred for surgical intervention. Conclusion e-Sanjeevani is an effective way to provide teleconsultations to patients in remote locations. The majority of the patients seeking ophthalmology consultations can be managed conservatively. Patients requiring surgical intervention can be referred timely, thus avoiding any delay in treatment.
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Affiliation(s)
- Ashish Markan
- Department of Telemedicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Alisha Kishore
- Department of Telemedicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Amit Agarwal
- Department of Telemedicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India,Correspondence to: Dr. Amit Agarwal, Department of Telemedicine, First Floor, PGIMER, Chandigarh, India. E-mail:
Prof. Meenu Singh, Department of Telemedicine, First Floor, PGIMER, Chandigarh, India. E-mail:
| | - Madhuri Akella
- Department of Telemedicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Aruna Singh
- Department of Telemedicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sonu Goyal
- Department of Telemedicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Manaswita Roy
- Department of Telemedicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Manvi Singh
- Department of Telemedicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Meenu Singh
- Department of Telemedicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India,Correspondence to: Dr. Amit Agarwal, Department of Telemedicine, First Floor, PGIMER, Chandigarh, India. E-mail:
Prof. Meenu Singh, Department of Telemedicine, First Floor, PGIMER, Chandigarh, India. E-mail:
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20
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Stolz D, Mkorombindo T, Schumann DM, Agusti A, Ash SY, Bafadhel M, Bai C, Chalmers JD, Criner GJ, Dharmage SC, Franssen FME, Frey U, Han M, Hansel NN, Hawkins NM, Kalhan R, Konigshoff M, Ko FW, Parekh TM, Powell P, Rutten-van Mölken M, Simpson J, Sin DD, Song Y, Suki B, Troosters T, Washko GR, Welte T, Dransfield MT. Towards the elimination of chronic obstructive pulmonary disease: a Lancet Commission. Lancet 2022; 400:921-972. [PMID: 36075255 DOI: 10.1016/s0140-6736(22)01273-9] [Citation(s) in RCA: 176] [Impact Index Per Article: 88.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 05/23/2022] [Accepted: 06/28/2022] [Indexed: 10/14/2022]
Affiliation(s)
- Daiana Stolz
- Clinic of Respiratory Medicine and Pulmonary Cell Research, University Hospital Basel, Basel, Switzerland; Department of Clinical Research, University Hospital Basel, Basel, Switzerland; Clinic of Respiratory Medicine and Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Takudzwa Mkorombindo
- Lung Health Center, Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Desiree M Schumann
- Clinic of Respiratory Medicine and Pulmonary Cell Research, University Hospital Basel, Basel, Switzerland
| | - Alvar Agusti
- Respiratory Institute-Hospital Clinic, University of Barcelona IDIBAPS, CIBERES, Barcelona, Spain
| | - Samuel Y Ash
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Mona Bafadhel
- School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK; Department of Respiratory Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Chunxue Bai
- Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - James D Chalmers
- Scottish Centre for Respiratory Research, University of Dundee, Dundee, UK
| | - Gerard J Criner
- Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Shyamali C Dharmage
- Centre for Epidemiology and Biostatistics, School of Population and Global health, University of Melbourne, Melbourne, VIC, Australia
| | - Frits M E Franssen
- Department of Research and Education, CIRO, Horn, Netherlands; Department of Respiratory Medicine, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Urs Frey
- University Children's Hospital Basel, Basel, Switzerland
| | - MeiLan Han
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Nadia N Hansel
- Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Nathaniel M Hawkins
- Centre for Cardiovascular Innovation, University of British Columbia, Vancouver, BC, Canada
| | - Ravi Kalhan
- Department of Preventive Medicine and Division of Pulmonary and Critical Care Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Melanie Konigshoff
- Division of Pulmonary, Allergy and Critical Care Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Fanny W Ko
- The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Trisha M Parekh
- Lung Health Center, Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Maureen Rutten-van Mölken
- Erasmus School of Health Policy & Management and Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Jodie Simpson
- Priority Research Centre for Healthy Lungs, Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia
| | - Don D Sin
- Centre for Heart Lung Innovation and Division of Respiratory Medicine, Department of Medicine, University of British Columbia, St Paul's Hospital, Vancouver, BC, Canada
| | - Yuanlin Song
- Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital and National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China; Shanghai Respiratory Research Institute, Shanghai, China; Jinshan Hospital of Fudan University, Shanghai, China
| | - Bela Suki
- Department of Biomedical Engineering, Boston University, Boston, MA, USA
| | - Thierry Troosters
- Department of Rehabilitation Sciences, Research Group for Rehabilitation in Internal Disorders, KU Leuven, Leuven, Belgium
| | - George R Washko
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Tobias Welte
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany; Biomedical Research in Endstage and Obstructive Lung Disease, German Center for Lung Research, Hannover, Germany
| | - Mark T Dransfield
- Lung Health Center, Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA; Birmingham VA Medical Center, Birmingham, AL, USA.
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21
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Shah U, Rajeshree S, Ravat P, Kalika M, Mehta S, Sapre A, Ravat SH. Challenges for low middle-income people with epilepsy during the COVID-19 pandemic: Lessons learnt, call for action. Epilepsia Open 2022; 7:665-673. [PMID: 36005396 PMCID: PMC9538458 DOI: 10.1002/epi4.12646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/16/2022] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE The COVID-19 pandemic impacted the care of people with epilepsy (PWE). Several online surveys were conducted but there is limited data regarding the impact on low-income PWE from lower-middle income countries (LMICs) who have no access or ability to answer online surveys. The purpose of this interview was to understand the challenges faced by low-income PWE during the lockdown phase of the pandemic. METHOD PWE visiting the epilepsy specialty outpatient department of a tertiary referral government hospital to avail of subsidized services were interviewed. In the interview, they discussed challenges in obtaining medical care, the impact on wellbeing, employment, and vaccination status during the lockdown phase of the pandemic. RESULTS Out of the 214 PWE interviewed, 20.6% had increased seizure frequency, 28.9% did not have access to medication mainly due to travel restrictions, 30.5% reported lack of availability of medication and 50% were not able to afford the medication mainly due to loss of income. 51% were unable to have follow-up consultations. 36% reported worsening of mood and some reported impact on other aspects of wellbeing. The impact on wellbeing was significantly associated with an increase in seizure frequency (P < .05). The study revealed hesitation related to vaccines in the majority and expectations of financial support by the government and assistance for procuring medication. There was a lack of awareness about telemedicine services and the same was not adequately offered by government hospitals. SIGNIFICANCE The study underscores the need to learn lessons from the challenging experiences of low-income PWE and create an action plan for the future to address the issues of lack of affordability of medical care and access to telemedicine. It is critical that the care of the marginalized, underrepresented PWE from lower-middle income countries is not neglected during a pandemic.
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Affiliation(s)
- Urvashi Shah
- Department of NeurologySeth GSMC and KEM HospitalMumbaiIndia
| | | | - Parthvi Ravat
- Department of NeurologySeth GSMC and KEM HospitalMumbaiIndia
| | - Mayuri Kalika
- Department of NeurologySeth GSMC and KEM HospitalMumbaiIndia
| | - Saloni Mehta
- Department of NeurologySeth GSMC and KEM HospitalMumbaiIndia
| | - Antara Sapre
- Department of NeurologySeth GSMC and KEM HospitalMumbaiIndia
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22
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de Kreutzenberg SV. Telemedicine for the Clinical Management of Diabetes; Implications and Considerations After COVID-19 Experience. High Blood Press Cardiovasc Prev 2022; 29:319-326. [PMID: 35579849 PMCID: PMC9111950 DOI: 10.1007/s40292-022-00524-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 05/07/2022] [Indexed: 12/15/2022] Open
Abstract
Telemedicine is a clinical approach that was seldom used in the day-to-day practice, if not only in certain settings, before the COVID-19 pandemic. As stated by the WHO, telemedicine is: the delivery of health care services, where distance is a critical factor, by all health care professionals using information and communication technologies (ICT) for the exchange of valid information for diagnosis, treatment and prevention of disease and injuries, …. Telemedicine has actually represented the most useful and employed tool to maintain contacts between patients and physicians during the period of physical distance imposed by the pandemic, especially during the lockdown. Diabetes in particular, a chronic disease that often needs frequent confronting between patient and health professionals has taken advantage of the telehealth approach. Nowadays, technological tools are more and more widely used for the management of diabetes. In this review results obtained by telemendicine application in type 1 and type 2 diabetic individuals during COVID-19 are revised, and future perspectives for telemedicine use to manage diabetes are discussed.
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23
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Singaram M, Muraleedhran VR, Sivaprakasam M. Cross fertilisation of Public Health and Translational Research. J Indian Inst Sci 2022; 102:763-782. [PMID: 35968232 PMCID: PMC9364283 DOI: 10.1007/s41745-022-00317-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 06/21/2022] [Indexed: 01/05/2023]
Abstract
Public health is defined as the science of protecting the safety and improving the health of communities through education, policy-making and research for the prevention of disease (Gatseva and Argirova in J Public Health 19(3):205–6, 2011, 10.1007/s10389-011-0412-8; Winslow in Mod Med 2(1306):183–91, 1920. 10.1126/science.51.1306.23; What is public health. Centers for Disease Control Foundation. Centers for Disease Control, Atlanta, https://www.cdcfoundation.org/what-public-health; What is the WHO definition of health? from the Preamble to the Constitution of WHO as adopted by the International Health Conference, New York, On 7 April 1948. The definition has not been amended since. 22 July 1946; signed by the representatives of 61 States (Official Records of WHO, no. 2, p. 100) and entered into force, 19 June;1948. https://web.archive.org/web/20190307113324/https:/www.who.int/about/who-we-are/frequently-asked-questions). Translational research in healthcare is not only useful and satisfying for the researchers to bring their work to market but it would also support public health by bringing affordable, attainable and scalable solutions to the community at large. This is of high significance because instead of increasing the GDP spent in public health, we should focus on the increasing the translational research spending, as this would lead to improved solutions. Hence, the public health offering would reach a larger community at an improved cost. The COVID-19 pandemic and the huge number of lives it claimed exposes challenges in the public health. The pandemic has caused economic and social disruption to millions of people around the world, with many falling into extreme poverty. In early 2021, it was estimated nearly 690 million people are undernourished and by end of 2021 to increase further by 132 million (Joint statement by ILO, FAO, IFAD and WHO. Impact of COVID-19 on people's livelihoods, their health and our food systems https://www.who.int/news/item/13-10-2020-impact-of-covid-19-on-people's-livelihoods-their-health-and-our-food-systems). The spending for public health has increased many folds during the pandemic and this is where translational research in healthcare can play a transformative role to reduce the burden on government healthcare budget (Covid-19 and its impact on Indian society. https://timesofindia.indiatimes.com/readersblog/covid-19-and-its-impact-on-india/covid-19-and-its-impact-on-indian-society-27565/). Over the past decade, public health research has started playing a major role in Indian academic settings. COVID-19 pandemic has further highlighted the role of public health. However, the potential of using technological advancement has not been fully utilised. This is where translational research and public health can play a role to tap the full potential of technology. This review paper explores the public health practices to understand the different practices to examine how both public health and translational research can cross-fertilise. It concludes with a short discussion on implications on policymakers.
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Affiliation(s)
- Muthu Singaram
- Healthcare Technology Innovation Centre (HTIC), Indian Institute of Technology Madras (IITM), Chennai, India
| | - V. R. Muraleedhran
- HSS Department and Centre for Technology and Policy, Indian Institute of Technology Madras (IITM), Chennai, India
| | - Mohanasankar Sivaprakasam
- Department of Electrical Engineering and Healthcare Technology Innovation Centre (HTIC), Indian Institute of Technology Madras (IITM), Chennai, India
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Kunwar B, Dhungana A, Aryal B, Gaire A, Adhikari AB, Ojha R. Cross‐sectional study on knowledge and attitude of telemedicine in medical students of Nepal. Health Sci Rep 2022; 5:e532. [PMID: 35224226 PMCID: PMC8855682 DOI: 10.1002/hsr2.532] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 01/22/2022] [Accepted: 01/26/2022] [Indexed: 11/11/2022] Open
Affiliation(s)
- Bijay Kunwar
- Department of Medicine Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital Maharajgunj Nepal
| | - Ayushma Dhungana
- Department of Medicine National Medical College, National Medical College and Teaching Hospital Birgunj Nepal
| | - Binay Aryal
- Department of Medicine Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital Maharajgunj Nepal
| | - Arjun Gaire
- Department of Medicine Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital Maharajgunj Nepal
| | - Aramva Bikram Adhikari
- Department of Medicine Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital Maharajgunj Nepal
| | - Rajeev Ojha
- Department of Neurology Tribhuvan University Institute of Medicine Maharajgunj Nepal
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25
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Shaikh A, Al Reshan MS, Sulaiman A, Alshahrani H, Asiri Y. Secure Telemedicine System Design for COVID-19 Patients Treatment Using Service Oriented Architecture. SENSORS 2022; 22:s22030952. [PMID: 35161698 PMCID: PMC8838818 DOI: 10.3390/s22030952] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/19/2021] [Accepted: 01/21/2022] [Indexed: 01/05/2023]
Abstract
The coronavirus pandemic, also known as the COVID-19 pandemic, is an ongoing virus. It was first identified on December 2019 in Wuhan, China, and later spread to 192 countries. As of now, 251,266,207 people have been affected, and 5,070,244 deaths are reported. Due to the growing number of COVID-19 patients, the demand for COVID wards is increasing. Telemedicine applications are increasing drastically because of convenient treatment options. The healthcare sector is rapidly adopting telemedicine applications for the treatment of COVID-19 patients. Most telemedicine applications are developed for heterogeneous environments and due to their diverse nature, data transmission between similar and dissimilar telemedicine applications is a difficult task. In this paper, we propose a Tele-COVID system architecture design along with its security aspects to provide the treatment for COVID-19 patients from distance. Tele-COVID secure system architecture is designed to resolve the problem of data interchange between two different telemedicine applications, interoperability, and vendor lock-in. Tele-COVID is a web-based and Android telemedicine application that provides suitable treatment to COVID-19 patients. With the help of Tele-COVID, the treatment of patients at a distance is possible without the need for them to visit hospitals; in case of emergency, necessary services can also be provided. The application is tested on COVID-19 patients in the county hospital and shows the initial results.
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26
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Sahoo S, Grover S. Profile of Patients Availing Marital and Psychosexual Clinic Services During the Pre-COVID and COVID Era: A Study From a Tertiary Care Center. JOURNAL OF PSYCHOSEXUAL HEALTH 2022. [DOI: 10.1177/26318318211068604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Aim: To assess the profile of patients availing the marital and psychosexual clinic (MPC) services through the telemode at a tertiary care center after the imposition of lockdown and compare the same with the profile of the patients attending the outpatient services, in-person MPC services during the prelockdown period. Materials and Methods: It was a retrospective study in which comparisons were made between patients availing the MPC services from March 24, 2020 to March 23, 2021 with the profile of patients during the period of March 24, 2019 to March 23, 2020 (ie, COVID period—lockdown). Results: A total of 112 patients availed the MPC services during the COVID study period compared to 307 patients in the pre-COVID period. However, when the proportion of MPC cases among the total walk-ins was compared, during the COVID period the proportion of MPC cases increased by almost 1.75 times. During the COVID time period, there was an increase in the patients who were significantly younger ( P = .002), females ( P = .003), more from urban locality ( P = .035), and being referred by self or caregiver ( P = .001). In terms of specific diagnosis, as compared to the pre-COVID timeframe, significantly higher numbers of patients were diagnosed with premature ejaculation (PME) and PME + erectile dysfunction while the services were being provided through the telemode. Conclusion: The present study suggests an increase in the proportion of patients seeking help for marital and sexual issues while the services are being provided by telemode.
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Affiliation(s)
- Swapnajeet Sahoo
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sandeep Grover
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Tuczyńska M, Matthews-Kozanecka M, Baum E. Accessibility to Non-COVID Health Services in the World During the COVID-19 Pandemic: Review. Front Public Health 2022; 9:760795. [PMID: 34976922 PMCID: PMC8716399 DOI: 10.3389/fpubh.2021.760795] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 11/10/2021] [Indexed: 01/05/2023] Open
Abstract
Background: COVID-19 pandemic caused by SARS-CoV2 has seriously impacted the global economy. Medical facilities around the world were not prepared for the enormous challenges posed by the growing number of patients each day, the shortage of personal protective equipment, and insufficient numbers of medical staff. Governments have tried to counteract the impact of the pandemic, but the measures taken have not always been sufficient to maintain access to and quality of health services at the same level as before the pandemic. The disruption of health services has resulted in more and more research reports from different parts of the world on the accessibility of health services during the COVID-19 pandemic. Methodology: This review article presents 21 selected scientific studies on access to health services in different regions of the world. Articles were found in PubMed, GoogleScholar, Medline, and ScienceDirect databases, then grouped, and significant data were extracted from each article. The results were summarized in a table. Results: The range of limited health services included a variety of specialties, including primary care, psychiatry, orthopedics, cardiology, neurosurgery, and more. Methods used in the studies were based on retrospective analysis or on the subjective assessment of patients in the form of a questionnaire or interview. Most authors claimed a decrease in accessibility to health services during the COVID-19 pandemic compared to the pre-pandemic period, including a decrease in planned surgeries, doctor appointments, patient admission to hospital or ER, and access to medicines. Additionally, some authors observed an increase in the mortality rate. One of the few medical services that have expanded rapidly during the pandemic was online appointments. Conclusions: The COVID-19 pandemic has most certainly affected the accessibility of health services worldwide. Lessons should be learned to prevent inaccessibility to medical services, especially as experts predict another wave of COVID-19 cases.
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Affiliation(s)
- Magdalena Tuczyńska
- Student Scientific Circle of Maxillofacial Orthopaedics and Orthodontics, Poznan University of Medical Sciences, Poznań, Poland
| | - Maja Matthews-Kozanecka
- Department of Social Sciences and the Humanities, Poznan University of Medical Sciences, Poznań, Poland
| | - Ewa Baum
- Department of Social Sciences and the Humanities, Poznan University of Medical Sciences, Poznań, Poland
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Banerjee J, Prem N, Pillai A. Making the seniors tech savvy: The way forward to bringing cancer care to the doorstep. CANCER RESEARCH, STATISTICS, AND TREATMENT 2022. [DOI: 10.4103/crst.crst_43_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Bagrodia V, Holla VV, Kamble NL, Pal PK, Yadav R. Parkinson's Disease and Wearable Technology: An Indian Perspective. Ann Indian Acad Neurol 2022; 25:817-820. [PMID: 36560983 PMCID: PMC9764889 DOI: 10.4103/aian.aian_653_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/20/2022] [Accepted: 08/23/2022] [Indexed: 12/24/2022] Open
Abstract
Parkinson's disease (PD) is the second most prevalent neurodegenerative disorder. In India, an accurate number of PD patients remains uncertain owing to the unawareness of PD symptoms in the geriatric population and the large discrepancy between the number of PD patients and trained neurologists. Constructing additional neurological care centers along with using technology and integrating it into digital healthcare platforms will help reduce this burden. Use of technology in PD diagnosis and monitoring started in 1980s with invasive techniques performed in laboratories. Over the last five decades, PD technology has significantly evolved where now patients can track symptoms using their smartphones or wearable sensors. However, the use of such technology within the Indian population is non-existent primarily due to the cost of digital devices and limited technological capabilities of geriatric patients especially in rural areas. Other reasons include secure data transfers from patients to physicians and the general lack of awareness of wearables devices. Thus, creating a simple, cost-effective and inconspicuous wearable device would yield the highest compliance within the Indian PD patient population. Implementation of such technology will provide neurologists with wider outreach to patients in rural locations, remote monitoring and empirical data to titrate medication.
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Affiliation(s)
- Vaishali Bagrodia
- Department of Neurology, National Institute of Mental Health and Neurosciences, NIMHANS, Bengaluru, Karnataka, India
| | - Vikram V. Holla
- Department of Neurology, National Institute of Mental Health and Neurosciences, NIMHANS, Bengaluru, Karnataka, India
| | - Nitish L. Kamble
- Department of Neurology, National Institute of Mental Health and Neurosciences, NIMHANS, Bengaluru, Karnataka, India
| | - Pramod K. Pal
- Department of Neurology, National Institute of Mental Health and Neurosciences, NIMHANS, Bengaluru, Karnataka, India
| | - Ravi Yadav
- Department of Neurology, National Institute of Mental Health and Neurosciences, NIMHANS, Bengaluru, Karnataka, India,Address for correspondence: Dr. Ravi Yadav, Department of Neurology, National Institute of Mental Health and Neurosciences, NIMHANS, Bengaluru, Karnataka - 560 029, India. E-mail:
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30
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Basavarajappa C, Grover S, Dalal PK, Avasthi A, Kumar CN, Manjunatha N, Sahoo S, Saha G, Mehra A, Singh OP, Tripathi A, Gangadhar BN, Math SB. Perceived advantages and disadvantages of telepsychiatry - An online survey of psychiatrists in India. Indian J Psychiatry 2022; 64:93-97. [PMID: 35400742 PMCID: PMC8992744 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_332_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 12/11/2021] [Accepted: 12/23/2021] [Indexed: 11/14/2022] Open
Abstract
CONTEXT Telepsychiatry is being practiced in India for many years but was formalized only in 2020. It has many advantages and disadvantages. AIMS This study aimed to understand the perceived advantages and disadvantages of telepsychiatry practices in India. SETTINGS AND DESIGN An online survey with ethics approval by the Indian Psychiatric Society (IPS) Ethics Review Board. All psychiatrists who are members of the IPS and whose email address was available with the society were sent the survey link by email. METHODOLOGY Information about existing telepsychiatry consultation practices in India and perception of advantages and disadvantages by the practitioners were collected between June and July 2020. STATISTICAL ANALYSIS Frequency, percentages, mean, and standard deviation were calculated. RESULTS Responses by 340 responders were analyzed. Majority of the responders felt that telepsychiatry would provide easy accessibility to mental health services (n = 283, 83.24%) and would lead to less exposure to infections (n = 222, 65.29%). Half of the responders (n = 177, 52.06%) felt that there would be an increased doctor shopping resulting in poor care and nearly three-fourth (n = 245, 72.06%) felt that mental health professionals would fall into a problem while dealing with a suicidal or a homicidal patient. Some expressed that the inability to do physical and central nervous system examinations could lead to missing out comorbidities. About one-third (n = 117, 36.56%) felt that the patient recording the consultation would be a legal issue. CONCLUSIONS This online survey showed that psychiatrists perceive many advantages and some disadvantages in practicing telepsychiatry.
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Affiliation(s)
- Chethan Basavarajappa
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Sandeep Grover
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Pronob K Dalal
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | | | | | - Narayana Manjunatha
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Swapnajeet Sahoo
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Gautam Saha
- Clinic Brain Neuropsychiatric Institute and Research Center, Barasat, Kolkata, West Bengal, India
| | - Aseem Mehra
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Om Prakash Singh
- Department of Psychiatry, NRS Medical College, Kolkata, West Bengal, India
| | - Adarsh Tripathi
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Bangalore N Gangadhar
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Suresh Bada Math
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
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Galagali PM, Ghosh S, Bhargav H. The Role of Telemedicine in Child and Adolescent Healthcare in India. CURRENT PEDIATRICS REPORTS 2021; 9:154-161. [PMID: 34642611 PMCID: PMC8499609 DOI: 10.1007/s40124-021-00253-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/14/2021] [Indexed: 12/01/2022]
Abstract
Purpose of Review We highlight the evolution and use of telemedicine in child and adolescent healthcare in India, in pre and post pandemic eras. Recent Findings The latest research endorses telemedicine as a successful strategy in resource-limited settings to provide accessible and equitable healthcare. Summary Telemedicine was initiated in India in 2001. The pandemic restrictions resulted in an increase in its use. The national telemedicine and telepsychiatry guidelines facilitated and enabled its widespread use. Telehealth was used by private and public health establishments, in urban, rural, and remote areas. It was used for triaging cases; managing and monitoring COVID patients in home isolation, in non-COVID medical and psychiatric care, and follow-up; continuing medical education; and health promotion strategies like teleyoga. The shortcomings included inability to provide privacy and confidentiality, perform physical examination, and provide emergency care. Most patients and their caregivers expressed satisfaction with telehealth services. Telemedicine is likely to become an integral part of healthcare services in the post pandemic era.
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Affiliation(s)
- Preeti M. Galagali
- Bengaluru Adolescent Care and Counselling Centre, No. 528, 10th Main Ram Mandir Road, 2nd Block Rajajinagar, Bengaluru, Karnataka 560079 India
| | - Sreyoshi Ghosh
- National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka India
| | - Hemant Bhargav
- Department of Integrative Medicine, NIMHANS, Bengaluru, India
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Zwaigenbaum L, Bishop S, Stone WL, Ibanez L, Halladay A, Goldman S, Kelly A, Klaiman C, Lai MC, Miller M, Saulnier C, Siper P, Sohl K, Warren Z, Wetherby A. Rethinking autism spectrum disorder assessment for children during COVID-19 and beyond. Autism Res 2021; 14:2251-2259. [PMID: 34553489 PMCID: PMC8646364 DOI: 10.1002/aur.2615] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 07/21/2021] [Accepted: 09/09/2021] [Indexed: 12/29/2022]
Abstract
The COVID-19 pandemic has posed unique challenges for families and caregivers, as well as for autism-focused clinicians, who are faced with providing a thorough and accurate evaluation of children's specific needs and diagnoses in the absence of in-person assessment tools. The shift to telehealth assessments has challenged clinicians to reconsider approaches and assumptions that underlie the diagnostic assessment process, and to adopt new ways of individualizing standard assessments according to family and child needs. Mandates for physical distancing have uncovered deficiencies in diagnostic practices for suspected autism and have illuminated biases that have posed obstacles preventing children and families from receiving the services that they truly need. This Commentary outlines several considerations for improving diagnostic practices as we move forward from the current pandemic and continue to strive to build an adaptable, sustainable, equitable, and family-centered system of care. LAY SUMMARY: Physical distancing and the abrupt end to in-person services for many children on the autism spectrum has forced clinicians to examine the existing challenges with autism spectrum disorder (ASD) diagnostic assessment and consider things they want to keep and things that should be changed in the years ahead. New approaches such as telehealth both alleviated and exacerbated existing disparities, and brought into stark focus the importance of equitable and timely access to family-centered care. This commentary suggests ways of improving clinical practices related to ASD assessment to continue along this path.
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Affiliation(s)
- Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Somer Bishop
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, California, USA
| | - Wendy L Stone
- Department of Psychology, University of Washington, Seattle, Washington, USA
| | - Lisa Ibanez
- Department of Psychology, University of Washington, Seattle, Washington, USA
| | - Alycia Halladay
- Autism Science Foundation, New York, New York, USA.,Department of Pharmacology and Toxicology, Rutgers University, Piscataway, New Jersey, USA
| | - Sylvie Goldman
- Department of Neurology, G.H. Sergievsky Center, Columbia University Medical Center, New York, New York, USA
| | - Amy Kelly
- Devereux Advanced Behavioral Health, Villanova, Pennsylvania, USA
| | - Cheryl Klaiman
- Department of Pediatrics, Emory School of Medicine, Atlanta, Georgia, USA
| | - Meng-Chuan Lai
- The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health and Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry and Autism Research Unit, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK.,Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Meghan Miller
- Department of Psychiatry & Behavioral Sciences and MIND Institute, University of California, Davis, California, USA
| | - Celine Saulnier
- Department of Pediatrics, Emory School of Medicine, Atlanta, Georgia, USA.,Neurodevelopmental Assessment & Consulting Services, Decatur, Georgia, USA
| | - Paige Siper
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Kristin Sohl
- Department of Child Health, University of Missouri School of Medicine, Columbia, Missouri, USA
| | - Zachary Warren
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Amy Wetherby
- Department of Clinical Sciences, College of Medicine, Florida State University, Tallahassee, Florida, USA
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Yadav K, Ginsburg O, Basu P, Mehrotra R. Telemedicine and Cancer Care in Low- and Middle-Income Countries During the SARS-CoV-2 Pandemic. JCO Glob Oncol 2021; 7:1633-1638. [PMID: 34860567 PMCID: PMC8654432 DOI: 10.1200/go.21.00249] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 10/08/2021] [Accepted: 10/28/2021] [Indexed: 12/29/2022] Open
Affiliation(s)
- Kavita Yadav
- Centre of Social Medicine & Community Health, Jawahar Lal Nehru University, New Delhi, India
| | - Ophira Ginsburg
- Department of Medicine at NYU Grossman School of Medicine, New York, NY
| | - Partha Basu
- Early Detection, Prevention & Infection Branch, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Ravi Mehrotra
- Chip Foundation, Noida, India
- Rollins School of Public Health, Emory University, Atlanta, GA
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Kesavadev J, Krishnan G, Mohan V. Digital health and diabetes: experience from India. Ther Adv Endocrinol Metab 2021; 12:20420188211054676. [PMID: 34820114 PMCID: PMC8606976 DOI: 10.1177/20420188211054676] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 10/04/2021] [Indexed: 11/15/2022] Open
Abstract
The digitization of healthcare and its usage in the delivery of healthcare have experienced exponential growth across the world in recent times. India's fast-growing diabetes population has been exerting immense pressure on the country's healthcare infrastructure. Various innovative and evolving technologies are converging to impact the trajectory of digital health in diabetes. The diabetes community has been adopting various technologies such as connected glucose meters, continuous glucose monitoring systems, continuous subcutaneous insulin infusion, closed-loop systems, digitalization of health data, and diabetes-related apps for the prevention and management of the condition. India has provided some excellent examples in exploiting the potential of digital transformation in revamping the diabetes ecosystem. Yet, there are still various hurdles in technology development, healthcare delivery, as well as concerns related to data privacy, digital divide, policies by the government, role of stakeholders, attitude, and absorption by healthcare professionals, and hospitals. This article provides an overview of the digital diabetes technologies currently practiced in India and recommends the need for strong technology adaptation and policy interventions for an ideal roadmap of digitalization of diabetes care in the Indian milieu.
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Consumer side economic perception of telemedicine during COVID-19 era: A survey on Bangladesh's perspective. INFORMATICS IN MEDICINE UNLOCKED 2021; 27:100797. [PMID: 34869827 PMCID: PMC8627376 DOI: 10.1016/j.imu.2021.100797] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 11/05/2021] [Accepted: 11/15/2021] [Indexed: 02/07/2023] Open
Abstract
In Bangladesh, the telemedicine industry is one of the few industries able to flourish in the contemporary era of COVID-19. But to thrive, the industry must know the viewpoints of both consumers (those who are interested in availing the services of the industry) and non-consumers to overcome deficits. This should be done to maximize profits and give optimal utility to users so that the industry can be made sustainable in the long run. The main aim of this paper is to analyze the economic perception of both the telemedicine consumers and non-consumers of Bangladesh and the actions required to be taken to optimize them. A survey was developed with 18 questions divided into several parts relating to the health identity of the respondent, the respondents' use of telemedicine, the analysis of the economic behaviors of the respondents with regards to telemedicine, and the consumer perception of the merits and demerits of telemedicine. The survey results show that about one-third has used some form of telemedicine during the COVID-19 pandemic. Among the telemedicine users, 48% used hospital-mandated telemedicine services whereas 41% used mobile telemedicine applications. The survey states that 75% were satisfied with the service they received. The average payment made by the respondent population was 532 Taka, and 62% of them thought that the amount they paid was justified. In conclusion, the results of this survey can be utilized in making economically viable telemedicine models that will give optimal utility to its consumers and help forecast the next stage of the industry for betterment in the health sector.
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Jain D, Rastogi A, Kartik K, Diwan A, Saha O. Medical abortion through telehealth in India: a critical perspective. Sex Reprod Health Matters 2021; 29:2107090. [PMID: 36017949 PMCID: PMC9423857 DOI: 10.1080/26410397.2022.2107090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
The COVID-19 pandemic and nationwide lockdowns have significantly impacted access to abortions for millions of people in India. One of the proposed solutions to address the inaccessibility of abortion services is the use of teleconsultation or "telemedicine" where pregnant persons consult with Registered Medical Practitioners (RMPs) over voice or video calls. The RMPs then prescribe the necessary medication electronically. However, telehealth services bring their own set of social and legal challenges. Although they can allow for greater access to medical abortions, especially in situations where pregnant persons are unable to opt for in-person medical care, it is important to note that telemedicine is not a one-stop solution for lack of access to timely, affordable abortions. This is particularly due to the structural barriers of caste, class, religion, gender, and disability that impede access to healthcare services. In this article, we examine the need for telehealth services in India as a means of increasing access to medical abortion services and the structural barriers that prevent it from being an effective and equitable solution for all.
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Affiliation(s)
- Dipika Jain
- Professor of Law & Director, Centre for Justice, Law and Society, Jindal Global Law School, New Delhi, India. Correspondence:
| | | | - Kavya Kartik
- Former Assistant Director, Centre for Justice, Law and Society, Jindal Global Law School, New Delhi, India
| | - Anmol Diwan
- Assistant Professor, Senior Research Associate, Centre for Justice, Law and Society, Jindal Global Law School, New Delhi, India
| | - Oieshi Saha
- Assistant Professor, Former Research Associate, Centre for Justice, Law and Society, Jindal Global Law School, New Delhi, India
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