Setting Up and Providing Telepsychiatry Services in India

Video consultations with “Paper and Pen” health record: A path-breaking solution to troubleshoot acceptability of telemedicine practice in developing countries

Telemedicine is the delivery of health care from a distance. It also includes research and evaluation of such services using health data which are stored in "Electronic Health Record" (EHR) platforms. EHR has proved to be useful in monitoring health care delivery but setting up of such platforms is tedious and resource-consuming in developing countries. With the recent surge of telemedicine utility during the COVID-19 pandemic, telemedicine has emerged to be pivotal in reaching stranded patients needing care without EHR-based practice. The practice of patient health record (PHR)-based teleconsultations in India has demonstrated how a conventional "paper and pen" method can be combined to popularise telemedicine utility. Thus, use of PHR-based system to maintain health records would prove to be a pragmatic solution for physicians in low-resource settings to improve their reach to a larger population in need for the future.

Telemedicine in Geriatric Psychiatry: Relevance in India

Telemedicine has evolved as a novel tool in delivering health care in the modern world. With the advancement in video conferencing technology at an affordable price and innovative digital medical instruments, it has grown from guiding paramedics in managing patients to aiding physicians in providing direct consultation. Delivering care for older adults has always been challenging due to comorbidities that may warrant a multidisciplinary approach leading to frequent visits across specialties. As per the preliminary reports of the Longitudinal Aging Study in India, 55% of this population suffers from any chronic illness, of which 40% have some form of disability and 20% deal with mental health issues. Over the years, telepsychiatry care for older adults has received increasing acceptability. Videoconferencing with improved connectivity and transmission rates has aided in evaluating, assessing, and providing mental health interventions at ease. The recent regulation of telemedicine practice in the country by rolling out the Telemedicine Practice Guidelines 2020 and Telepsychiatry Operational Guidelines 2020 has fast-tracked its utility during the COVID-19 pandemic. Concerns of physical examination, psychological satisfaction of consulting physician in person, confidentiality, and security of information shared are points that need better addressing in the future. However, Telemedicine is recommended to be used judiciously, taking the risk and benefit of older adults on a case basis as it can significantly bring down the financial and emotional burden.