Chennai, March 27

The coronavirus outbreak has taken over healthcare infrastructure the world over, forcing countries including India into a lockdown. With almost 4.8 lakh infections and 21,000 plus deaths, hospitals across the world are being tested badly. India’s healthcare infrastructure, with over 700 confirmed cases and the threat of a sharp increase in the number of infections, is already under pressure. The government is advising hospitals to postpone elective surgeries (scheduled in advance and that do not involve an emergency) and other treatments to focus just on the pandemic. Where does that leave non-Covid patients who cannot step out of their homes during this crisis?

Many innovative options are emerging across the world and in India mostly using technology to bridge this gap.

In Chennai, for instance, a group of nearly 28 doctors -- ranging from orthopaedists to paediatricians to general surgeons and pathologists -- alumni of Sri Ramachandra Institute of Higher Education and Research (formerly Sri Ramachandra Medical College & Research Institute), have come together to provide free online medical consultation at Lockdown Clinic (www.lockdownclinic.com).

Prakash Ayyadurai, an arthroscopy surgeon from the Centre for Sports Science, who heads it, says: “At the Centre for Sports Science, we planned to give online consultation to our post-operative patients for follow-up and rehabilitation, anticipating a lockdown. We tried this on a few of our patients and to our surprise, the patient compliance was amazing. So, we continue to follow-up with patients online, till date, along with a team of 4-5 doctors, rehab physicians & physiotherapists.”

“Since the idea worked for a set group of patients, I thought it would work better and definitely cater to a larger group of people during the lockdown and this is essential since hospitals are preparing to cater to the outbreak and regular patients will suffer a lot,” he adds, explaining how they came up with the idea.

The team of doctors -- who work from their homes, clinics, consultation suites, and hospitals -- have started providing consultation since Thursday night. Patients have to register via a WhatsApp number with their name, age, gender and give a short description of the problem they are facing. They will then be given a video consultation link and routed to a specialist in the concerned department.

Portea Medical, a company that provides in-home medical care in India, on the other hand, made its live video consulting facility for physiotherapy a full-fledged service a couple of weeks back.

“In our case, we provide homecare where all our doctors and nurses go to patients’ homes to treat them,” says Vaibhav Tewari, its Chief Operating Officer. But right now, people are wary of somebody coming home. So we are offering them live video consults for physiotherapy and we are seeing an uptick in that, he adds.

“Patients who are on chemotherapy right now already have limited immunity and a lot of them are currently wondering if they should stop their treatment or continue,” says Rashie Jain, co-founder and CEO of Onco.com, a virtual care platform for cancer patients.

It launched Call Onco, a teleconsultation service, four days ago, where a cancer patient can get a 20-minute call with an oncologist within the comfort of their homes. Within 24 hours, a video call or a telephone conversation is arranged, depending on what the patient prefers.

“Once the call is done, we assign a care manager to the patient, who basically is an Onco team member,” Jain says. The care manager will stay in touch with him/her for the next two to three months for all kinds of help -- he will basically become the contact point for the patient, she adds.

In order to provide a proper framework to deliver healthcare services remotely, via phone or online, the Ministry of Health and Family Welfare with NITI Aayog, on Wednesday, released the official guidelines for telemedicine practices in the country. The guidelines focus on important telemedicine practices, the data privacy and confidentiality of patients and documentation of the consultation.

“We have begun offering telemedicine services for domestic patients at an individual level, since the past week, to our older patients,” says Aparna Jaswal, Additional Director, Cardiology and Electrophysiology, at Fortis Escorts Heart Institute & Research Centre. The institute is also working on setting its platform and it should be ready soon, she adds.

But in the case of emergency situations, what is the procedure that these platforms follow? How equipped are they to handle such instances? Emergency consultations cannot be done through this (online consultation), says Ayyadurai. “In such a situation, we use our network to find which hospital closest to the patient’s area is available and accordingly advise them.”

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