ABSTRACT
Purpose: Digital health is an important factor in Indias healthcare system. Inclusive policy measures, a fertile technological landscape, and relevant infrastructural development with unprecedented levels of telemedicine adoption catalysed by the recent COVID-19 pandemic have thrown open new possibilities and opportunities for clinicians, end-users, and other stakeholders. Nevertheless, there are still several challenges to properly integrating and scaling telemedicine use in India. This studys objective was to understand the views of practising physicians in India on the use of telemedicine and the challenges experienced during the accelerated rollout during the first wave of the COVID-19 pandemic. Methods: We acquired data through an anonymous, cross-sectional, internet-based survey of physicians (n=444) across India on the COVID-19 frontline. These responses were subjected to qualitative data analysis (via inductive coding and thematic analyses) and descriptive statistics, as appropriate. Results: Most responses (n=51) were categorised under a code indicating that telemedicine-led healthcare delivery compromised treatment quality. The second largest proportion of responses (n=22) suggested that Accessibility, quality and maturity of software and hardware infrastructure was a considerable challenge. Conclusions: Despite the considerable uptake, perceived benefits, and the foreseen positive role of telemedicine in India, several challenges of telemedicine use (viz., technical, user experience-based integration, and non-user-based integration challenges) have been identified. These must be addressed through suggested relevant opportunities to realise telemedicines potential and help inform the future design of effective telemedicine policy and practice in India.
Subject(s)
COVID-19ABSTRACT
Objectives India has committed to formulating a roadmap for realising a resilient health system, with digital health being an important element of this. Following the successful implementation of a free telemedicine service, eSanjeevani, India published the Telemedicine Practice Guidelines in 2020 to further scale telemedicine use in India. The main objective of the current study was to understand the perspective and use of telemedicine by medical doctors in India after the release of its telemedicine policy. Methods Data were acquired through an anonymous, cross-sectional, internet-based survey of medical doctors (n = 444) at a pan-India level. Replies were subjected to statistical analysis. Results Telemedicine was used for various non-mutually exclusive reasons, with the top two reasons being live audio or video consultations (60.4%) and online payments (19.1%) and smartphones were the most frequently used device type (60.6%). The telemedicine benefit that the greatest proportion of respondents (93%) recognised was its potential to reduce COVID-19 infection risk for healthcare professionals. Interestingly, nearly 45% of respondents felt that limited and fragmented insurance coverage was an important limitation to the practice of telemedicine in India and 49% believed reduced patient fees for teleconsultations could help incentivise telemedicine use. Conclusions This study helps to appraise the use of telemedicine in India after the publication of telemedicine guidelines in 2020. Furthermore, the findings can inform the development of telemedicine platforms, policies and incentives to improve the design and implementation of effective telemedicine in India. Public Interest Summary India has committed to formulating a roadmap for realising a resilient health system, with digital health being an important element of this. In 2020, India published its Telemedicine Practice Guidelines to scale telemedicine use in India. The main objective of the current study was to survey medical doctors in India to understand their perspectives on and use of telemedicine after the release of India’s telemedicine policy. Our findings revealed that the top two reasons doctors used telemedicine were for live audio or video consultations and online payments. Interestingly, a large proportion of respondents felt that limited and fragmented insurance coverage was an important limitation to the practice of telemedicine in India. This study helps to appraise the use of telemedicine in India after the publication of its telemedicine guidelines and can inform the development of telemedicine platforms, policies and incentives to improve the design and implementation of telemedicine in India.
Subject(s)
COVID-19ABSTRACT
Objectives To estimate COVID-19 infections and deaths in healthcare workers (HCWs) from a global perspective. Design Scoping review. Methods Two parallel searches of academic bibliographic databases and grey literature were undertaken. Governments were also contacted for further information where possible. Due to the time-sensitive nature of the review and the need to report the most up-to-date information for an ever-evolving situation, there were no restrictions on language, information sources utilised, publication status, and types of sources of evidence. The AACODS checklist was used to appraise each source of evidence. Outcome measures Publication characteristics, country-specific data points, COVID-19 specific data, demographics of affected HCWs, and public health measures employed Results A total of 152,888 infections and 1413 deaths were reported. Infections were mainly in women (71.6%) and nurses (38.6%), but deaths were mainly in men (70.8%) and doctors (51.4%). Limited data suggested that general practitioners and mental health nurses were the highest risk specialities for deaths. There were 37.17 deaths reported per 100 infections for healthcare workers aged over 70. Europe had the highest absolute numbers of reported infections (119628) and deaths (712), but the Eastern Mediterranean region had the highest number of reported deaths per 100 infections (5.7). Conclusions HCW COVID-19 infections and deaths follow that of the general world population. The reasons for gender and speciality differences require further exploration, as do the low rates reported from Africa and India. Although physicians working in certain specialities may be considered high-risk due to exposure to oronasal secretions, the risk to other specialities must not be underestimated. Elderly HCWs may require assigning to less risky settings such as telemedicine, or administrative positions. Our pragmatic approach provides general trends, and highlights the need for universal guidelines for testing and reporting of infections in HCWs.
Subject(s)
COVID-19 , DeathABSTRACT
The publicly available data on COVID-19 cases provides an opportunity to better understand this new disease. However, strong attention needs to be paid to the limitations of the data to avoid making inaccurate conclusions. This article, which focuses on the relationship between the weather and COVID-19, raises the concern that the same factors influencing the spread of the disease might also affect the number of tests performed and who gets tested. For example, weather conditions impact the prevalence of respiratory diseases with symptoms similar to COVID-19, and this will likely influence the number of tests performed. This general limitation could severely undermine any similar analysis using existing COVID-19 data or similar epidemiological data, which could, therefore, mislead decision-makers on questions of great policy relevance.