Client satisfaction with telemedicine services during COVID-19 pandemic: A cross-sectional survey from a teaching institute of North India.

Introduction: Telemedicine has emerged as an essential interface between health care providers and patients during the pandemic. The present study was done to assess this technology's level of acceptance and satisfaction amongst the patients. Methods: We did a retrospective study amongst patients >18 years (n = 300) who had availed telemedicine services in different departments of a tertiary care hospital between May and August 2020. The patients were interviewed telephonically using a pre-tested semi-structured tool that collected information about the socio-demographic and clinical characteristics of the patients, and satisfaction was measured on a 5-point Likert Scale. Results: Fifty-five percent patients received teleconsultation via a telephone call, while the others preferred video calling services on WhatsApp messenger. Overall, more than 97% of the clients depicted satisfaction with the telemedicine services in three major domains: registration/appointment services, consultation with the doctor and post-consultation services. Some of the common feedback included difficulty in getting medicine using the scanned copy of prescription slip generated by the hospital, problems faced in reimbursement of the bills, long waiting period, and poor quality of video calls due to slow internet. Conclusion: Telemedicine proved to be an efficient means of communication for many patients during the pandemic. Though patient satisfaction was high with the services received by them, timely assessment of the problems encountered in the implementation of telemedicine services will help evolve the services not just during the pandemic but even after that.

Telemedicine and ethics: opportunities in India.

Prior to the Covid-19 pandemic, telemedicine was an upcoming modality of diagnosis and treatment, but was limited by inadequate guidelines and legislation. Now, during the pandemic, policy makers worldwide have found it prudent to set forth new telemedicine guidelines to ease and regulate operations. The Government of India, along with the Board of Governors (in supercession of the Medical Council of India), amended the Indian Medical Council Act, 1956, and published the Telemedicine Practice Guidelines in 2020 to lay down a framework for telemedicine practice in our country. This step will provide a medico-legal context for the delivery of online health services. However, the Guidelines in their present form only partly address the ethical aspects of telemedicine in India. Here, we briefly describe these Guidelines and highlight the ethical concerns surrounding the teleconsultation process in our country. We also suggest possible solutions to these ethical issues surrounding the practice of telemedicine.

Factors Leading to Reverse Migration Among Migrant Workers During the COVID-19 Pandemic: A Multicenter Study From Northwest India.

OBJECTIVE: To examine the various psychosocial factors associated with reverse migration among migrant workers during the coronavirus disease 2019 (COVID-19) lockdown in India. METHODS: A cross-sectional multicenter study was conducted at 4 sites in Northwest India. The migrant workers were recruited from various shelter homes, and information was gathered from reverse migrant workers and controls using various tools including a sociodemographic profile; knowledge, attitudes, and practices questionnaire; and reasons for migration and reverse migration questionnaires. A total of 275 reverse migrant workers and 276 controls participated in the study. RESULTS: There was a considerable difference between reverse migrant workers and controls regarding the question of whether it was safe to travel during lockdown (76.0% vs 26.4%, respectively). The most common route of spread of COVID-19 infection was through touching and sneezing, and symptoms were fever, dry cough, and sore throat in both groups. Reverse migrant workers had low self-esteem and were reluctant to participate in customs of their migration city. A large number of reverse migrant workers reported that they had no money to survive, worried about family back home at their village, felt pressured by family members to come back to the village, and had been terminated from their job. CONCLUSIONS: Reverse migrant workers had the attitude that it was safe to travel during the lockdown. About one-fifth of the reverse migrant workers reported no place to live and fear of getting an infection. The reverse migrant workers also reported feeling low and gloomy, restless, and uncertain about the future and fear of death. Lack of jobs was a major factor driving migrant workers from their native homes.

Psychiatric morbidity and substance use in migrant workers: A population based study.

BACKGROUND: The prevalence of mental health problems and substance abuse in the migrant population is higher than the general population. AIMS AND OBJECTIVES: To assess the prevalence and pattern of mental health issues and substance use in the migrant population and highlight the association with the reverse migration of migrant workers. METHODOLOGY: The field staff visited the shelter homes for migrant population in four cities of Northern India (Chandigarh (UT), Bhatinda (Punjab), Panchkula (Haryana) and Jaipur (Rajasthan). After maintaining the social distance and wearing masks by the staff and migrants, written informed consent was taken for participation in the study. The socio-demographic details of reverse migrants were noted down and Hindi version of Patient Health Questionnaire (PHQ-9) for mental health problems and screening tool for pattern of substance abuse was administered. Geographically matched undisplaced were also administered these tools. RESULTS: A total of 275 reverse migrants and 276 undisplaced were included in the study. The prevalence of ever use for all the substances among reverse migrants was 44.4% (122/275) and among undisplaced, it was 45.3%. The prevalence of alcohol, tobacco and cannabis was higher than the general population. The prevalence of at least one diagnosis on PHQ-9 is 13.45% (reverse migrants 19.3% and undisplaced 7.6) and the prevalence of other depressive disorder is significantly higher in reverse migrants (17.1%) than undisplaced (4.0%). CONCLUSION: The study concludes that prevalence of mental health issues and substance abuse in migrant population is significantly higher than the general population and the prevalence of at least one diagnosis and other depressive disorder is significantly higher in reverse migrants than undisplaced.