ABSTRACT
Background: COVID-19 pandemic has highlighted the importance of telemedicine in health care delivery worldwide. However, the true success of telemedicine depends on patients' acceptance, which in turn is decided by their interest in telemedicine. In this study, we aim to assess the population interest in telemedicine services across India during the COVID-19 pandemic. Methods: We measured national-level public interest in "telemedicine” using terms related to telemedicine in Google Trends during the years 2019 and 2020. The relationship between population search volume for telemedicine (composite score) and the number of COVID-19 cases during the early phase of COVID-19 was analyzed. The literacy rate and relative interest in telemedicine in the states were analyzed to assess the impact of education on telemedicine interest. Results: The interest in telemedicine in the year 2020 is higher compared to the year 2019 (U = 269.5, z = -7.043, p < 0.001). The search trends for telemedicine increased consistently during the early phase of the COVID-19 pandemic. The greatest search volume was seen in Andhra Pradesh. There was a strong correlation (r = 0.65, p < 0.001) between the initial increase in the number of COVID-19 cases and population-level interest in telemedicine over time. The relative interest in telemedicine for the year 2019 showed a significant direct relationship with the literacy rate (r = 0.47, p = 0.04). However, the relative interest in telemedicine for the year 2020 showed no relationship with the state's literacy rate signifying the spread of telemedicine across literacy barriers. Conclusion: Population interest in telemedicine was higher in the year 2020 compared to the previous year and remained high even after the easing of lockdown. The COVID-19 pandemic has played an important role in increasing the Indian public's interest in telemedicine. © The Author(s). 2022Open Access This article is distributedunder the terms ofthe Creative Commons Attribution 4.0InternationalLicense (https://creativecommons.org/licenses/by-nc/4.0/)
ABSTRACT
BACKGROUND AND AIMS: There is an increasing burden of kidney diseases in developing countries like India where access to specialist care is available only to a small proportion of patients. Telemedicine, has been relatively less used in India especially in public sector hospitals. The current study was designed to assess the patient's knowledge, attitude and acceptance of telenephrology services at our institute, a public sector hospital in a developing country. METHOD: This study is a cross-sectional survey carried out among patients who had availed our telenephrology services during the preceding three months. A total of 150 patients were selected by stratified random sampling from the list of attendees of telenephrology consultation in the past 3 months. The questionnaire was administered in local language by telephone interview method. The frequency distributions and average and median values for each of the questionnaire variables were calculated using SPSS software. RESULTS: The average age of the study cohort was 42.52±15.1 years (17-83yrs). 68% of the patients were males. The questionnaire was answered by the patient himself/herself in 56% cases, spouse in 14.0% and children in 20.7% cases. 51.3% patients were graduates or post graduates. 40.7% patients belonged to the upper middle and 39.3% belonged to the lower middle socioeconomic class. 54.6% patients were residing in towns, 28.7% in cities and 16.7% in villages. Prior to the telenephrology service, the median distance travelled to attend our OPD was 113.5 (3-2249 km). Attendees incurred loss of work in 54.7% cases. Information about availability of telenephrology services was obtained from institutional helpline number by 59 (39.3%) patients while 50 (33.3%) patients obtained it from the internet. Others got information from friends, television or short message service (SMS). The average number of teleconsultations was 2 per patient. A large majority of patients (99.3%) felt that Telenephrology service was a right approach during the COVID-19 pandemic. On asking how they felt regarding Telenephrology experience, 70.67% said they were very happy, 25.3% were happy and 4.0% said they were apprehensive or doubtful. 96.6% patients said that they were confident discussing their complaints over phone. 92.6% patients were comfortable sharing reports over phone while 7.3% needed help from caretakers. Regarding the problems faced during teleconsultation, 36% patients responded that they wish to see the doctor in person to feel satisfied while 3.3% found difficulty in understanding drug dosages. 86% patients felt that Telenephrology services should continue even after the COVID pandemic. CONCLUSION: In developing countries like India, with the majority of the population residing outside major cities, wherein the accessibility to a specialist is limited and the digital development outscores the physical infrastructure, Telenephrology has huge potential to provide quality nephrology care to the remotest parts of the country.