A Booster Shot for Rural Healthcare

At a time when the poorest 20 percent of the population captures only 10 percent of the public health subsidy in the country and with newer diseases affecting more and more people, especially in villages and remote areas, there a need to go beyond the conventional healthcare system. Providing access to medical aid through teleconferencing or video conferencing assumes greater significance in this context. That there is severe dearth of medical specialists in rural areas is a known fact. According to NITI Aayog, India faces a shortfall of six lakh doctors, 10 lakh nurses and two lakh dental surgeons. The World Health Organization prescribes a doctor-patient ratio of 1:1000; in India it is around 1:2000. In the about six lakh villages where 70 percent of India’s population lives, the number of doctors are only a fourth of those in urban areas. The problem is not limited to human resources alone. There are severe infrastructure challenges as well. In 2015, about 35 million people in hinterlands relied on local public health center s (PHCs) that didn’t have any electricity supply, government data show.

Rising demand

Even as healthcare delivery challenges, on the other there are rising demands of healthcare services. It is here that assisted telemedicine can play a significant role in bridging the gap. Assisted telemedicine hold much promise also because about 70 percent of OPD (outpatient department) cases do not need in-person visits as indicated by independent researches. Further, statistics show that only 15-16 percent of the patients treated by way of telemedicine had to visit a hospital for further treatment. New age healthcare delivery mechanisms, particularly telemedicine, can also take advantage of the deeper penetration of internet technology and lower data costs. Assisted telemedicine is the presence of healthcare workers like paramedics or nurses in remote areas who help villagers connect with a doctor through teleconferencing or video conferencing to better assist the patient and may also help the patient in getting necessary diagnostics tests done and relay the results to the doctor, again through the use of technology.

While simple telemedicine system has its relevance, assisted telemedicine has certain clear and distinct advantages for the patient community in smaller places. It is also more suited in the Indian context as literacy levels in rural areas are abysmally low. Hence, it is bringing about a paradigm change in the healthcare delivery system in the country. The cost of creating healthcare infrastructure, operational logistics, and skilled resources running into lakhs of crores. It is estimated that 70 percent of expenses on healthcare are out-of-pocket. Approximately 7 percent of the population annually plunges below poverty line due to healthcare costs. With government expenditure on healthcare being only 1.2 percent of GDP it will still take some time for the services to effectively reach the rural areas. However, with assisted telemedicine the healthcare needs of rural population can be addressed quickly at a much-reduced cost. Assisted telemedicine-based systems will not only be a complimentary and effective way of healthcare delivery to government PHCs and CHCs, it is also in line with the government vision of digital India. Internet connectivity and technological advancements, including better quality of audio video transmission, has made this a revolutionary system in terms of costs.

Despite all its challenges, India is on the right track with renewed focus on rural health. What wasn’t a topic of discussion till some time back is now in the spotlight, thanks to the announcement of Ayushman Bharat. However, the various stakeholders need to be sensitized to help them understand the potential impact the system can have on Indian healthcare. The foremost challenge is the belief that assisted telemedicine will be replacing physicians. This belief is unfounded as this system is designed to create larger impact on the existing doctor base and will help the medical fraternity to become a larger force. An important aspect of telemedicine also is the dissemination of medical knowledge and spreading awareness through telecommunication to remote areas. Also, the strength lies in the integration of assisted telemedicine with new and existing healthcare infrastructure. This will of course require enhancement of the technical know-how of medical staff dependent on old systems. It has been found that doctors and medical staff are more tech-savvy than generally believed. Technology, however, can only assist and make our jobs easier. It cannot replace the human warmth that one can extend to those who are in need. – The Hindu BusinessLine

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