K. Ganapathy
Director,
Apollo Telemedicine Networking Foundation and Apollo TeleHealth Services

Remote Healthcare: A Reality In 2019

2019 is the last teen year of this century. It is only fitting that the telehealth space (as a clinician I do not like the term industry!) is on its way to becoming a young adult with unbelievable growth potential. Not even in the lifetime of my great grandchildren will we have enough brick and mortar hospitals, GPs, specialists, nurses, paramedics, hospital beds, diagnostics, pharmacies, or ambulances, to cater to 1.3 billion people. Even the hitherto skeptical cynic now accepts that ICT (information and communication technology) is the only way to bridge the urban-rural health divide. 5G, drones, AI in healthcare, quantum computing, are all likely to make their presence felt in the coming decade.

Lest the readers think that I am living in a non-existing Utopia I wish to give concrete examples to illustrate that the future is not tomorrow but today. Pilots and proof of concept studies in telehealth have been replaced by large projects commissioned by various state governments in a PPP mode. Apollo Telehealth Services is running three centers in Himachal Pradesh in mountainous, treacherous, isolated areas. In 40 months 13,3000 teleconsults have been conducted  including 1025 tele emergencies. In Andhra Pradesh of the 0.6 million who have visited 164 eUPHC in 26 months almost 10 percent have had specialist consultation in the PHC itself. The Mukhyamanthri Eye Kendra project has 115 vision centers. In just 10 months 0.65 million have had an eye checkup. This included 165,000 remote fundus examinations by 30 ophthalmologists located in Chennai. At the National Thermal Power Station located in a disturbed area in remote Assam 2600 teleconsults have been provided, including 520 emergencies.

In a CSR initiative funded by an MNC, 740,000 individuals have been screened over 40 months. Of this 14,500 have been provided with real-time teleconsults in a camp mode. Similar projects are starting under the tutelage of the Government of Jharkhand and Uttar Pradesh. The World Bank is funding a mega project to develop 7500 electronic health sub-centers in Andhra Pradesh. Telemedicine facility would be available in all these centers. The Indian Navy is in the process of providing virtual healthcare across the seas on its ships. `65 crore was earmarked for this in 2015. ISRO is assisting the Indian Army in reaching the unreached. Geography has become history. Distance is becoming meaningless. Hospital CEOs need to realize that the time has now come for every hospital/clinic/diagnostic center to make available facilities for virtual teleconsults.

In a 2012 interview with Wharton Business School, I had stated estimates suggest that the telemedicine market is at least for 800 million Indians. Even if half of these 800 million need to consult a specialist once a year, that still amounts to 400 million specialist consultations per year. Even if 10 percent of these are enabled through telemedicine we are talking about 40 million consultations per year from rural India alone. The market potential for telemedicine is obviously enormous. Experts have valued the telemedicine market for Asia-Pacific in 2019 as `63,000 crore. The very fact that there are multiple detailed market reports available predicting a CAGR of 18 percent in the telehealth market, indicates that telemedicine will eventually reach center stage. Reducing physical footfalls and increasing virtual consults to anyone anytime anywhere may actually increase RoI. As early as 2016 Kaiser Permanente, one of the largest healthcare organizations in the US announced that virtual visits had exceeded physical footfalls. We ourselves are facilitating almost 3000 tele consults every day. I look forward to adding another zero at least, in my lifetime.

Telehealth has at last come of age. The journey has been slow but the wait was worthwhile. In 2019 as we get out of our teens we will surely reach that critical mass essential for a successful take off.

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