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The use of technology in healthcare has expanded rapidly as smartphones and digital devices have become more accessible to the general public. Telemedicine in particular has enabled better healthcare service and capacity in primary healthcare, in a country where the healthcare workforce is inadequate and unevenly distributed, leading to disparities in health access and outcomes. As COVID-19 spread throughout the globe, while we saw communications technologies minimizing the barriers of restricted travel and social distancing, they also became critical for ensuring the wellbeing of large swathes of the population. A primary healthcare system is the first line of defense for the healthcare system and fields the health concerns of most of the population. With the spread of COVID-19, it became imperative to rapidly increase primary healthcare capacity through telemedicine to help continue essential health services while also addressing the rising infections. A surge of teleconsultations was seen in established platforms. Apps such as Practo sometimes saw an over 100% rise in teleconsultations week by week, a trend that was observed across the world. COVID-19 had created a void of primary care access that everyone rushed to fill.
To better understand the resulting telemedicine landscape, Swasti Health Catalyst conducted a landscape study on the available COVID-19 helplines across the country. The study covered helplines with a range of target beneficiaries, including COVID-19 positive individuals, the general public, pregnant and lactating women, senior citizens, low-income individuals, and other vulnerable groups. The helplines were also diverse in terms of services offered: Some were focused on mental health, and others designed to help supply food and medications. As the results from the study took shape, they raised key questions: Are telemedicine services truly building capacity for primary care? Are they an effective channel to provide critical information in a crisis situation? What can we learn from the way telemedicine was deployed during the initial phase of the pandemic?
While analyzing the case stories of these helplines, recurrent themes emerged, which are described below.
Conclusion
The challenges and nuances outlined above, including the technological problems, the diversity of community member queries, and the limitations of risk assessment are solvable, and in many cases have been solved. Enabling organizations, entities, and agencies working on telecare solutions to coordinate and learn from each other will serve both them and the targeted communities by ensuring that efforts are not duplicated, patients' needs are met and resources are utilized optimally. These lessons and the infrastructure created will both support the system through the pandemic, but also strengthen existing primary care avenues that serve communities, pandemic or not.
Nilakshi Biswas is a Technical Specialist working on research at Swasti Health Catalyst. Savinitha Prakash is a Medical Officer and Technical Specialist at Swasti.