key: cord-1052923-6ek2kme2 authors: Das, Payal; Rahi, Manju; Sharma, Amit title: Deployment of telemedicine as another mitigation tool during the ongoing COVID-19 catastrophe in India date: 2021-07-29 journal: Public Health Pract (Oxf) DOI: 10.1016/j.puhip.2021.100167 sha: 3113738bb843fbad444b9d7e8f37e21037698763 doc_id: 1052923 cord_uid: 6ek2kme2 Healthcare systems in resource scarce countries continue to face unprecedented challenges due to the COVID-19 pandemic, including saturation of healthcare system capacities. Data suggest that medical staff deployed for COVID-19 containment are at higher risk of exposure and thus greater susceptibility to infection, further decreasing the available workforce. Telemedicine, as an additional healthcare delivery approach, can circumvent hospital visits of non-critical COVID-19 patients and thus reduce exposure of both providers and non-COVID-19 patients. Widespread implementation of telemedicine at this watershed moment for healthcare system in India will establish a new public health alternative that can cater to the COVID-19 pandemic and beyond. clinic-epidemiological surveys, a increasing proportion of the Indian population, including in 26 the rural areas, remains vulnerable to acquiring SARS-CoV-2 infection, as is evident from the 27 second wave of infections. [1] The onslaught of the second wave in India in 2021 has 28 pushed the capacities of its healthcare system beyond limits in many foci. The medical 29 infrastructure in India is under intense pressure due to the vast numbers of critical patients. In addition to risks from exposure to COVID- 19 Telemedicine has other notable advantages. Besides reducing exposure of providers to 51 SARS-CoV-2, widespread implementation of telemedicine can also contribute[3]to COVID-52 19 mitigation via: (1) "Forward triage" i.e., sorting patients before arrival in emergency 53 departments (2) fast tracking of mild cases to obviate hospital visits (3) scheduling visits of 54 non-respiratory symptom patients to reduce peak load in COVID-19 times (4) leveraging 55 access to wider range of medical specialists (5) round the clock remote clinical care, 56 especially when physical access may be unfeasible due to lockdowns or poverty (6) online 57 pre-screening based on medical records and diagnostic tests (7) healthcare centres (and cater to ~50 thousand). An essential provision of deploying 90 telemedicine countrywide in India will be its availability to all levels of healthcare system as 91 India's graded system necessitates establishments of virtual networks for primary, secondary 92 and tertiary care. Thus the COVID-19 crisis presents an opportunity to consider investment 93 into telemedicine that can provide equitable medical access to all levels of social organization 94 in India and other countries with imbalanced health systems. 95 96 Telemedicine-specific developments and subsequent deployment of information technology 98 is the backbone of telemedicine. [9] Nationwide rollout of telemedicine will have to cross 99 will need to be integrated, (b) technological barriers that include lack of hardware and 101 software required for digital integration, (c) legal barriers where clarity on digital 102 prescription, malpractice liability and insurance claims will need to addressed, (d) financial 103 barriers for the initial establishment of telemedicine networks, and (e) social barriers wherein 104 patients may be resistant towards adopting virtual consultations given the comfort feeling 105 associated with direct contacts with medical professionals. However, since COVID-19 has 106 necessitated both sudden infusion of financial resources and urgent rollout of uniformity in 107 national public health policies in many countries, the time is ideal for overcoming any 108 obstacles in the road towards telemedicine universality. 109 110 The current COVID-19 crisis worldwide provides an opportunity to circumvent the usual 112 inertia and lassitude in adoption of new healthcare provisions. It is apparent that telemedicine 113 is a disruptive technology whose expansion and widespread implementation can play a 114 decisive role in public health. The investments in public health management due to COVID-115 19 emergency must provide sustainable and strategic solutions so that once this scourge 116 recedes or diminishes, the national healthcare infrastructures it leaves behind can be 117 redirected easily towards the provision of quality healthcare. Thus, expansion of telemedicine 118 will contribute not only towards better COVID-19 patient management in India but will also 119 bear fruit in coming times for the health of other nations. 120 121 122 A prospective 158 observational study of clinico-epidemiological profiles and associated risk factors of 159 SARS-CoV-2 positive patients from India Virtually Perfect? Telemedicine for Covid-19 Telehealth for global emergencies: Implications for coronavirus disease The COVID-19 pandemic: Major risks to healthcare and other workers on the 178 front line Racial Capitalism: A fundamental cause of Novel Coronavirus 181 (COVID-19) pandemic inequities in the United States This time must be different: Disparities during the COVID-19 183 pandemic The only 186 solution for better healthcare during COVID-19 Pandemic? Indian Heart JEpub 2020 Evaluating barriers to 190 adopting telemedicine worldwide: A systematic review Not applicable 138 The authors declare that they have no conflict of interest. 141 J o u r n a l P r e -p r o o f ☒The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.☐The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.