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Written by Vijay

The crisis caused by the rapid spread of the Covid-19 virus has severely impacted the functioning of the medical fraternity. The several months long lockdown meant that patients were unable to seek treatment for their ailments and elective surgeries were getting delayed. Patients sought only emergency care. Not only were doctors and hospitals busy with the crisis caused by the constant flow of patients inflicted with the virus but we also saw patients hesitating to seek appointments with their doctors due to the fear of contracting the virus. This is where Teleconsulting or Video Consulting became more popular as a means of replacing in-person consultation. After a year, both doctors and patients ask alike if Teleconsulting can ever replace or be a substitute for in-person consultation. The answer would be ‘maybe in some cases”.

Challenges for patients and providers

One of the biggest challenges for patients has been to understand how Teleconsulting works. Technologically challenged patients, patients from remote areas with less than reliable internet or steady source of power could not move easily to Teleconsulting. Another challenge for everyone was to understand what happens when they login and are kept waiting by doctors because they are delayed. How can the patient be kept engaged? Can information about the availability of the doctor be given in real time? Can the doctor’s assistant or someone from the clinic login on time and talk to the patient till the time the doctor becomes available? If this is not possible, can a message be sent to the patient in advance that the doctor may be delayed. Can a pre-appointment assessment be done? A lot of information can be collected ahead of the appointment. Can all of this be converted to a virtual waiting room that is 100% safe from the virus.

The lockdown also ensured that patients had to use an online appointment system or make a call to book a video consulting appointment – both of which could prove difficult because very few doctors have the feature of booking online appointments for their patients. We strongly urge all doctors to have their own web presence with the feature of booking online appointments (including Teleconsulting appointments). Patients will find it easy to reach them at all times on a 24*7 basis. An additional challenge was the “trust’ factor. Patients wondered how they can trust their doctors when they could not see them in person. This problem was partially resolved due to the fact that smart phones and social media sites allow us to be in touch with our loved ones over video calls.  

How to get the best from the virtual consultation?

It is still doubtful if we can replace in-person appointments with Teleconsulting. In some cases it may not be effective at all as compared to an in-person appointment. In the case of small children it could be very difficult. In such cases doctors may ask the patient to seek an in-person appointment. Proper website use/digital manners greatly help in an effective Teleconsulting appointment. Eliminating background noise/distractions, longer pauses, being in the centre of the video frame, glare reduction and correct level of sound settings for the hearing challenged can make the entire experience pleasant for both parties. Taking a call from home or a familiar setting puts the patient at ease. The additional stress of travel and costs associated with that can also be positives.

It is still too early to say if similar levels of clinical outcomes are achieved by in-person and Teleconsulting. Nevertheless Teleconsulting is here to stay. A recent study in the US indicates that 20-25% of all care would be delivered remotely.

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