Post Covid: What will change in healthcare: Tele tele everywhere

When we started Teleradiology Solutions over a decade and a half ago, it was unheard of. The concept was new, untested. Radiologists were raw, untrained, unused to this new way of reporting diagnostic scans which was very different than being in person in a hospital. Bandwidth was expensive, unreliable and weak. However, pre covid-it had become a well oiled global teleradiology healthcare practice with smooth and robust IT enabled, radspa enabled workflows.  And Radiologists typically worked part or full time from home as per their personal preference. So when the 4 hour notice lockdown hit India, we could keep working-from homes in India, from homes in America, from homes globally. Suddenly, everyone realised the potential benefits of what we had been doing for what seems like forever!

As we have been touting for a while, teleradiology makes a lot of sense-allows one radiologist to cover multiple hospitals, avoids the time spent on commuting making the radiologist more productive, reduces traffic on the roads and one’s carbon footprint, allows for great life work balance and in times such as this pandemic, allows a radiologist to continue to read patient scans without the risk of getting infected. This last benefit will probably apply even post the pandemic. A small team of radiologists on site in hospitals for ultrasounds or interventional work and the vast majority working from home can help keep rads safe and our collective carbon footprint low. A weekly group meeting in house or on a digital platform can keep everyone connected, as is being done now in many organisations. In March 2020, a radiologist blogger Barry Julius said he sees the pandemic as a “wake-up call” to allow more of his peers to work from home and once the Covid dust settles, he predicts a “sea change” in the specialty. This new reality will include universal teleradiology. So, post covid, teleradiology will likely go from being used by some hospitals and docs to being used by all.

March 25th, 2020 will go down as a red letter day in the history of telemedicine in India. It is the day the Ministry of health of the government of India officially and finally made teleconsultations legal in India. Until then, there was ambiguity and fear among doctors. As recently as May 2019, in our state, the Karnataka medical council advised doctors against engaging in online teleconsults as it was “illegal”. It took a virus and the central government of India to get the council to take a U turn on their stand and legalise telemedicine.

The legalisation of telemedicine has led to doctors scrambling to get online, companies rushing to market their apps and tele health platforms, and every tele health platform scrambling to on board more doctors and capture market leader position with patients. At our RXDX clinics in Bengaluru (http://www.rxdx.in), tele consultations have jumped up ten-fold from 10 per day to over 100 per day during this pandemic.

The benefits of telemedicine in today’s Covid world are obvious-doctors can see their patients without the risk of getting corona, patients can see their doctors even during a lockdown and without the risk of being in a crowded clinic or hospital. This also allows for social distancing at the hospital with only those doctors and those patients who actually need to see each other physically being present. Post Covid, I think digital teleconsultations, while perhaps not as many as are currently happening, will continue to be an avenue for doctors and patients to connect with each other from home, without either having to deal with our infamous traffic.

I have been running an e-teaching program in Pediatric cardiology for post graduates since 2010. When we first started with support from Childrens heart link (https://childrensheartlink.org), there were plenty of naysayers-the clarity is poor, the students can’t learn on a digital platform, face to face is very important blah blah blah. Precovid-Ten years and 750 eclasses later, this is the longest running free tele teaching program in Pediatric cardiology, today in partnership with the Pediatric cardiac society of India (https://pedicardioclasses.net). The technology has smoothened out, the students love it and one teacher is able to create content for students across the country and world.

In the post Covid world, all doctors are either attending e-lectures or giving e-lectures. It is now mainstream. Teaching in medicine will never go back to being the same. The importance of lecture halls and conferences will reduce, online digital medical teaching in all specialities will take center stage this decade.

We have been doing tele gym classes with an instructor in Manipur recommended by Dr Chhavi for a few years now. The biggest advantage for us was that we could do our class from anywhere in the world when we were travelling. Wifi and whatsapp video and we were all set with our live personal gym trainer! Today, post Covid lockdowns, the world has moved to fitness and yoga sessions online. The joy of not having to deal with traffic in an attempt to get to a gym has now been discovered. Even the yoga gurus have been doing digital meditation for their thousands of followers. At our office, during this pandemic, we initiated free online physiotherapy, fitness, counselling (both mental and nutritional) sessions for our staff and their families. Post covid, this will hopefully be a way to have everyone maintain health and manage their exercise routines-from home, from hotel rooms, from anywhere.

As every whatsapp forward is predicting, the world will not be the same post the pandemic. And the same will apply to doctors, patients, fitness providers and the overall health care ecosystem. Tele, tele everywhere. A little virus has indeed managed to cause a big change in medicine.

Author: Dr Sunita Maheshwari (Paediatric Cardiologist, Chief Dreamer & Loop Closer) – Teleradiology Solutions.