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COVID Pandemic- Transforming the Future of Rural Healthcare

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Dr Saurabh Chawla is a renowned clinician and founder of Docterz.com, an exclusive video consultation platform that has established itself with 1000+ eminent doctors. The platform currently records an average 7000+ unique personal consultations monthly.

Bollywood has given most of us a stereotypical image of Rural India. Either we relate it to struggling former as in mother India or we imagine sunflower fields of DDLJ. But in reality, there is much more to experience. During a few years of my service at rural health facilities, I had an opportunity to closely peep into rural healthcare as well as social structure. One can find the great disparity between rural areas spread across the country. These differences can be owed to socio-economic structure, monetization value of the crop and the state to state-changing government policies. Nevertheless, there is one thing that is omnipresent, and it is the Aspiration.

The youth of Rural India has aspirations similar to those of anyone in Urban India. They want best of healthcare services and facilities alike their counterparts in cities and towns. The Indian states like Punjab, Haryana which have high per capita formal income boast of villages which are semi urbanised. In most of their households, you can easily find DTH boxes and smartphone devices. With the new generation being increasingly tech-savvy and gadget savvy, acceptability of online shopping and online transactions has increased manifold.

All was going to hale and hearty when COVID pandemic entered our lives in early 2020. A miniature virus, invisible to the naked eye, has brought down the most intelligent species on the planet on its knees. This led to the imposition of lockdown. Finding opportunity in adversity is the nature of humankind. The whole world started looking for options to carry on their daily tasks without getting affected by the pandemic. Telemedicine or Telehealth emerged as one such solution in these testing times.

Telemedicine includes, but is not limited to, online consultation between doctor and patient over a digital platform. This can be done in two ways, one is through personal video calling and secondly by registering oneself on an online doctor portal. This method of communication is very time and resource-saving as the patient does not need to travel and wait outside the doctor's clinic. All they have to do is book an appointment with the doctor online, by paying the fee and check in the app at the time allotted. This has been a great boon in the COVID pandemic as online consultation saves patient from unnecessary exposure to infections at the hospital or during the travel for the same. Similarly, the doctor saves themselves and their staff and patients from similar exposure.

Telemedicine was available for the last few years but was not popular amongst the masses. But with guidelines by the government of India and the erstwhile MCI along with the availability of affordable data connectivity, the field of telemedicine is gazing towards exponential growth. The credit of rising of telemedicine goes to the COVID pandemic but it is definitely going to be a game-changer in rural healthcare. It is not a hidden fact, that the health infrastructure in rural India is inadequate and overburdened. Apart from government hospitals and dispensaries, one can hardly find any medical specialist in most of these areas.

Ignorance and mushrooming of quackery add to the woes of rural patients. Solving this problem, over the last few years, various online portals have come up, where one can find a medical specialist for online consultations. Similarly, many doctors are available on various social media platforms like WhatsApp, Instagram for consults. Furthermore, specialised portals like DOCTERZ.COM, PRACTO, DOCSAPP provide a more refined list of doctors to consult online. Nevertheless, many state governments have already started providing online consultation to the patients. This has greatly increased acceptability of the concept, amongst both, doctors and patients.

Furthermore, governments can use this medium to provide mother-child health services to pregnant ladies and their newborn kids. The government can also utilise telemedicine to provide health services and guidance to adolescents under programmes like ARSH. As per my opinion, a centralised command centre should be established where specialists can be employed to provide online consultations to patients visiting various peripheral government health facilities, under supervision of healthcare worker at that facility.

This will greatly reduce the cost both for the patient and the provider. Moreover, timely intervention by early screening and detection will be possible. Indeed at many places ICUs are being monitored by intensivists from a centralised command centre. Lab investigation and radiological reporting are also being done over a Telehealth portal by experts sitting far away. As we get to see new gadgets every fortnight, time is not far when we will get to carry smartphones or fitness bands which can monitor armature health parameters and share them with the doctor in real-time.

But things are not as simple and easy as they appear to be. One needs to understand that the good connectivity across the country is still unavailable, hence, the digital infrastructure needs to be strengthened. Also, the mobile apps or portals should be user-friendly, most importantly in vernacular languages, only then a revolutionary transformation in rural healthcare is possible. Another aspect which needs attention is payment