When COVID 19 hit the world with unprecedented force in early 2020, medical services globally were forced to step up their game, in the hope that staying ahead of the curve, may help flatten it.

Along with its arsenal of early diagnosis, contact tracing, vaccine and drug development focused on COVID 19, the medical community faced another challenge. How do patients of chronic illnesses, trauma or acute symptoms other than COVID get access to medical health, without risking a trip to the doctor’s office or the hospital? The healthcare industry in India, had to learn to adapt rapidly given the increasing spread of the virus, turning their attention to IOMT.

The Internet of Medical Things is a connected infrastructure of medical devices, hardware, software applications and health systems, which when combined serve as a powerful tool to improve access to healthcare. The generation of larger pools of patient data, stored in cloud platforms or internal servers, accessible to healthcare providers, is a pivotal stepping stone in the evolution of the healthcare ecosystem. This resulted in improved connectivity to long term patients, especially those in remote areas, or elderly patients with co-morbidities.  Application of IOMT devices and technology ramped up as the industry struggled to keep up with patient influx and disease management in the background of a global pandemic, with lockdown measures, transportation difficulties and resource scarcity.

This led to many innovative applications, of which the most impactful are:

Telemedicine

The growing popularity of online consultations through common applications like Whatsapp, Face Time, Zoom (providing text, video or audio-based communications) or other patented appointment management platforms have put faces to names for healthcare workers and patients. It has shown to have a positive outcome with patient compliance and engagement. Tele-health systems for virtual consultations will probably be a constant feature of the digital medical world, as physicians have found it to be very useful and cost-effective, calling the patients in only for investigations or interventions if required. Patients are agreeable as it cuts down waiting time in clinics or outpatient departments, as well as travel time from remote areas.

We have seen robust telemedicine systems capable of managing chronic disease, maintaining patient follow up, aid in diagnosis and rapid treatment, while protecting both patients and healthcare workers from each other during the COVID crisis. This model also helps to conserve the use of personal protective equipment, medical supplies and bed space, in a situation where they are scarce, keeping low-risk patients at home to be managed conservatively.

This was a large grey area, in India, until the COVID crisis helped to fast track the regularization of telemedicine, leading the Medical Council of India to release nationwide guidelines in May 2020[1] giving detailed standard operating procedures to the practice, enhancing confidence and credibility

Robotics

As person to person transmission rose, robots were sent into hospital rooms to do basic procedures like taking temperature, dispensing medication, decreasing face to face interactions with suspected or proven COVID positive patients.

Application of Electronic Health Record Data

 Work on Electronic Health Records had started in first world countries quite some time ago. It has already helped to streamline medical records and patient histories, suitable for health systems that are largely dependent on insurance companies or state-provided healthcare.

Data provided from updated EHRs though has helped the medical community to track patterns of COVID symptoms and progression of disease in massive patient populations, adding to research efforts as we try to find out more about the virus and work towards vaccine and drug trials. It also helps with contact tracing through a detailed history, and therefore cluster identifications.

Chat Bots

Hospital or clinic websites updated chatbots, initially to help patients with immediate advice, to reduce physical visits. They showed the potential to help patients even further, as artificially enhanced chatbots could answer specific disease-related questions from patients to provide them with timely, verified information.  

Wearables

Sensor-based wearables help in monitoring patient status while maintaining social distancing and stay- at home guidelines, ensuring quarantine compliance. It makes it easy for physicians to track patient progression and can include pulse, blood pressure and pulse oximetry monitoring, for faster diagnosis of symptoms. Enhancing m-health technology, wearables generated data linked to mobile applications or transmitted to physician accessible databases, wearables providing patients with the convenience of mobility under continuous virtual supervision and real-time data to doctors and researchers.

Telehealth for Education

Social distancing measures ensured that workplaces and colleges were disrupted and traditional means of disseminating knowledge and information moved to the virtual space, with webinars, video conferencing, virtual reality and social media platforms.

Barriers to digital healthcare

While the advantages of getting patients more involved in the delivery of their healthcare, has had a relatively positive outcome for both providers and patients, many are sceptical about the quality of care they may receive. They believe that a doctor’s physical presence for an examination is necessary, and maybe reluctant to participate in online consultations if they do not have privacy at home. Education and IT support is also required, especially for the older generation who may require training if technologically challenged. Millennials are unsurprisingly more comfortable with the digital process. Even though teleconsultation is touted as a solution to the current times, there are concerns about patient confidentiality and data record protection.

 COVID 19 led to an unimaginable loss of life and economic strife. However, the quick adjustments the medical community had to make in order to survive has galvanized a new outlook towards e-health and telehealth, carving out a new normal for the future of healthcare delivery.

 References

1. Telemedicine Practice Guidelines Enabling Registered Medical Practitioners to Provide Healthcare Using Telemedicine [Appendix 5 of the Indian Medical Council (Professional Conduct, Etiquette and Ethics Regulation, 2002] 2020 https://www.mohfw.gov.in/pdf/Telemedicine.pdf