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LETTER TO EDITOR
Year : 2020  |  Volume : 9  |  Issue : 4  |  Page : 379-380

Promoting teleconsultation in the coronavirus disease era Sir,


1 Department of Community and Family Medicine, AIIMS, Guntur, Andhra Pradesh, India
2 Department of ENT and Head and Neck Surgery, AIIMS, Guntur, Andhra Pradesh, India

Date of Submission21-Jul-2020
Date of Decision24-Jul-2020
Date of Acceptance14-Aug-2020
Date of Web Publication15-Oct-2020

Correspondence Address:
Dr. Satvinder Singh Bakshi
Department of ENT and Head and Neck Surgery, AIIMS, Mangalagiri, Guntur - 522 503, Andhra Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijhas.IJHAS_169_20

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How to cite this article:
Kalidoss VK, Bakshi SS. Promoting teleconsultation in the coronavirus disease era Sir,. Int J Health Allied Sci 2020;9:379-80

How to cite this URL:
Kalidoss VK, Bakshi SS. Promoting teleconsultation in the coronavirus disease era Sir,. Int J Health Allied Sci [serial online] 2020 [cited 2020 Oct 21];9:379-80. Available from: https://www.ijhas.in/text.asp?2020/9/4/379/298114



Coronavirus disease 2019 (COVID-19) has wreaked havoc on the health-care system around the world. Not only has the pandemic taken a toll on the infrastructural capacity but also many health-care workers themselves have sacrificed themselves in this battle. The main transmission of the virus is through contact and in such a scenario, teleconsultation has great potential as it permits us to give supportive care while minimizing contact with patients. However, certain barriers exist. For example, patients may be willing to consult only the health-care provider with which they have previously established a relationship with or patients may be unaware of the option of teleconsultation. Furthermore, patients may be reluctant to use new technology and stick to the old way of interacting with the health-care system and there may be lack of resources for accessing teleconsultation.[1],[2]

The usefulness of teleconsultation for patients with chronic illness such as asthma[3] and diabetes[4] has already been proven. These people are more susceptible to COVID-19 and teleconsultation can be done. In addition, teleconsultation may help in identifying suspected patients with COVID-19 infection. The consultation can be further enhanced with home measurement of temperature, pulse, and respiratory rate. The health-care professional can also observe the general condition such as pallor, use of accessory muscles for respiration or labored breathing, presence or absence of cough, look for congestion of the oropharynx, and ask the patient to examine his/her neck for lymph node enlargement. A judgment can be made as to whether the patient needs further testing, and a plan of management including notification of appropriate authorities can be drawn up. This technique has several advantages such as reduce the exposure of health-care professionals and the community, reduce the load of health-care professionals in the field, allay the fear of many patients who think they may be suffering from the infection, and help in the judicious utilization of the already-scarce resources.

There are, however, certain challenges such as the need for more technical training and equipment for both the health-care professionals and patients, reduction in care continuity of patients as the follow-up of a patient may be with another health-care provider who may not have access to the patients records,[1] the policy on health insurance claims via telemedicine is also not clear, and the patient may not be in a position to choose the physician of his/her choice; in addition, there is still a chance of misdiagnosis and wrong treatment being offered to patients.[1] The present pandemic has given an impetus to telemedicine, and these challenges will eventually be overcome in the near future.

We, as health-care professionals, can promote teleconsultation by educating patients about the usefulness and efficacy of teleconsultation as an alternative to visit the health-care provider, helping them to understand how teleconsultation work and give them instructions on how to use it. Lastly, it will help generate resources and workforce for making the process cost-effective and smooth. The pandemic has given us an opportunity to strengthen and develop novel ways to provide teleconsultation, and this will help us not only after the pandemic is over but also if another pandemic or disaster arises in future.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Almathami HKY, Win KT, Vlahu-Gjorgievska E. Barriers and facilitators that influence telemedicine-based, real-time, online consultation at patients' homes: Systematic literature review. J Med Internet Res 2020;22:e16407.  Back to cited text no. 1
    
2.
Well A. Telehealth Index: 2019 Consumer Survey 2019. Available from: https://static.americanwell.com/app/uploads/2019/07/American-Well-Telehealth-Index-2019-Consumer-Survey-eBook2.pdf. [Last acessed on 2020 Apr 5].  Back to cited text no. 2
    
3.
Chongmelaxme B, Lee S, Dhippayom T, Saokaew S, Chaiyakunapruk N, Dilokthornsakul P. The effects of telemedicine on asthma control and patients' quality of life in adults: A systematic review and meta-analysis. J Allergy Clin Immunol Pract 2019;7:199-216, e11.  Back to cited text no. 3
    
4.
Timpel P, Oswald S, Schwarz PE, Harst L. Mapping the evidence on the effectiveness of telemedicine interventions in diabetes, dyslipidemia, and hypertension: An umbrella review of systematic reviews and meta-analyses. J Med Internet Res 2020;22:e16791.  Back to cited text no. 4
    




 

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