On March 24, 2020 in the evening, at the very beginning of the pandemic. There are about 500 cases of the new coronavirus in India, the most populous country in the world after China. India’s Prime Minister Narendra Modi announces the world’s largest nationwide lockdown by ordering 1.3 billion people to stay at home for 21 days. The measure takes effect four hours later.
Anxiety sets in in the population. As several hospitals close their ambulatory care services, access to the already underfunded healthcare system is becoming more difficult than ever. Especially since the country has hundreds of millions of people living in poverty, many of them in overcrowded urban areas.
From the first day of confinement, the Ministry of Health and Family Welfare publishes the first guidelines for the use of telemedicine, which was not yet clearly legal and whose attempts to implement it on a large scale had been unsuccessful.
In Gurugram, just 30 kilometers southwest of the capital of New Delhi, Dyvia Laroiya is embarking on the marathon of her career. The entrepreneur and co-founder of MyHealthcare — a health technology start-up launched in 2017 — and her team have been working around the clock for three weeks to develop a virtual consultation platform.
Until now, their mobile application only allowed to make an appointment for an in-person consultation. After launching its new feature, the young shoot recorded an average of 2000 virtual consultations per day.
Two years later, telemedicine apps like MyHealthcare are commonplace in India: since the pandemic, they have multiplied to meet unprecedented demand. The health system is transformed.
Accept technology
Myhealthcare’s offices, located in a large glass building, overlook downtown Gurugram. The 1.7 million inhabitants of this city, its shopping centers and its beautiful roads contrast with the chaos and the ambient poverty of certain districts of New Delhi.
Inside, in a large teleworking space, the atmosphere is one of productivity and innovation: the employees, mostly young, hold meetings and brainstorming sessions. Despite her schedule planned to the minute, Dyvia Laroiya, 48, is happy to stop to reflect on the past two years.
“There has been a major change in India since the pandemic. Digital healthcare was not a reality and our population felt the need to be seen and examined in person,” she explains to the To have to.
The entire health system was slow to embark on digitization. The co-founder says that before the crisis, she had to drag her three thick paper files during her medical visits: “My doctor told me jokingly: which book should I dive into today? »
Digital medical records are much more common now. “The technology is much more accepted than before the pandemic. Before, prescriptions were all done by hand, whereas today, hospitals find value in digital prescriptions. They no longer get lost in the system and it’s easy to pass them on to patients,” she summarizes.
Nearly 25 million patients—nearly three times the population of Quebec—and some 100 private hospitals still do business with the start-up today. Because despite the return to normal and the costs to be paid, many patients who used these services during the pandemic have not gone back.
“Many patients find it convenient to save time by avoiding travel. It is no longer necessary to wait in waiting rooms. Even today, many of them opt for an initial face-to-face consultation with a doctor, but all their follow-ups are done remotely,” explains Dyvia Laroiya.
Replace in-person consultation?
More than 2100 kilometers south of Gurugram, we arrive in Bangalore, the “Silicon Valley” of India. The city of 13 million inhabitants, with its palm trees and tropical climate, is highly renowned for its IT hub.
The hundreds of high-tech companies located there can take advantage of the many modern cafes, bars, pubs and restaurants the city has to offer — provided you brave the endless traffic that paralyzes the roads. Traffic congestion can cause motorists to lose hours every day — an incentive for many to teleconsult.
About 15 minutes from the city center are the offices of the start-up MFine, which employs 300 people and has become one of the most popular telemedicine applications in the country. Sitting at the end of a long white table smeared with notes written in erasable pencil, Prasad Kompalli, dressed in a white polo shirt, takes out his cell phone.
The CEO and co-founder of the start-up founded in 2017 opens its MFine mobile app. Many key services are displayed on the interface: a virtual consultation, home medical analyzes or even assistance for COVID-19. The application also allows you to measure your blood oxygen saturation level and heart rate without an external device.
It takes a few minutes to book a virtual consultation with a doctor or specialist from an affiliated hospital after switching to virtual triage. This consultation costs about ten US dollars.
“From the start, there is an artificial intelligence that interacts with you. You must indicate the reason why you want to consult a doctor, what your symptoms are and how long they have persisted”, summarizes the co-founder, who is approaching his fifties.
Between 70% and 80% of medical consultations can be managed by telemedicine if the platform is adequate
Mr. Kompalli is aware of this: India’s digital healthcare revolution can never replace emergency medical care. If the user’s answers indicate a possible medical emergency, the application will recommend that they go directly to the hospital. This occurs for about 7% of consultation requests, estimates the CEO
Other medical issues, such as recurrent infections and medication adjustments, can be handled remotely. “Between 70% and 80% of medical consultations can be managed by telemedicine if the platform is adequate,” he estimates.
At the height of the pandemic, 1.5 million patients were using the app each month. Today, the app registers 750,000 monthly users, which is still twice as high as before the crisis, according to Kompalli.
A national program
As apps from private companies took off at the start of the pandemic, the Indian government also launched its national teleconsultation service. The creation of the new platform will have taken 19 days. On April 13, 2020, the public service, eSanjeevaniOPD, was launched.
Unlike private applications, the government initiative does not allow consultation with specialists and waiting times are longer, but the service is free for citizens. Here too, the pandemic has propelled interest in the application, which today has enabled more than nine million teleconsultations.
That said, despite the transformation catalyzed by the crisis, there are many obstacles that are hindering the establishment of large-scale telemedicine in India. Confidentiality, data security and diagnostic errors remain concerns for many patients.
Added to this is the low digital literacy of physicians and patients, says Dr.D Haleema Yezdani, a general practitioner who accumulates several years in private practice with telemedicine. Met in Bangalore, the latter observed that many Indians still have difficulty navigating mobile applications. This lack of digital literacy is even more acute in rural areas of the country, where poverty, lack of reliable internet access and illiteracy are common.
Despite everything, she is enthusiastic about all the progress made since the pandemic. “The change that would have happened in ten years has happened in the last two years,” she says. With more training [aux médecins et à la population]it could be a game changer for the future. »
This report was financed thanks to the support of the Transat International Journalism Fund.The duty.