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COMMENTARY
Year : 2021  |  Volume : 69  |  Issue : 2  |  Page : 352--353

Telemedicine: An Integral Part of Clinical Neurosciences

Krishnan Ganapathy 
 Apollo Telemedicine Networking Foundation, Chennai, Tamil Nadu, India

Correspondence Address:
Dr. Krishnan Ganapathy
Apollo Telemedicine Networking Foundation, C/O, Apollo Main Hospital, No. 21, Greams Lane, Off Greams Road, Chennai, Tamilnadu - 600 006
India




How to cite this article:
Ganapathy K. Telemedicine: An Integral Part of Clinical Neurosciences.Neurol India 2021;69:352-353


How to cite this URL:
Ganapathy K. Telemedicine: An Integral Part of Clinical Neurosciences. Neurol India [serial online] 2021 [cited 2022 Sep 24 ];69:352-353
Available from: https://www.neurologyindia.com/text.asp?2021/69/2/352/314545


Full Text



It is with a sense of contentment that I read the article “Turning a New Chapter in Neurosurgery Outpatient Services: Telemedicine A “Savior” in this Pandemic”.[1] 23 years ago telemedicine was a “dirty” word. Today, the telehealth division of the Apollo Hospitals Group alone have provided 13 million teleconsultations including 32,500 in neurosurgery and neurology.[2],[3] A strand of RNA has acted as the Global CTO (Chief Transformation Officer) and succeeded in steadily increasing the acceptance of technology enabled Remote Health Care worldwide. Previous publications on telemedicine in neurosciences from India have pointed out that virtual consults can often substitute for a physical face-to-face encounter.[4]

Raheja et al., in this issue have described telemedicine as a savior in providing neurosurgical OP services during the period of intense lockdown, when even non-emergency OP services were closed. In a feedback obtained from 231 patients, 97% opined that teleconsultation was beneficial, as it reduced risk of exposure to Covid-19. Is this technology acceptance a forced response or will this persist even after Covid-19 is denotified as a pandemic?

A study done in Aug 2020 across 25 Indian states analyzed 3200 responses from telemedicine users. This covered family practice and most specialties. An interesting observation was that 72% tele consulted their own existing doctors. The writing is on the wall. Clinicians need to understand that once a new technology rolls over you, if you are not part of the steamroller, you will be part of the road. Patients are starting to understand this!

The author has, in the last 9 months alone, reviewed 13 submissions to international telemedicine journals, from various specialties in various countries, dealing with patient perspectives, challenges in implementing telemedicine and the necessity for behavioural modification, both of the beneficiary and the Health Care Provider. The number of publications in the area of telehealth in the last nine months has been unprecedented denoting that worldwide, telehealth has come of age. Re-organization in neurosciences is not restricted to Out Patient Services. Grand rounds and clinical meetings are being executed in a hybrid mode. CME programmes are essentially webinars, with State Medical Councils recognizing virtual mode for CME credits. Even neuro-intensive care in developing countries is now available virtually.[5]

The world has turned upside down. It is naïve to assume that acceptance of remote health care, now being increasingly reported, is a knee-jerk lockdown enforced response. Introspection will eventually highlight enormous advantages of remote health care. Clinicians need to be future ready, adapting to changes in the patient's interests, understanding that traditional face to face reviews are not always mandatory. Digital manipulation of images can be done virtually, as well as on an MRI console. Fundus examination can be done remotely. Videos of movement disorders can be replayed. Uncommon clinical signs can be recorded and second opinion obtained. Multi-point video conferencing enables tumour board meetings.

Empathizing with a remote patient, providing tender loving care virtually is entirely doable. Technology, grey regulatory areas, cultural acceptance and return on investment – concerns which faced us two decades ago are slowly but surely being addressed. Neurologists and neurosurgeons are an endangered species. We will be doing a disservice to our patients if we do not considerably extend our traditional limited physical reach. Let us virtually go to wherever the patient is, for reviews and follow ups. Cost-effective, need-based and an appropriately customized technology is available. What is required is a radical change of mindset. We need to evangelize and practice telemedicine – showing the way to our patients and other specialists. Today distance, has become meaningless. Geography has become History!

References

1Amol R, Niveditha M, Kanwaljeet G, Vivek T, Vivek G, Shashwat M, et al. Turning a New Chapter in Neurosurgery Outpatient Services: Telemedicine a “Savior” in This Pandemic. Neurol India 2021;69:344-360.
2Ganapathy K, Reddy S. Technology enabled remote healthcare in public private partnership mode: A story from India. In: Latifi R, Doarn CR, Merrell RC, editors. Telemedicine, Telehealth and Telepresence. Vol. 14. Springer, Cham; 2021. p. 197-233.
3Ganapathy K, Das S, Reddy S, Thaploo V, Nazneen A, Kosuru A, Nag US. Digital Health Care in Public Private Partnership Mode. Telemed J E Health doi: 10.1089/tmj.2020.0499. Online ahead of print.
4Ganapathy K. Telemedicine and neurosciences. Neurol India 2018;66:642-51.
5Haranath SP, Ganapathy K , Kesavarapu SR, Kuragayala SD. eNeuroIntensive Care in India: The Need of the Hour. Neurol India 2021;69:245-251.