PGIMER, a tertiary care institute, is the first port of call for over 40 per cent of the patients who visit it. A survey by the Departments of Internal Medicine and Gastroenterology, over the last few months, found out that they had not even visited a dispensary or undergone any tests.
The department formulated a series of questionnaires to understand the profiles of patients seeking tele-consultation, and the nature of their disease etc. “Our statistics and data show, over 40 per cent patients approach PGI as first port of call, which is shocking and not right, as they should first go to a primary or secondary care centre. What’s more surprising is the fact that one-fourth of them had no investigation done ever, only 10 per cent require immediate attention or hospitalisation and 35 per cent require an ultrasound or CT scan. If they get these before coming to PGI, they can save time and money,” said Prof RK Kochhar, Gastroenterology department, PGI.
He said of the patients seeking tele-consultation, one-third are from Punjab, 25 per cent from Chandigarh, 18 per cent from Haryana, 10 per cent from HP and the rest from J&K or Uttarakhand, the numbers telling the inadequacy of healthcare in these states.
“Half of the patients, we found out, could be managed at a centre of convenience near them, tehsil hospital, medical college, civil hospital and need not come to PGI, reducing the burden on the hospital and saving them a lot of time and effort,” Dr Kochhar added.
The Telemedicine department is being used to guide about 1,500-1,800 patients a day, with one-third new patients. This is 20 per cent of the original number, as earlier, PGI was addressing close to 9,000 patients in different departments at OPD.
Telemedicine was so far used for teaching and transmitting academic activities to some medical colleges. It was also providing tele-consultation to Punjab tehsil and district hospitals by prior appointment. Last year, it had done this about 1,325 times.
As part of telemedicine OPDs, new patients are guided to get investigations, prescribed treatment or asked to go to a centre of convenience or come to PGI emergency.
Cancer patients and those with malignancy, pregnant women and children continue to be examined in OPDs. The emergency ward is also operational.
The pandemic has imposed many limitations. Only 40 per cent of the staff is working in OPDs or the emergency.
Prof Kochhar points out that after their duties, doctors and nurses are required to quarantine for a week at the hospital, as a result of which a large number of staff is out of circulation. “We should ideally have more tele-consultations, as part of which doctors from medical centres in other states can talk to PGI doctors for interpretation and guidance. The scope of telemedicine needs to be exploited,” he said.
Nodal officers in Punjab, Haryana, Himachal and Chandigarh will be soon expected to communicate with the PGI regarding patients, COVID and non-COVID and send their summary.
“I believe 60 to 70 per cent of patients can be managed under guidance at the nearest facility and if they require further critical care treatments, like a dialysis or ventilator, arrangements can be made here,” Kochhar said.
He maintains that tele-facilities in India are under-utilised and poorly organised. “Why don’t doctors in district hospitals and medical colleges teleconsult PGI specialists? The scope is unlimited, patients with stroke, heart attack, poisoning can be guided and treated remotely and many investigations like an ECG can be seen on WhatsApp. This facility can really help poor patients and those in far-off areas,” Prof Kochhar said.
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