How PGI’s Telemedicine Department focusing on reducing rush of follow-up patients

“This means access to specialist consultation through tele consultation, with the focus being tele follow-ups, and virtual follow-up consultations for palliative care and post-operative patients to ensure continuity of care. The idea is to save time, money and travel for patients. About 50 per cent of patients in institutes like PGI are follow-up patients, with a change of medicine the most common outcome of the visit. They travel long distances with attendants and spend both time and money. For instance, in the pain clinic, where intervention is not required, tele follow-up can be a gamechanger,” explains Aggarwal.

The pilot project, adds Aggarwal, will soon start in AIIMS, PGI and other AIIMS-like institutes, through the hospital information system and the e-Sanjeevani platform, with the start of an integration process.

A CR number will be generated on the HIS, then the patient will be given an option of an online or offline consultation, and based on the choice, the consultation will proceed.

“For the first time, the patient has to come to the OPD, and subsequent follow-ups can be done through tele consultation, reducing the burden on patients and hospitals. An economic evaluation as per previous data shows that, on average, with tele medicine services, Rs 972 per person was saved,” the doctor says, adding that as per government data, close to 10,000 tele consultations per month are provided to Haryana hub.

Aggarwal says PGI is guided by a “hub and spoke” model, where the primary health care and community health care centres (the spoke) seek consultation from the institute, a tertiary care centre. “The health care worker is the first contact of the patients and from there they are referred to a doctor here at PGI.”

As part of a five-year projection plan for various tele medicine projects to be implemented at various medical institutes across the country, including PGI, several e-health initiatives are part of the plan, including those in cardiology, dermatology, neurology, oncology, psychiatry, dentistry, pain management, tele ICU etc.

Apart from tele follow-ups, tele cardiology is a valuable initiative, with the incidence of heart disease increasing steadily. According to the WHO’s 2021 factsheet, cardiovascular diseases account for 32 per cent of global deaths, with heart attacks contributing to 85 per cent of these fatalities.

The proposal aims to significantly reduce mortality resulting from heart attacks, a leading cause of premature deaths worldwide, including in India. By enabling the timely interpretation of electrocardiograms (ECGs) through a monitoring unit that continuously streams real-time ECG images to specialists, this initiative supports primary and secondary healthcare providers in delivering immediate interventions, responses, and referrals. The system, explains Aggarwal, will particularly benefit patients in remote areas by facilitating easy engagement with specialists.

In tele dermatology, the integration of tele dermascopy with e-Sanjeevani 2.0 serves as a crucial diagnostic tool to enhance the quality of dermatological diagnosis and treatment, adds Aggarwal.

Utilising a dermascope, a magnifying apparatus is essential for studying skin physiology, diagnosing pathologies, and devising management plans. This technology allows for the connection of dermascopes to phones or computers, enabling captured images to be sent to specialists for interpretation and subsequent treatment planning.

Medical officers from primary health centres (PHCs) will undergo orientation programs to effectively utilise dermascopes, highlighting the advantages they bring to the existing healthcare system.

Benefits, says Aggarwal, include strengthening early detection of skin cancer, improving monitoring of skin conditions, facilitating referrals, and promoting a cost-effective healthcare system.

“Incorporating artificial intelligence algorithms into image analysis can further enhance diagnostic accuracy, streamline workflows, and optimise resource utilisation in dermatological care delivery,” shares Aggarwal.