The doctor will see you now – virtually

When 57-year-old Mamta Mehta from Mumbai started feeling weak and uneasy a few weeks ago, she decided to take an online medical consultation. Mumbai, the city with the largest number of Covid-19 cases in the country, was on a strict lockdown which led Mehta’s son to quickly call on the helpline number of Portea Medical, a home healthcare startup.A video call to a doctor was set up soon. Mehta explained her symptoms to the doctor and mentioned the fact that her blood pressure level was borderline low. After understanding her detailed history, the doctor suggested that it may be a case of dehydration and advised Mehta to rest and drink electrolyte water.“I didn't find too much of a difference in terms of experience while consulting the doctor through video consultation in comparison to a face-to-face meeting,” Mehta told ET Digital.With Covid-19 preventing people from stepping outside, healthcare institutions, clinics, doctors and professionals decided to bring the services to patients’ homes, leveraging electronic media. Calls, chats and video consultations are now one of the most trending features in the healthcare industry, which has also given a push to healthtech startups such as Portea, Lybrate, Practo, Navia, medlife and 1mg.Dial a doctorOn March 25 this year, the Health Ministry of India issued guidelines on the use of telemedicine services to prevent risk of coronavirus spread between both patients and doctors. Prime Minister Narendra Modi too had encouraged the means of telemedicine to states to tackle Covid-19. The government itself launched a telemedicine app named Aarogya Situ Mitr offering free telemedicine and consultation services to address coronavirus-related queries.Since clarity around telemedicine arrived in the country, healthtech startups are seeing a spurt in the online consultations. “Our telemedicine platform grew by 500% since March 1st. Queries regarding fever, cough, cold, sore throat and body ache have increased by more than 200%. Most of the queries are from people in the age group of 25 - 40,” Alexander Kuruvilla, Chief Health Strategy Officer, Practo, told ET Digital.Practo’s telemedicine services include both phone calls and video consultations and 30-35% of the consultations are from women. According to Kuruvilla, Practo’s telemedicine services has been operational for the last two years, which means the startup has been able to get a lot of doctors to adopt technology.Another benefit of telemedicine startups, Kuruvilla says, is that it is time-friendly. “When someone has a stomach pain or something not too serious, he is either likely to get self medicated or run to the nearest pharmacy for a pill. At the most, people decide to visit a doctor someday later or evening when they feel they will be less busy. Now all these people can ask for a doctor in 60 seconds and get professional help,” he said.Practo is not alone when it comes to risk business. Experiencing similar sales figures, Lybrate, a Delhi-based healthtech startup had seen a sudden surge of doctors on its platform. With a growth of more than 120% since the lockdown began, the firm’s user segment lies in the age group of 25-45 years.“The questions being asked are related to health issues ranging from cold, cough, flu, fever, claustrophobia to joint pain, back ache, healthy diet, headache, meditation, yoga and stress and immunity, among others. Women, especially are asking the maximum number of questions across all age groups,” said Saurabh Arora, founder and CEO, Lybrate, which enables online consultations through phone calls, video calls and chats. 76275643Telemedicine appears to work wonders for patients having non-threatening and chronic conditions. For Gurugram-based Navia Life care, most of their patients require online consultations from general physicians, pulmonologists, internal medicine/diabetologists, and psychiatry.Further, the price disparity in online and offline health consultations is very appealing. Many telemedicine firms believe that telemedicine could cover the affordability gap among the user segment, particularly those who are often unable to afford frequent checkups and pay the consultation fee every time.Prakhar Singh, General Physician and a doctor at Lybrate, told ET Digital, “Many of the patients who come to us are those who do not have money to get access to a good doctor. At Lybrate, I charge about Rs 350 and we give them 20-25 minutes of time, which is often not given by many physicians offline.”He further added that apart from consultation fees, offline services also make the patient shell out money for their travel, parking and after consultation, any immediate testing or medicinal purchase can be very expensive.“In telemedicine, when we prescribe blood tests or any other tests online, then the patient has the time to wait and get it booked at a cheaper cost. Most of my patients are ordering medicines from networks and pharmacies who are giving 20% or more discount. People can also get medical tests like x ray, ultrasound, CT, MRI through the 1mg and other such portals, which are more affordable,” he said.Old concept, new boostWhile telemedicine seems to be finally striking the chord with both patients and doctors after the government cleared regulations around it a month ago, it is interesting to note that the term is not new in the healthcare industry. According to Singh, it has been more than seven-eight years since telemedicine has set foot in India.“According to the American Heart Association, which was the first body to regularize the services in America, anything that is not an emergency can be dealt over a call. Because what happens is we are generally using evidence-based medicine, which means that we need a proof of whatever we are treating. So, a patient can come to us with his chronic problems like diabetes, hypertension, thyroid, anything that is not an emergency,” he said. 76275775He added that, however, the government in India has set certain guidelines around medical conditions that cannot be treated through telemedicine, such as abortion is illegal in telehealth, even acute conditions like chest pain, abdominal pain cannot be treated through telemedicine, because they may be an indication of heart attacks.What lacks?Living in such a digitally-advanced era seems to have made telemedicine a seamless experience. However, the transition from traditional checkups with the physical presence of doctors to explaining your symptoms to doctors behind an LCD screen follows two main constraints- digital literacy and infrastructure.Prashant Tandon, CEO and co-founder of 1mg, told ET Digital that its online consultation services, which saw a more than 400% spike since it was launched, are currently present in precisely 1,600 cities in the country. Metros contribute a large share in the user segment, which Tandon believes is mostly because their services are not yet deployed in many local languages. However, the 1mg team witnessed a totally different behaviour in Tier II, III and rural areas when it comes to availing telemedicine services.“In metro cities, a lot of people will be doing their own consultations. In Tier II, II and IV cities what happens is that one account will undergo 30-50 consultations every month, that means different patients most of the time using the same account. Similarly, in villages, it is basically just one person who has a smartphone and is tech savvy. That person becomes a gateway to health care for everyone in the village, he or she is the local entrepreneur who facilitates that,” he said.If infrastructure is not an issue, incompatibility with technology with users can be a problem. “The biggest challenge that is often faced by telemedicine service providers like us is the lack of technical knowledge among the consultation seekers. Many times, the patients or their family members find it difficult to use the technology to effectively communicate with us,” said Portea’s Ganesh.The unease of sudden transition to online consultations was also felt among doctors. “Use of technology is not new for our doctors, but during their everyday practice the doctors are used to seeing the patients in person. So, getting them to adopt any new platform needs to fulfill certain critical requirements - ease of use, low complexity, and availability of support,” Gaurav Gupta, co-founder, Navia LifeCare said. 76275536Promising futureDespite the challenges and telemedicine being limited to chronic medical conditions and non-emergency cases, many firms see a bright future for it.Meera Iyer, Chief Marketing Officer, Medlife believes there will be a prolonged change in the behavior of people post-Covid which involves people not willing to step out of their houses. “This prolonged behaviour change will automatically set a new baseline where people will adapt to digital practices more including telemedicine. I think there is also going to be increased realization of the convenience and value when you give quality service. With telemedicine, routine checkups for chronic patients are going to be equally easy and will move much faster. When more and more doctors will come on the platform, patients will be able to select the doctor of their own choice.”1mg’s Tandon believes that there will be a structural change. “People will now first call to report anything they feel can be consulted digitally. Some people will still go for offline consultations for things they fear are more concerning. Still, I think people are going to find telemedicine the new normal, where the primary access to health care would be easily available,” he said.

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