Waking up one morning a few weeks ago, 49-year-old Murugesan, a product manager based out of Chennai, found himself plunged in a major dilemma. Since the previous night, the scar from his open-heart surgery had been looking red and puffy, but he did not want to step out to a hospital so he could avoid worsening his condition.
Fortunately for Murugesan, a scary in-person visit was not the only option; thanks to Kauvery Hospital’s teleconsultation service, his doctor was able to examine the scar remotely and advise him on treating the minor infection that had developed. “Being able to check in with the doctor remotely took away all the stress of deciding if a hospital visit was the safest and best choice,” says Murugesan.
For Murugesan and thousands of others with acute or chronic heart conditions, regular and consistent care is a major necessity. However, with hospitals being at the frontline of the war against COVID-19, the need for new ways of care and monitoring arose. Thankfully, emerging technologies have been able to fill the void left by disappearing in-person consultations. “Thanks to these digital technologies, patients don’t have to sit at home scared for their health. They can connect with doctors no matter where they are,” says Dr Sujit VI, Senior Consultant Cardio Thoracic Surgery, Heart and Lung Transplant Surgery at Kauvery Hospital, Chennai.
While forays into telemedicine have been made since the early 2000s in India, it was the COVID-19 pandemic that made this form of medical care widespread and popular. When the pandemic forced doctors and patients to rethink if each visit was absolutely necessary or avoidable, communications technologies became a viable solution.
Unlike a telephone check-in, explains Dr Sujit, video consultations allow doctors to visually examine patients, examine test results, and get a view of the patient’s in-home environment. While telemedicine cannot eliminate the need for in-person visits when a serious condition is anticipated, it can reduce the need for routine visits. “With video, we can check in on patients and advise them in case of most normal scenarios and tell them when a situation is serious enough to warrant a visit to the hospital,” explains Dr Sujit.
Dr Sujit VI, Senior Consultant Cardio Thoracic Surgery, Heart and Lung Transplant Surgery at Kauvery Hospital, Chennai.
Teleconsultations are not only convenient but also effective in improving adherence to medical regimens, as patients are in more regular contact with doctors and hence there is greater accountability for following prescribed changes and routines. More importantly, given the drastic shortage of doctors in India, and their concentration in metropolitan and urban areas, teleconsultations help equalise access to specialised care. With telemedicine, explains Dr Sujit, patients in rural or remote areas are no longer hindered by their distance from tertiary care hospitals.
Beyond doctor consultations, wearables such as smart watches provide patients with basic information about their own health. While wearables have not yet reached the point of replacing traditional diagnostic devices, they do provide rough estimates of factors such as heart rate, blood pressure and oxygen saturation, which allow people to know if they are falling within the normal ranges or are deviating in ways that raise concern. “Such devices promote preventive medicine, by alerting people early to any problems,” explains Dr Sujit.
While self-monitoring focuses on basic indicators, patients who have had surgical interventions with devices implanted for continued cardiac care require more sophisticated monitoring. This is where advances in technologies like Bluetooth and the Internet of Things contribute to significant medical advantages. “Implants such as pacemakers, ventricular assist devices and defibrillators have intrinsic parameters specific to each device. Such data cannot be directly understood by patients, and only healthcare workers can understand what they mean,” explains Dr Sujit.
Kauvery Hospital, Chennai.
Traditionally, this meant that patients would have to come in to hospitals for devices to be checked on a periodic basis. However, with smart implants, such data can easily be relayed to a smartphone or computer, and then passed on to doctors for analysis. “With such data, doctors can easily tell when a device is working properly or malfunctioning, and whether the patient is experiencing any problems,” explains Dr Sujit.
While specialty care such as cardiac care has traditionally required admission or frequent visits to a super-specialty or tertiary care hospital, cardiac medicine is moving towards a more distributed care model. For instance, several countries are already experimenting with emergency teams equipped with remote cardiac monitoring equipment. Such teams are able to connect patients with specialists at an early stage in order to decide what kind of emergency care should be provided and even what kinds of facilities patients can be admitted to in order to provide the most rapid and effective treatment possible.
“With such equipment, the doctor sitting in a metropolitan hospital can tell emergency teams if the patient needs a tertiary or primary care hospital, even whether they should be taken for surgery immediately, and so on. All this minimises the confusion in an emergency situation and ensures that the patient’s treatment is managed rapidly without any delays,” explains Dr Sujit.
This article was created in association with Kauvery Hospital.