The Changing Face of Remote Healthcare

Narayan is a daily wage labourer. He had been saving up all of his income, for his daughter’s wedding that would be imminent in two months’ time. Lately, he has been experiencing trouble sleeping and breathing difficulties, especially at night.

Making a visit to the doctor would consume his entire day as there were no hospitals within walkable distance. The expenses at the city hospital would definitely wipe away all of his savings. So instead, he just makes earnest prayers to the Almighty for his quick healing.

The scarcity of healthcare services in rural areas of India is a major predicament that deserves prompt attention. According to the Overview of National Health System Report, “74% of the graduate doctors live in urban areas, serving only 28% of the national population, while the rural population remains largely unserved.”

A million people like Narayan yearn for nearby health-care services in order to be relieved of their minor ailments. To fulfil such dreams, the Ministry of Health and Family Welfare instituted the Accredited Social Health Services (ASHA) in 2005. It took another seven years for its complete execution. With the launch of Narendra Modi’s National Health Mission (NHM) in 2013, every village with a population of at least 1000 people was to have one ASHA worker.

ASHA’s were female community health workers who were educated and trained to act as distributors of health education within the villages. They would spread awareness among the local village dwellers about the importance of sanitation, family planning, immunization programs, first-aid and encourage women to give birth at hospitals. They also maintained community health data, supported health-service delivery, identified disease cases, registered births and deaths, and helped mobilise the community to seek healthcare services.

However, this attempt slowly turned ineffectual.

Some of the reasons for scarce healthcare services in rural areas are:

1. Distance and Transport:

The geography of India is extremely vast and varied. As a result, adequate penetration of healthcare to all of these areas is difficult. People from rural settlements have to travel a considerably long distance to access primary healthcare services and may not have public transportation facilities for the same. Having to travel such long distances may also require time and as such these patients tend to postpone their consultation visits leading to disease progression.

2. Health Expenditure:

Oftentimes, money constraints have a big influence on rural residents seeking healthcare. Heavy expenditures incurred at hospitals hold them back from making a visit to the doctor.

3. Poor literacy rate and Social stigma:

Poor educational backgrounds of the people hailing from rural areas may restrain their level of health awareness. Consequently, they dismiss the idea of visiting a healthcare professional for their ailments. Rural residents also hold certain orthodox views and opinions. Sometimes, seeking help for mental issues, pregnancy, venereal diseases can be stigmatizing for them.

4. Lack of Healthcare Workforce in rural areas:

As mentioned previously, a great majority of medical practitioners and graduates are concentrated in urban settlements. Low pay scale and dilapidated living environments of rural areas cause them to retreat from performing health services in such areas.

Strategies that were adopted previously to improve access to quality healthcare in rural areas

A highly suggested strategy that was agreed upon by the government as well as the hoi polloi to improve rural access to healthcare was to increase the number of doctors within rural areas. However, this method could not be implemented effectively as doctors usually refrain from practising in rural places owing to lack of proper diagnostic technologies and infrastructure. All such attempts that were made to serve healthcare in the rural areas have turned in vain. To draw a line to these inefficient strategies, today technology plays an important part.

Technology contributing towards improving healthcare in rural settlements

With the advent of the Internet in India, both rural and urban people alike have access to information in the form of educational materials, entertainment and news. People from the villages are now aware of the present technologies, businesses and trends. This has also helped primary healthcare centres of rural areas develop their physical and diagnostic infrastructure.

Telemedicine is one such technology that can make a major impact on contributing to healthcare in rural areas. It can serve as the tool to bridge the division that exists between rural and urban settlements. With the help of telemedicine, small rural healthcare settings can provide high-quality healthcare at an affordable cost. Patients do not have to travel long distances to consult specialised doctors. This saves their time as well as money expenditure.

In order to support care with Telemedicine; medical devices like the digital stethoscope, blood-pressure monitoring machines, blood sugar testing kits, ECG machine, thermometer, weighing scale, etc. are made available at the point of care. Consultations are done just like in-person consultations and patients receive care very similar to the care they would receive at hospitals.

Artificial Intelligence has also been revolutionizing remote healthcare with its natural language processing abilities. Computers can now easily understand human languages. Today, AI can also help analyze patient data to generate laboratory investigation recommendations, procedure recommendations and provisional diagnosis.

Arintra is an AI-enabled history-taking tool that incorporates such features. Visit: Arintra API to know more.

Arintra’s contribution to telemedicine

A healthcare initiative in Karnataka made use of our history-taking tool ‘Arintra’ to capture patient history prior to the consultation. They commented, “the elaborate history of presenting illness and the requisite past clinical records helped in reducing the time per patient. It saved us from the exhaustion due to the overwhelming OP crowd”

With about five to eight minutes of the patient’s history input into this tool, Arintra generates a comprehensive report that is ready to be shared with the doctor. This history-taking API captures 80% of a patient’s history prior to the consultation and generates a concise report of it. With the help of this remotely captured history, doctors can save up to 45% time per consultation, reduce chances of miscommunications during video consultations by 80% and identify the right specialization for remote patients.

Arintra can also assist ASHA workers in taking MBBS grade clinical history as it uses simple terminologies and is available in many languages. Currently, it’s secure API has in store eight different languages: English, Tamil, Marathi, Gujarathi, Kannada, Bengali, Hindi, and Telugu. More languages are continuously being added.

A team of healthcare professionals were directly involved in the collection of patient history using Arintra. They could document accurate patient histories of a large number of patients, within a very short span of time. This consequently helped reduce instances of misdiagnoses.

Arintra in Bidadi, India
Arintra in Bidadi, India

Today, with our learnings from the COVID-19 pandemic, the urgency to maximize the capacity of the healthcare workforce is distressingly clear. It is high time for healthcare providers to integrate medical intelligence into their existing digital infrastructure.