Coronavirus Impacts – Telemedicine Need of Hour

April 24, 2020

It was an emergency in a hospital. A patient needed to be immediately operated for a surgery. A super-specialty doctor who could handle this situation was in another city far away from the hospital. Immediately, in-house doctors approached the surgeon over the phone and a video conference was arranged. On one side, the super-specialty surgeon was giving directions, on the other side, the in-house doctors were performing the surgery. The operation was successful, the patient was saved.

If that videoconference was not arranged to take the directions of the surgeon who was far away, the patient could not have been saved.

Another incidence. The whole nation was shut down as there was a call for a bandh in protest against a policy. In a village, a boy was severely suffering from fever.

Neither the public transport nor a private vehicle were available to take the boy to a doctor residing in the nearby town. The patient’s family members contacted the doctor. The doctor collected the information about the symptoms and other details speaking to the patient over the phone and sent the prescription. Taking the prescribed medicines, the boy was able to recover from the illness. Thank God, there was provision to keep the pharmacy open as an essential service.

On that day, if the phone connection was not there to contact the doctor, it would have been a difficult situation for the patient and family members. Not necessarily during an emergency or some special incidents like bandh. When a patient is in a remote area, no transport facility is available. Bedridden patients, lack of medical staff, shortage of funding and deficient infrastructure, telemedicine help to bridge the gap between patients and doctors.

The credit goes to the telecommunication technology with which a patient or patient’s party can contact a physician and the other way around. In the present condition of novel coronavirus chaos and people eagerly looking for one or the other medicine, laymen having heard the word ‘telemedicine’ may guess that a new drug is in the pipeline. No, telemedicine is not a medicine as such, nor is a medicine sent through the phone (Who knows? In the future, that technology may also be invented!). Just like television with which we can watch live events occurring somewhere else, with telemedicine one can access the healthcare services from a long distance (tele = distant). The World Health Organization (WHO) defined telemedicine as 'Healing from a distance'.

Obviously, for any physician, personal interaction and inspection of a patient using primary healthcare devices, including a stethoscope, sphygmomanometer, blood glucose meter, weight scale, and thermometer are indeed very much essential to diagnose and prescribe a proper treatment. Every time the situation is not the same, and patients may not be able to physically contact the doctors or doctors may be unable to rush to the patients. Under such conditions, telemedicine has a significant role.

Currently, telemedicine has so advanced that it is well equipped with many portable kits for monitoring vital signs of patients, such as a digital stethoscope, pulse oximeter, electronic stethoscopes, automated blood pressure monitor, otoscope, dermatoscope, eTime’s home endoscope and many more. With all these compact devices, patients’ health conditions can be accessed in real-time (live) enabling the doctors to prescribe the proper treatment. However, these digital tools have to be handled by trained persons or local medical practitioners. Under such a case, the data generated can be forwarded to specialists to seek further clinical advice. Not just general physicians, it may be cardiologist, ophthalmologist, psychiatrist, radiologist, dermatologist, pediatrician, neurologist, nephrologist, dentist and surgeon (accordantly, the services are said to be telecardiology, teleophthalmology, telepsychiatry,teleradiology, teledermatology, telepaediatrics, teleneurology, telenephrology, teledentistry and telesurgery) and so forth who can extend healthcare services depending upon their expertise. In support of telemedicine, there is also telepharmacy that looks into supplying the prescribed medicines and other healthcare items to needy people at their doorsteps.

Though telemedicine seems to be a recent version of healthcare service, it has a long history. Way back in the 1950s, during the civil war, an electrical telegraph was used to report the injuries and the causalities to place the order for medications. The adoption of bio telemetric system to remotely monitor the ECG in the hospital by Dr Linthoven in 1903 is a landmark invention in telemedicine. In fact, in 1879 only, an international peer-reviewed medical journal The Lancet has published an article forecasting the utility of telephone in the medical field. It was in the 1970s, Thomas Bird coined the term telemedicine. When all the terrestrial-based communications collapse during disasters like earthquakes, tsunamis, volcanic eruptions, landslides, hurricanes, floods and more, the role of satellite-based telemedicine plays a vital role. During the Mexico City earthquake in 1985, the Soviet Armenia earthquake in 1988, the role played by NASA using satellite-based telemedicine service is a remarkable one. As and when, new communication and other allied technologies such as the telephone, radio, television, semiconductor, transistors, video-telephony, digital telephone, wireless communication devices, smartphone, two-way interactive television, computer, remote sensor, satellite and computer networks have been invented, telemedicine also went on evolving at an advanced level. Thanks to the scientists who invented communication and other technologies that made the world a ‘global village’. Today, one can instantly communicate from one corner of the world to the other. As far as telemedicine is concerned, many hospitals in India have installed advanced communication systems for the mutual sharing of information and services across the world. A doctor in the USA or UK can extend his/her expertise to a hospital in India, and similarly, a specialist in India can share his/her knowledge with other countries.

Information technology has also been coupled with communication technology making telemedicine a more effective healthcare service. Centre for Development of Advanced Computing (C-DAC), Noida in 1966 deployed the first indigenously developed hospital information system software at Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP.

Currently, there are many software programmes (AnywhereCare, eVisit, NexHealth, VSee, PatientPop, etc) accessible helping doctors to practice telemedicine with higher efficiency compared to earlier days. Ministry of Electronics and Information Technology – Govt of India recently launched a mobile app ‘Aarogya Setu’ to be installed in the mobile for helping the general public as a safety measure against the novel coronavirus infection. In the present ‘App era’, telemedicine has also been modernized with many apps (Telemedicine Apps: Lybrate; Portea; Practo, etc). An app like Skype, a communication tool for free calls and chat can be installed in the smartphones useful at both ends between doctors and patients. It is appreciated that some multispecialty hospitals and medical colleges in India, including Karnataka, initiated providing healthcare services to their patients with the aid of customized-apps. Today, the mobile phone has become an integral part of our life; a smartphone with its various facilities like camera, scanner, browser, embedded memory, text message, voice message, installed apps, net pack and many more, are very helpful to avail the benefit of telemedicine. Well-advanced communication technologies, apps, software, gadgets, service providers are available to implement telemedicine. Most of all, the end-users; if unaware of the concept of telemedicine, nothing becomes useful. Therefore, equally important is creating awareness on telemedicine and its significance to the general public, particularly people of rural India.

India is a large country (seventh biggest in the world) with a population of 1,352,642,280 (As per the WHO 2019 revision of the World Population Prospects). There is a shortfall in the doctor-population ratio. As per WHO recommendation, a minimum doctor-population ratio is 1:1,000 (minimum one doctor for 1,000 people). According to the World Bank 2017 data, the ratio in India is 0.8:1,000. Hence, it is a major challenge to provide healthcare services to all the people, particularly in remote places.

Moreover, most of the Registered Medical Practitioners (RMPs) prefer towns or cities rather than villages to lead their professional life. Under these circumstances, telemedicine can fill the gap, provided that a high range network facility for communication must be established. Nevertheless, India is not lagging in implementing telemedicine service. At the international level, India occupies a special position in adopting and developing telemedicine technology. In 2001, Indian Space Research Organization (ISRO) in a joint venture with Apollo Hospital successfully implemented the Telemedicine Pilot Project, to provide satellite-based healthcare service linking between the hospitals in Chennai and Aragonda, a village in Chittoor district of Andhra Pradesh. The Govt of India, Ministry of External Affairs, Ministry of Health and Family Welfare, Department of Information Technology successfully implemented telemedicine in rural India and some state governments also joined hands with the union government.

National Rural Telemedicine Network (NRTN), Integrated Disease Surveillance Project (IDSP), National Cancer Network (ONCONET), National Telemedicine Task Force (NTTS) by the Health Ministry in 2005 are some of the glaring examples for the efforts implementing telemedicine in India. The first successful tele-transmission of ECGs of a patient from his home to a hospital by a team of doctors in GR Medical College, Gwalior, in 1975 (by converting ECG output into high-frequency sound at the receiver end through telephone) is one more feather in the cap.

Launching of SEHAT (Social Endeavour for Health and Telemedicine) by the Government of India in collaboration with Apollo Hospitals to connect 60,000 common service centres across the country to a common network and provide healthcare access to millions of citizens was a big telemedicine initiative in 2015.

An advantage of telemedicine is that it avoids the possible spread of contagious diseases by infected patients to others waiting in the hospitals/clinics, in a crowd.

However, telemedicine is not the ultimate solution. It has some limitations as well. A community residing in a remote area where there are no modern facilities, telemedicine does not work. Most importantly, telemedicine is applicable only if a patient’s condition is mild or severe. If it is an emergency like cardiac arrest, brain haemorrhage, obstructed labour, poisonous snakebite, causalities and others, then patients have to be immediately hospitalized.

In the current COVID-19 pandemic scenario, the nationwide lockdown (of course, worldwide) has become a necessary evil. Nearly one month of lockdown period is over, and we do not know how many days of extension to avoid the risk of mass spread of the novel coronavirus disease is demanded. Many hospitals closed or restricted the Outpatient Department (OPD) services. Moreover, many physicians locked their clinics and stopped practicing for the last month to avoid the possible risk of getting infected by the novel coronavirus. In this critical situation, the role of telemedicine is very crucial. Now, everywhere, we hear about the novel coronavirus havoc; it does not mean that all other diseases ran away in fear of the virus or patients with one or the other chronic disease (asthma, arthritis, cancer, obstructive pulmonary disease, diabetes and so on) have recovered. No doubt, diagnosis and treating of novel coronavirus infected persons whoever and wherever they are, is the priority. In the meantime, patients suffering from other illnesses cannot be sidelined; they should equally be accessible to take the treatment. It is very sad to mention that during this lockdown period, many people passed away without getting timely treatment as reported by many print and visual media now and then. It is the right time for RMPs to help society through telemedicine. By employing any or all the three basic versions of telemedicine, namely, ‘Store and Forward’, ‘Remote Monitoring’ and Real-time Interactive, physicians can integrate telemedicine as a part of their service. In this crucial period, a public domain composed of a list of doctors providing telemedicine service can be generated region-wise that will be useful to people. From the economic point of view, anyway, there are many options for electronic money transfer like net-banking, Paytm, Phone Pe, PayPal India, Mobikwik, Google Pay and several others.

There is a popular saying in our culture, 'Vaidyo Narayano Harih', which means, a doctor is equivalent to God. Big hats off to all the doctors for their great service to mankind saving lives.

Registered Medical Practitioners (RMPs) willing to extend the service in terms of telemedicine have to follow the norms and regulations formulated by the Government of India. The Union Government under the Medical Council of India (Professional Conduct, Etiquette, and Ethics Regulation, 2002) in collaboration with NITI Aayog, recently (March 25) notified a revised framework ‘Telemedicine Practice Guidelines’. (

Adhering to the guidelines, RMPs can now provide consultation through video, audio, email or text. There is also an interactive web-portal hosted by the Centre for Health Informatics under the auspices of the National Institute of Health and Family Welfare (NIHFW) and the Ministry of Health and Family Welfare (MoHFW) - Government of India (

A team of doctors led by Dr Vinoth G Chellaiyan of Chettinad Hospital and Research Institute, Chennai, published a research article focussing on the current status of telemedicine in India, in the January 2019 issue of the Journal of Family Medicine and Primary Care, and is also worth reading (!po=3.12500).

Overall, telemedicine is a time saving, secured, real-time, safe and cost-effective healthcare service not only to remote areas, but also during critical conditions like a lockdown. The impacts of the novel coronavirus pandemic are multi-dimensional, and one drastically affected area is the health sector. Therefore, telemedicine is a need of the hour. In this harsh situation of pandemic COVID-19 and nationwide lockdown, let the benefit of telemedicine reach rural and urban India with its full potential.

Photo courtesy:  Jonathan Borba on


By Dr Prashantha Naik, Byndoor
Prashantha Naik, born and brought up in Byndoor (Udupi district), is currently serving as professor and chairman in the Department of Biosciences, Mangalore University. He has been publishing Kannada and English articles to create awareness on environmental issues and other aspects for the last 20 years. You can reach him at:
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Comment on this article

  • Dr. M. S. Mustak, Mangalore

    Tue, May 12 2020

    It is wonderful information during the lockdown period. Very informative for academics also. I wish him more article on this line. It will be helpful for the society.

  • Jayaprakash, Bangalore

    Thu, Apr 30 2020

    Excellent coverage. Article is need of the hour. Congratulations.

  • Padmanabha, Mangalore

    Wed, Apr 29 2020

    Thank you sir very nice suggestions. New era in medical history

  • Dr. R. F. Bhajantri, Dharwad

    Mon, Apr 27 2020

    Dr. Prashant Naik,
    You have done a very good job in sharing the importance about the telemedicine during such a lockdown situation. I think this is a second article during this period and the first article was on Covid19. Congratulation to you for your hard work and sincere efforts to write the informative articles and I wish you good luck for your future articles.

  • Ananda, Kundapura

    Sun, Apr 26 2020

    Your article on Tele medicine is informative. KMC Manipal and TMA Pai Rotary Hospital, Karkala have introduced this system recently.

  • Prof. M. Krishnamoorthy, Mangaluru

    Sun, Apr 26 2020

    I have read a very resourceful article on Telemedicine which is the need of the day. I congratulate and appreciate Dr. Naik for all the efforts put for writing such a useful article.

  • DEVARAJ, Bangalore

    Sun, Apr 26 2020

    This information is very helpful. I had never heard of the TELEMEDICINE method before but it sounds very useful. Thank you Dr. Prashanth for sharing such an informative article.

  • Dr. Dasharatha Angadi, Mangalore

    Sun, Apr 26 2020

    You have written excellent article to create awarnes about COVID-19 pandemic but you have put more efforts to give lot of information and its impact to human kind I wish you to more and more work on this virus.


    Sun, Apr 26 2020

    Congratulations sir. You wrote very good informative article. Nowadays , at this time your article is very important. Keep it up. We expect more this type and related articles at the time of covid-19. Good Luck .

  • Prof Arjula R Reddy, Hyderabad

    Sat, Apr 25 2020

    Telemedicine is a powerful method in health care delivery and also for creating awareness in people across all strataof the society. Academics have role to play in creating that awareness in society and such articles will go a long way in doing that. In India where more than half of its population are rural, telemedicine can be a boom. Your article is in that direction and I wish you success in popular science writing endevor

  • Vichaarvyakthi, Udupi

    Sat, Apr 25 2020

    India is a large country (seventh biggest in the world) with a population of 1,377,048,3219 (as of April 13). There is a shortfall in the doctor-population ratio. As per WHO recommendation, a minimum doctor-population ratio is 1:1,000 (minimum one doctor for 1,000 people). According to the World Bank 2017 data, the ratio in India is 0.8:1,000 (meaning 1 doctor for 1,800 people). Hence, it is a major challenge to provide healthcare services to all the people, particularly in remote places. 1, India is a large country (seventh biggest in the world) with a population of 1,377,048,3219 (as of April 13). There is a shortfall in the doctor-population ratio. As per WHO recommendation, a minimum doctor-population ratio is 1:1,000 (minimum one doctor for 1,000 people). According to the World Bank 2017 data, the ratio in India is 0.8:1,000 (meaning 1 doctor for 1,800 people).


    I recalculated and found that to be 1: 1,250 is much better than what you thought is the situation. Still short though but doesn’t look that bad.

    I used your figure 0.8: 1000 and got the figure as quoted above

  • Pramod Machimada, Coorg

    Sat, Apr 25 2020

    Nice and very informative article sir.... expecting more from you... congratulations

  • Dr. Parvathi G Aithal, Kundapura

    Sat, Apr 25 2020

    It's a very interesting article. The tremendous advancement of Science is so heartening to hear. In the context of the present crisis, in order to minimise the deadly corona effect the telemedicine as suggested by Dr.Prashanth Naik will no doubt be of great help. The article is very well written.
    Dr.Parvathi G.Aithal

  • Aboobakar Ahmad, Punjalkatte

    Sat, Apr 25 2020

    Well drafted. You have explained it broadly. I personally know you are a humble person with ample knowledge. Keep up good work Sir.

  • Nagaraja Nayaka, Kundapur

    Sat, Apr 25 2020

    It's a good article .... Thank you for sharing your knowledge, sir...

  • H M Somashekarappa, Mangaluru

    Sat, Apr 25 2020

    Very good, timely and useful article.


    Sat, Apr 25 2020

    The information narrated in this article was excellent and needed for all the people in a critical situation like lock down . I appreciate Dr Prashant Naik for this need based article.

  • Kumara, Periyapatna, Mysuru

    Sat, Apr 25 2020

    This is a very needy and essential article at this present situation which would reach to the people who are unaware of telemedicine system. The article is well established with a lot of patience and a keen literature review. I applaud Dr Prashank Naik for his wonderful writing and having a social concern. I hope this article will reach the concerned officials to promulgate more or more information regarding telemedicine to comabat novel COVID-19

  • SUBBA NAIK M, Konaje

    Sat, Apr 25 2020

    Sir the article presented by you is most relevant to the present situation. Wish you all the best for your further investigation in this regard. Thank you sir.

  • Dr. Rajasamarsen Modi, Kalaburagi

    Sat, Apr 25 2020

    It's very good article and need of hour.. Telemedicine which nis very effective Medicine system at present circumstances

  • Shankar, Mangaluru

    Sat, Apr 25 2020

    Thank you Dr. Prashanth for this informative article.
    Thanks again to Daiji team for selecting and introducing the finest brains in our region.

  • Prabhakara jogi, Udupi bantakal

    Sat, Apr 25 2020

    So super and valuable news....thanks for ur writing...

  • Harish Shenoy, B C Road Bantwal

    Sat, Apr 25 2020

    The article on telemedicine is TIMELY at this moment of crisi when whole country is facing lock down due to COVID19.The article clearly traces the development of telemedicine over the years and stresses its importance at this juncture where patients can avail the services of Doctors and specialists by taking advantage of the IT and electronic media. Altogether I must say that this is one of the finest articles to fulfill confidence in the patients . I appreciate Dr Prashant Naik for this splendid article and wish him continue this saga of writing .

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