1. Super-Specialty Medical Teleconsultations to Remote Areas of Ladakh, India, via Esanjeevani Under the Hub-and-Spoke Model: A Pilot Study.
- Author
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Jain, Siddharth, Arora, Shreya, Chauhan, Anil, Agarwal, Amit, Saikia, Biman, and Singh, Meenu
- Subjects
PATIENT satisfaction ,MEDICAL personnel ,HEALTH facilities ,PILOT projects ,CONTINUING medical education ,MEDICAL research ,TELEPSYCHIATRY - Abstract
Objectives: To assess the feasibility, spectrum, outcomes, and challenges of delivering super-specialty consultations through telemedicine to remote areas of the Union Territory (UT) of Ladakh. Methodology: The authors report on a prospective, observational (descriptive), pilot study. Super-specialty medical teleconsultations were provided to healthcare providers in UT Ladakh by specialists in the Department of Telemedicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India, from October 2021 to May 2022, employing the Hub-and-Spoke model of the Ayushman Bharat Digital Mission. Doctorto-doctor teleconsultations were initiated by treating doctors at healthcare facilities in UT Ladakh on the eSanjeevani™ platform. An audio-video model was used for teleconsultation, and digitally signed prescriptions were shared. The outcome measures included demand and spectrum of super-specialty teleconsultations, the outcome of consults (whether managed successfully at the teleconsultation level or required referral for in-person visits), and technical challenges faced. Results: A total of 26 super-specialty teleconsultations were provided: 14 (54%) were for women. Patient distribution was uniform across all age groups. The super-specialty-wise distribution of consultations was nine from endocrinology, nine from neurology, three from hepatology, two from cardiology, and three from neonatology. Reasons for seeking consultation were assistance in diagnosis (3, 12%), optimization of therapy (10, 38%), or both diagnostic evaluation and treatment optimization (13, 50%). Five cases (19%) were referred for physical visits to a higher center for advanced diagnostic testing like liver biopsy, brain biopsy, upper GI endoscopy, etc.; other cases were managed remotely. Problems with audio-visual connectivity were encountered in three patients. Conclusion: This pilot study demonstrates that telemedicine can effectively deliver complex, super-specialty medical consultations to remote areas. Future research should focus on assessing long-term outcomes, patient satisfaction, and cost-effectiveness to evaluate this model's impact better. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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