Hyderabad: The National Telemedicine Service initiative by the Indian government, e-Sanjeevani, is facilitating healthcare accessibility in the country since its launch in 2019.

Origins of government’s telemedicine initiatives

The e-Sanjeevani was first launched to connect Health and Wellness Centres to specialists in November 2019. In this model, assisted consultations through community health officers were enabled.

During the pandemic, in April 2020, e-Sanjeevani outpatient services were rolled out, connecting patients directly to doctors. The OPD telemedicine service can be accessed using the internet from anywhere in the country, on any computing device.

How does the procedure work?

To avail a consultation on the e-Sanjeevani website, the mobile number should be verified using OTP, and patient registration details must be filled out. After which, the ailment details and previous health records can be provided. After selecting the appropriate OPD, a video call with a doctor will be initiated.

The e-Sanjeevani states that, so far, 39,78,94,482 patients have been served across 150 specialities. Allopathy as well as Ayurvedic consultations can be availed according to the OPD timings.

In rural areas, Ayushman Bharat Health and Wellness Centres (AB-HWC), known as spokes, facilitate assisted consultations with doctors and specialists.

Users can also link their Ayushman Bharat Health Account (ABHA) and manage their existing health records.

Critical healthcare gaps

This initiative was launched to address critical healthcare gaps such as a shortage of doctors, especially specialists, overburdening of district and tertiary hospitals, absence of health record creation and to provide a continuum of care.

When patients do not have smartphones available to consult online, they travel to the nearest health centre where they can use the e-Sanjeevani services. However, this comes with its share of problems. The patients still have to travel a fair distance to reach the healthcare centre.

Rural centres are understaffed and overcrowded

Most health centres in the rural areas are understaffed and overcrowded, the impact of which is that in many instances, doctors do not have enough time to take online consultations as well as examine the patients in the hospital OPD.

Inadequate digital infrastructure impedes the implementation of services to those who need it the most. In areas with poor network connections, doctors as well as the patients struggle to log onto the e-Sanjeevani website.

A lack of awareness about this initiative has also rendered it underutilised. A Scroll article cites pressure of meeting unofficial targets has led doctors and health workers to register unnecessary consultations for cases that can be treated using basic medicines.

A report published in Medianama stated, “In our study, we found that only around one-fifth of eSanjeevani referrals lead to useful and appropriate prescriptions, if the doctor abides by ethical and safe prescribing guidelines.”

Another critical challenge is that basic health check-up requires things such as the pulse, temperature and blood pressure readings, and most patients in rural areas do not have the equipment to provide these.

With an increase in awareness campaigns, improvement in digital infrastructure and better training, e-Sanjeevani can truly bridge the rural healthcare gap persisting in the country.