What are Teleconsultation and TeleHealth Insurance?

We have all heard about telemedicine consultations. The recent COVID-19 pandemic has ensured that Telemedicine Consultations are now a part of life for everyone.

What do we understand by Telehealth Consultation? According to the World Health Organization, Telemedicine is healthcare services delivered by healthcare professionals in cases where distance plays a crucial role. It uses technology and information for communication and the exchange of all data considered valid for diagnosing, treating, and preventing diseases and injuries.

What is TeleHealth Insurance?

Insurance Regulatory and Development Authority of India (IRDA) issued guidelines in June 2020 addressing all health insurance providers in India directing them to cover telemedicine in all cases where the terms and conditions of a health insurance policy cover consultation with a medical practitioner. This means that whenever a health insurance policy has a benefit or a rider of OPD consultation, the company will cover such Telemedicine Online Consultation.

Care Health Insurance offers OPD Care as an add-on rider for a very reasonable cost, along with its following health insurance policies:

1. Care Supreme
2. Care Advantage
3. Care Senior

These policies form a part of Tele Health Insurance and will cover Telemedicine Consultation.

OPD Care for Care Supreme and Care Advantage offers you reimbursement for 4 consultations in a year from 14 specified specialists, the reimbursement is capped at Rs. 500 per consultation. In Care Senior 2 claims are allowed per year, with the amount in the range of Rs. 5,000 and Rs.50,000, based on the Sum Insured.

Care Advantage offers unlimited e-consultations with a general practitioner through the mobile app as part of the plan's built-in benefits.

Note: OPD Care and Tele Health Insurance are subject to predefined limits.

Origins of Telemedicine Consultation

Contrary to popular belief, Telemedicine Consultation is not a modern development and has been around for a long time. Way back in 1959, the doctors at the University of Nebraska in the USA were the forerunners in the usage of video communication for interacting with patients for medical purposes. This was the start of modern online telemedicine consultation as we know it. In May 1961, the National Aeronautics and Space Administration (NASA), the US space agency, pioneered remote monitoring of a patient by studying certain vital readings of Alan Shepard, the first American to be in space. More ground-breaking progress was made in the field of Telemedicine Online Consultation with the success of a US Government project called Space Technology Applied to Rural Papago Advanced Health Care (STARPAHC).

Telemedicine Consulting has progressed by leaps and bounds from these humble yet astounding beginnings. What was already a practice gaining acceptance gained a nearly compulsory status with the outbreak of the COVID-19 pandemic worldwide.

Types of Telemedicine

There are 3 types of Telemedicine Consultation:

Store and Forward

This is the most common type of Telehealth Patient Consultation, in which clinical information is collected and forwarded electronically to another site for evaluation. This uses cloud storage technology extensively and is always encrypted to protect patient data. If you get some clinical test done, take a photograph of the reports or send a photograph of the progress of some external condition and send it through some messaging service or upload it to a site, you would be using a store and forward method of telemedicine. Some examples of store and forward telemedicine are as follows:

• Teledermatology
• Teleradiology
• Teleophthalmology

Remote Monitoring

Remote Monitoring means health providers have 24x7 access if so required, to the readings of Remote Patient Monitoring (RPM) devices to monitor and analyse the patient’s conditions from outside the hospital premises. The patient may be at home and suffering from an acute or chronic condition and the physicians monitoring have the advantage of being able to make proactive decisions.

Real-Time Interactive Services

In this telemedicine consultation, the patients connect to the medical professional using real-time video, and the consultation, assessment, diagnosis, and prescription processes are done remotely. Physical distance is overcome here. You will recall that in the wake of the Covid 19 pandemic, a substantial chunk of patients who were not suffering from comorbidities used this method to connect to their medical professionals.

The Indian Perspective

There is no law in India specifically dealing with Telemedicine Consultation. However, this should not be misconstrued to represent that this makes it illegal in India. To provide a framework for this practice, the Government of India, in March 2020, released a set of guidelines called ‘Telemedicine Practice Guidelines’, incorporating it into the Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulation 2002, as Appendix 5. A brief mention of the guidelines below will help you to understand the best practices recommended:

1. Who Can Practice Telemedicine: Any Registered Medical Practitioner (RMP) enrolled in the Indian Medical Register or the State Medical Register can practice telemedicine.
2. Identification of RMP and Patient: Anonymous Telemedicine Consulting is not allowed. Before starting, the physician must introduce himself, state his qualifications, and identify and confirm the patient’s name and age.
3. Mode of Telemedicine to be Used: The RMP makes this decision based on his experience and the situation.
4. Consent: Explicit consent from the patient is required before telehealth patient consultation.
5. Prescribing Medicines: The RMP is required to exhibit responsibility at the same level as that of an in-person consultation. The RMP must mention his registration number and send a scanned copy, a photograph, or a digital copy of a signed prescription over any messaging platform or e-mail an e-prescription to the patient. Any RMP is not authorised to prescribe schedule X drugs during a telemedicine online consultation.
6. Ethics and Confidentiality: The RMP must adhere to all established principles of medical ethics and ensure that the privacy or confidentiality of patient data is not violated.
7. Misconduct: Advertising for telemedicine or forcing a patient who prefers in-person consultation to go for Telemedicine Consultation will be considered misconduct.
8. Documentation: The RMP has to maintain a record of the Tele Health Patient Consultation.
9. Fees: The physician may charge appropriate fees and has to provide a proper receipt.
10. Emergencies: In emergency cases, the patient should be advised to go for an in-person consultation.

The Government of India has supported Tele Medical Consulting and some well-known hospitals have been successful in establishing the practice – Sri Ganga Ram Hospital, Delhi; Regional Cancer Centre, Trivandrum; Sanjay Gandhi Postgraduate Institute of Medical Sciences are some of the prominent healthcare institutions that have instituted the practice.

The Indian Space Agency, ISRO, has used its network to connect 45 rural hospitals, remote hospitals and 15 super speciality hospitals.

Private players like Narayana Hrudalaya, Apollo, Escorts and others have also taken an active part in adapting to Telemedicine Consultation. Numerous apps have also been created and are being used for telehealth consultations.

Advantages of Tele Health Consultation

The following are the advantages of Online Telemedicine Consultation:

1. Reduced Exposure to Contagious Patients: As you do not need to physically be present in a medical facility or in a physician’s waiting room, the exposure to patients with contagious diseases is reduced.
2. Improved Time and Commute Efficiency: Online Telemedicine Consultation from the confines of your home or office saves time and expenses of an often long commute. This is especially relevant if you are based in a remote area. You are also saving on the time wasted physically waiting for your turn to consult the doctor. Instead, you can just log in or connect at your predetermined time slot. Follow-up consultancies are also easier and more convenient.
3. Enhanced Privacy: You can log in or connect to the doctor directly bypassing some other people, both staff of the facility and other patients. Your consultation process is more private with Tele Health Consultation.
4. Lower Cost: Renowned and experienced doctors tend to be very expensive. The fees for Telemedical Consultations normally tend to be cheaper than those for in-person consultations.
5. Better Access to Special Medical Options: Often, special medical options are based in cities other than where you stay. Telemedicine opens up a world of doctors and practices from all over the country. Telemedicine Consultation allows you to access these special medical options which you may otherwise find inconvenient to access.
6. Flexible Work Hours: This is from the physician’s point of view. They, too, enjoy the convenience of flexible work hours as they are not bound by any physical medical facility. A relaxed medical professional is better for you as a patient.
7. Better Analysis Referring to Stored Data: In Telemedicine Consultation, the medical practitioner has access to stored data from previous interactions and what you have sent him or uploaded. The physician may refer to this data in detail for better analysis.
8. Possible Disaster Management Solutions: In times of natural disasters and pandemics where patients are not able to physically access medical health providers, Online Telemedicine Consultation is the fastest way to be able to get accurate solutions. This has been widely and effectively demonstrated during the worldwide COVID-19 pandemic.

>> Also Read: Important Tips to reduce your Health Insurance Premium

Disadvantages of Tele Health Consultation

There are certain disadvantages of Telemedicine Online Consultation:

1. Possibility of Misdiagnosis: The physician does not have physical access to the patient, which makes it difficult to take some essential readings like current blood pressure, pulse rate, etc. It may sometimes be difficult for a doctor to examine you visually. These factors may contribute to misdiagnosis in rare cases.
2. Patients May Not be Familiar With Modern Technology: Certain people, especially senior citizens, may not be accustomed to using modern gadgets and technology.

Conclusion

You have seen how Telemedicine Consultation has anchored itself firmly in the Indian healthcare scenario. Health Insurance companies such as Care Health Insurance are also offering coverage for Telehealth Insurance through their plans. Do choose wisely, keeping all this in mind while purchasing a Health Insurance policy.

Disclaimers: All plan features, benefits, coverage, and claims underwriting are subject to policy terms and conditions. Kindly refer to the brochure, sales prospectus, and policy documents carefully.