Doctor diagnosed me virtually and healed from distance - Tele-Neurology works !!!

Telemedicine was considered futuristic and experimental some years ago, but it is a reality today. It is now emerging as an important and convenient tool for specialized healthcare, particularly for patients in remote locations with limited access to standardized healthcare services. However, there are multiple challenges to realize its full potential. Hence, the recent guideline on telemedicine practices published by the Ministry of Health and Family Affairs in collaboration with NITI Aayog and Board of governors , Medical Council of India on 25th March 2020 . These new guidelines have given authenticity and confidence to doctors to get into this new platform.

For years, healthcare has been provided by the traditional methods of face-to-face contact in the physician’s clinic or hospital. However, technology has changed, 21st-century strategy for healthcare access helps it be delivered without any hassles. Many patients now expect to interact with their healthcare providers online, and geographical barriers that once prevented some patients from receiving care can be removed using teleconsultation tools. Telemedicine means ‘healing from a distance’.

The World Health Organization (WHO) has adopted the following description of telemedicine: The delivery of health care services, where distance is a critical factor, by all health care professionals using information and communication technologies for the exchange of valid information for the diagnosis, treatment, and prevention of disease and injuries, research and evaluation, and for the continuing education of health care providers, all in the interests of advancing the health of individuals and their communities.1 This includes facilitating access to healthcare to both privileged and underprivileged populations, providing faster, cheaper, and better communication for treatment, follow-up by experts and to store records. It helps remove geographical barriers to healthcare, especially by reaching distant areas poorly connected by any means of transport.

A virtual consultation is a process of getting a medical opinion without visiting the specialist in person, which is the only difference from a traditional medical consultation. Virtual consultations also allow a physician to start a chat session with another physician to consult various electronic medical records.

Zydus Hospitals, Ahmedabad started their own Tele health platform for providing care to their patients during COVID 19 pandemic. Tele – Neurology consultation was particularly helpful in follow up patients who only required dose adjustments or continuation of the previous medications. For them it came as a great relief as they were reluctant to visit the hospital in view of the ongoing pandemic. For new patients and first consultations however, the challenges of Tele- Neurology were many. Apart from an accurate history, a thorough Neurological examination is vital for localization of the disease {Brain, Spinal cord, Peripheral nerve or Muscle) which is not entirely possible with tele- consultation. When I was asked to do tele consultation for a new patient, I had my share of doubts and apprehensions as I would not be able to physically carry out a neurological examination of the patient. After all, Neurology is all about “Where” and “What” the lesion is. I did the consultation and diagnosed a 60 year old gentleman as a case of IPD ( Idiopathic Parkinson disease) based on characteristic tremors, short shuffling gait and slowing of all activities of daily life. I did let him understand the limitation on teleconsult as I could not examine him and advised him to visit the hospital after 10 days. He made an appointment in 7 days which made me wonder if there was any improvement on treatment or had I made the wrong conclusion. Pleasantly enough, he came to thank me after significant improvement on starting the medications. He was pleasantly surprised that I diagnosed him without touching him and virtually. Other necessary investigations were later done. I looked at him and smiled and said that Neurology is all about a good clinical history and told him “you were the great story teller”.

By : Dr. Arvind Sharma

Sr. Consultant - Neurophysician & Stroke Specialist