Problem: Access to quality primary healthcare is scare in rural India. According to a report by IMS – “Understanding Healthcare access in India”– about 45% of the population travels more than 100 kms to access a higher level of care. The situation has worsened given the Covid-19 situation and the resultant lockdown or social distancing measures. This coupled with the fact that the existing healthcare facilities are focusing to manage the Covid-19 crisis. Thus the rural communities are also deferring to visit the PHCs or CHCs in the fear of potential exposure to the virus. This is likely to severely impact the health of the rural communities suffering from other health conditions, and could result in higher mortality. History provides that during the previous epidemics such as Ebola, people with other critical health conditions suffered severely due to reduced access to care, medicines and diagnostics.
Our Covid-19 response: The benefits of having an existing model in place have allowed us to respond quickly. Within a few days, our tech team built an up-gradate to our existing “nurse-assisted” tele-consultation software that has been tested with more than 100,000 patients. The new system allows direct “patient to Doctor” consultation with a weblink over a smartphone or laptop. While our remote consultation software garnered positive interest from the community, certain users groups such as remote and elderly faced challenges with tech adoption, and internet access. In order to democratise this service, we went back to our drawing board and added an additional feature of tele-consultations over phones where our frontline nursing staff act as a bridge between the patient and the doctors.
Our Solution: Our 24-hour helpline and counseling service, equipped with dedicated community healthcare workers, and counselors, enables doctors to provide consultation to rural patients in their vernacular language. Our guidance provides the necessary information and awareness to rural individuals about Covid-19 isolation, physical distancing and hygiene best practices. Our remote symptom screening tracks high risk patients, who can be referred to the right healthcare facilities to avoid delays in diagnosis, treatment and necessary quarantine measures. We have also built capabilities to provide contact-less delivery of medicines within the reach of our existing 25-clinic network. Leveraging our tech systems to triage the patients requiring tests or referrals, we aim to augment the efforts of the government in building grassroots Covid19 preparedness and healthcare system capacity.
Progress so far: We have launched our helpline and are counseling ~100 people everyday in rural communities of Rajasthan, Haryana and Madhya Pradesh. Within 4 days of launch of the services, our team has counseled more than 200 people, enabled consultations of about 100 patients and referred about 4 covid-19 suspect cases to local government facilities.
Next step: It is advisable that most Covid-19 suspects or confirmed patients can self-isolate and recover at home. However, they need to be counseled for regular support, mental health and periodic follow-ups for symptoms monitoring. Significant cases (~90%) of such patients could be managed at their respective houses with online support of the primary health care providers. For such patients, our counselor can provide the necessary support to cope with the home isolation.