Daily Times

The coronavirus outbreak that began in Wuhan, China at the end of December 2019 was not anticipated to have taken over the world in such a deadly manner, killing thousands along its way. For Pakistan, the scenario is still not as bad as it could have been. Let’s take this opportunity to reflect on the need of online health care service in Pakistan.

Hospital OPDs in government hospitals across Punjab, the potential site of coronavirus patients and the site of maximum people to contact, are in full occupancy. Every patient coming to an OPD is accompanied by at least two to four family members. In case of patients who are ill and retained in emergency departments, the number of attendants per patient range from two to as many as ten. We are deep into the coronavirus crisis but the concept of social distancing and staying at home has failed in our society, and that is increasing the spread of the virus.

It is reported that only one doctor is available for every 6,325 people in Pakistan. Every year Pakistan produces thousands of new doctors, so why do we still have such a disproportionate doctor-patient ratio? One reason is that some of these doctors are lost to flawed health policies as they move to better health systems abroad.

A national healthcare system is only as strong as the primary and secondary healthcare level, which in Pakistan comprises basic health units, rural health centres and district headquarters. These centres are deficient in medical facilities and manpower, which forces a large patient population from rural areas to tertiary care hospitals located in big cities. These tertiary care facilities cannot afford to cater the patient load coming in from peripheral centres at a time when the coronavirus threat is at its peak.

Out of the hundreds who visit emergency departments of public hospitals every day, only about 40 percent are real emergencies. The remaining 60 percent or so are non-emergency (OPD) cases that unnecessarily overcrowd emergency rooms at a time when anyone could be a suspected coronavirus case.

Since a full lockdown was never an option for Prime Minister Imran Khan and social distancing campaigns have not generated the response they should have, there is an urgent need to introduce telemedicine or an online healthcare system. Electronic communication has revolutionised services like banking, travelling, buying and selling of goods, among others. It is about time medical care in Pakistan also entered the digital world.

Telemedicine uses the concept of health information and communication technology to overcome geographical barriers and provide standardised healthcare to areas where corporeal medical facilities are unavailable.

Health organisations in our country should invest in integrated digital healthcare so that we are better equipped to counter deadly contagious infections such as the coronavirus

There is a long way before online healthcare sees daylight in Pakistan, but if given due attention it has the potential of growing into a system where video consultation services, and electronic transmission of laboratory, imaging and healthcare informatics between doctors and patients could be made possible. Patients who are bed bound and require ambulatory services to reach hospitals and white-collar syndrome patients (who avoid hospitals because of anxiety and phobia) would be better managed by the online pathway. Eventually, the overall cost of healthcare would be controlled.

Mass storage of medical records and real-time monitoring of blood pressure or blood sugar level of patients who reside far away from hospitals can be done along with therapeutic adjustments, thus leading to better disease outcome.

Telemedicine can provide our female doctors who have to quit their jobs after marriage the opportunity to restart their careers within the confines of their homes. This online approach also takes care of anonymity, particularly of female patients with gynaecological issues who do not want their identity to be revealed.

When the world is being infected with coronavirus, it is times like this when an online healthcare system can come to the aid of our people. Coronavirus patients can be kept in isolation, treated and monitored using digital means without putting healthcare workers in direct contact with the patient. It would also help decrease patient load in hospital OPDs and ERs that are already overwhelmed by coronavirus patients.

The World Health Organization has stated that provision of efficient and effective online medical services is the solution to many of the health problems prevalent in developing countries. Health organisations in our country should invest in integrated digital healthcare so that we are better equipped to counter deadly contagious infections such as the coronavirus and the dream of “healthcare for all” could be made a reality.

The writer is an Islamabad-based doctor and can be reached on Twitter @drkhalidshab