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Proposed guidelines for Registered Medical Practitioners (2022) by the National Medical Council

Posted on July 14, 2022July 20, 2022

Author – Dr Nalanda Singh (Medical Consultant, Intelehealth)

The draft document has been released in the public domain recently by National Medical Commission (NMC) regarding Professional Conduct Regulations (2022) which includes Telemedicine Practice Guidelines for Registered Medical Practitioners (RMP). This will serve as a set of self-regulatory guidelines for the RMP to practice medicine both physical and remote teleconsultations, and commitment to patients, society, and professional colleagues.

Highlights:

Prefix, Suffix, and Modern Medicine:

Only those RMPs who are registered under NMC Act, 2019, can use Medical

Doctor (Med Dr.) as a prefix before their names

Only NMC recognized medical degree/ diploma as a suffix
All RMPs, employed or self-employed should display the unique registration number below the RMPs’ signatures
RMPs are allowed to practice only one system of medicine.
RMPs need to be involved in public education & awareness activities without involving advertisement.

Prescribing Generic Medicine:

Every RMP is expected to prescribe drugs using “generic”/“non-proprietary”/“pharmacological” names only.
Encourage patients to purchase drugs from Jan Aushadhi Kendras.
To avoid misinterpretation prescriptions should preferably be written in capital/ typed and printed.

Continuing Professional Development (CPD):

30 credit hours required every 5 years, to be updated online regularly by

receiving training from recognized medical colleges, health institutions or medical societies.

Ethics:

Guidelines reflect relevant professional as well as social expectations from

RMP.

Must not refuse to treat a patient in case of a medical emergency, nor

discriminate based on gender, religion, caste, or economic grounds.

In case of abusive, unruly violent patients or relatives, the RMP can document, report, and refer the patient.
When an epidemic occurs, an RMP with all necessary medical protection and his own health permitting should not abandon his/her duty for the fear of contracting the disease him/herself.
Should not engage in endorsement or promotion of any drug, or medical product.
RMP & their families must not receive any gifts/travel facilities/ hospitality /cash/ monetary grants.
Inclusion of Declaration of Geneva 2017 called ‘The Physician’s Pledge’.

Penalties:

Strict and detailed penalties have been enumerated for uniformity across the country in the assessment of liabilities and award of disciplinary actions in case of professional misconduct.
The disciplinary actions mentioned are – Reformation, Temporary suspension of license to practice, which can range from 1 month to 3 years.
Debarring the RMP will depend on the level (severity) of misconduct proved.

Digitization of Medical Records:

Every self-employed RMP shall maintain medical records of all patients for 3 years from the date of the last contact with the patient. This should be done within 3 years of publication of the official gazette.

Consent:

Before performing any clinical procedure, or operation, the RMP should obtain the documented informed consent of the patient. In case the patient is unable to give consent, the consent of the legal guardian or family member must be taken.
In an operation that may result in sterility, the consent of both husband and wife is required.
In-vitro fertilization or artificial insemination shall be undertaken only after informed written consent from the female patient, spouse, and the donor.
A RMP shall not publish photographs or case reports of patients without their permission in a manner by which their identity could be revealed.
For the use of patient data in academic teaching or clinical case discussions, patient consent is required. Under no circumstances will the patient’s data be posted on social media.

Social media conduct:

RMP can provide factually verified information/ announcements on social media.
Should avoid discussing treatment or prescribing medicines and soliciting patients on social media

Telemedicine:

Principles of medical ethics that are mandatory for the profession must also be respected in the practice of telemedicine.
A RMP is eligible to provide telemedicine consultations from any part of India and should be familiar with guidelines, processes, and limitations of telemedicine practice, hence they need to undergo CPD training on the same.
Teleconsultations should not be anonymous, the patient and RMP should know each other’s identities.
In the case of a minor patient, teleconsultation should proceed only in the presence of a parent/legal guardian.
Patient confidentiality, privacy, and data integrity should not be compromised.
Mandatory consent.

Telemedicine Application types-

Mode of communication – video, audio, text
Timing of the information transmitted – real-time, asynchronous
Purpose of the consultation – nonemergency (first consultation & follow up), emergency (first aid, counseling, referral)
Interaction between individuals involved – patient to RMP, caregiver to RMP, RMP to RMP, health worker to RMP.

Patient management-

Health education- related to health promotion & prevention
Counseling- specific advice related to underlying condition
Medicines- can prescribe any drug except schedule X drugs

Guidelines for technology platforms enabling telemedicine:

RMPs must not participate in telemedicine platforms that provide ratings by the patient or others including reviews, advertisements, and promotions of RMPs by any means (manipulation of algorithms/search engines).
Technology platforms providing telemedicine services are obligated to ensure that consulting RMPs are duly registered.
The platform must provide the name, qualifications, registration number, and contact details of every RMP.
In case of non-compliance with guidelines/ existing laws applicable to the

provision of services, appropriate legal action can be initiated against the

platform.

Artificial intelligence/ machine learning is not allowed to counsel the patients or prescribe any drugs but can assist and support the RMP on

evaluation, diagnosis, or management.

Technology platforms must ensure a proper grievance redressal mechanism for end-users of their services.

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Quality Assurance Mechanism

Posted on July 12, 2022September 20, 2022

Author : Dr. Shilpa Bhatte (Chief Program Officer – Global Lead, Intelehealth)

Telemedicine is the remote diagnosis and treatment of patients using telecommunications technology.

It is a reasonably new medium for providing and seeking healthcare services due to its sudden thrust into the limelight during the COVID-19 pandemic. As healthcare providers, we are still in the process of understanding and exploring how these services can be optimized and made effective and efficient to suit patients’ needs while also inculcating a sense of trust in the medium through which the advice is provided.

At Intelehealth, we believe that healthcare providers will need ongoing user support and troubleshooting with tech-related issues to adapt to a new medium and will require support to deliver healthcare advice effectively.

To support our healthcare providers and standardize their skills – we maintain a rigorous quality assurance mechanism for our helplines and telemedicine platforms. Specifically, with helplines, we do a thorough and ongoing medical audit of a few core areas, such as:

Communication skills
Quality of the advice/information provided

The clinical team conducts the audit based on details recorded on the app and given to them. But they can contact the concerned backend doctor/s, frontline health worker/s, or patient/s for further understanding.

With communication skills, our focus is to emphasize the need to engage the patients with empathy and compassion, understand their symptoms and ask relevant questions to understand the morbidity better.

Introduction: Stating who you are and the organization/government you are calling on behalf of is extremely important, along with the reason for the call – it can be disorienting to a person/patient if they do not understand who you are and the nature of the call
Using speech effectively: Speaking slowly is essential, and so is pronouncing words well. Maintaining a calm tone is important, and mumbling or speaking fast may have a counter-effect in the person not being interested in the consultation. One has to also quickly assess if they can hear your questions satisfactorily and can respond accordingly.
Language: It is essential to adjust the language according to the listener/patient, optimizing their engagement and responses. It is also vital to always be respectful and empathetic in your questions
Minimize use of medical language: Health providers assume that patients will understand the nature of the morbidity under question. This may not always be true. Hence use descriptive language to explain the color, shape, size, etc.
Script: Having a written down prompt sheet is extremely important to ensure all the points that need to be covered are completed. This ensures that the call was efficient in receiving information from the patient in case the conversation drifts and hence helps bring back focus to the subject under scrutiny.
Listen well: Communication is about speaking and active listening, which shows the person/patient that you are paying attention to what they are saying.
Summarizing: Repeating important information/instructions on prescription helps ensure that the advice provided was well received and understood. Note down a follow-up schedule if required or pertinent

While assessing the quality of advice/information provided by the health provider, our focus is to evaluate:

Ensure that evidence-based information is provided to the patients
Updated information based on local government guidelines is provided
Wherever possible – holistic information on preventative, curative, and/or treatment plans is shared with patients
Treatment standards are applied to ensure that all patients receive appropriate care regardless of financial means

Overall the Medical audit includes the vetting of the following parameters:

Registration: Process, Completeness, Closure of visit
Demographic details
Consent
Case history: Completeness of information by matching with an appropriate mind map and checking for ambiguity in the information given in the recording versus that registered on the app
Issues about past, family history, etc
Issues about measuring and registering vitals: Registering vitals, the correctness of values
Issues about physical examination including complete assessment: Diagnosis, investigations, prescription, follow-up, referral
Turnaround time – TAT: time-lapse between upload of the case and a prescription issued
Time-lapse between consultation by backend doctors and patients receiving prescription
Patient outcome
Tech-related issues: app or user-related issues
Doctor patient communication
Quality of advice and information provided

The quality assurance process is a fact-finding process rather than a fault-finding endeavor to provide regular feedback to the health providers to build their capacity to provide effective and efficient teleconsultations. This, in turn, has a virtuous effect on the trust-building process between patients and telehealth providers and increases the robustness of the telemedicine platform.

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#10000Voices: Her Journey for a Better Future

Posted on April 5, 2022June 2, 2022

Soni Prasad, Community Health Worker, Kamde

My name is Soni Prasad. I am posted at Health & Wellness Centre, Kamde as CHO (Community Health Officer). Like many others, I did not have a privileged childhood with a lot of parental support. I was driven and ambitious in my pursuit of a successful career. My parents eventually recognized my ambitions and became supportive of my dreams as I grew older. Fortunately, I was married to a man who was both supportive and understanding. It was difficult at first, but my determination never let me give up on my dreams. With the support of my family and husband, I was able to complete my B.Sc. in Nursing and later decide to become a teacher. After 5 years of a successful teaching career, I was given an opportunity to work as a CHO at a Health & Wellness Centre (HWC) in Kamde.

eSanjeevani is a platform that connects people in rural areas to remote doctors for quality healthcare services. The majority of the rural population earns minimum wage and lacks the financial means to access quality health care. They have received free consultations from certified remote doctors and specialists through HWCs. eSanjeevani is a great initiative for providing quality healthcare to the last-mile population where there is no doctor. I hope to serve those in need and put forth my best effort for the community’s well-being.

Jijabai Motiram Chaudhary, Anganwadi worker, Kapurne village, Nashik

“Jijabai Motiram Chaudhary has been working as an Anganwadi worker for the last 40 years. So it was no surprise that I (Dr. Shilpa Bhatte) found myself discussing the health needs of the community with her, at the Gram Panchayat meeting in Kapurne village, Nashik, during my community needs assessment visit. Jijabai shared her experiences of the various vaccination drives they had conducted in the village to the seasonal health challenges the villagers faced during monsoon. It was a pleasure hearing about her experiences in the field and the changes in healthcare that have happened over the years.

Her husband, Motiram, is a farmer and a huge supporter of her work. Her 95-year-old mother lives with them, and her grandson, who is 21 years old, recently married. As a result, four generations are living under the same roof, each contributing in some way to the village’s development.

Access to smartphones is always a challenge for women, especially in rural/tribal areas – however, Motiram made it quite clear that Jijabai was an important member of the community and needed to be the primary owner of the household phone. Kudos to the spirit of these “barefoot doctors”!

Khalimun Khatoon, Sahiya Worker, Khujra village, Lohardaga District

“My name is Khalimun Khatoon, and I am from the Lohardaga district’s Khujra village. I live with my husband and other family members. I have been a housewife for a long time. My life after marriage was difficult. My in-laws and husband were frequently rude to me and used to harass me about household chores. I always craved respect in my life, which I never received as a housewife from my family.

Around this time a ‘Sahiya’ representative came to our village. I had no idea what ‘Sahiya’ meant. The representative explained that a team of health workers constitutes ‘Sahiya’ workers. I was intrigued by their goals and desired to be a part of the team. I always assumed that if I worked like everyone else, I would be respected and perhaps even supported by my family. My husband and I talked about this opportunity and my desire to work with ‘Sahiya’ workers. He was thoughtful and supportive. I realized that now was the time for me to establish my own identity, to go out and learn new things, meet people from all walks of life, listen to their problems, and help them as much as I could.

I was warmly welcomed to the ‘Sahiya’ team. I attended several training sessions with highly experienced health professionals, where I was guided through the complexities of healthcare. I was able to be a part of the eSanjeevani initiative, which aims to provide affordable and high-quality healthcare to every corner of the rural sector through Telemedicine. During the COVID-19 outbreak, we educated people about COVID safety protocols in rural areas as well as the HWC (Health & Wellness Centre) initiative. I’ve been working for 15 years. I got an opportunity to build my own identity, be self-sufficient, secure my life, and most importantly, earn respect.”

Savitri Devi, Health worker (working under Ekal Arogya Telemedicine project, Ranchi)

“I am Savitri Devi, and I’m from Sanch Silli in Ranchi’s Anchal Ramgarh district. I have been living with my husband, Megnath Mahato, my father-in-law, and two children. I was a housewife before joining Ekal Arogya. Because I was the only woman in the house, I was responsible for all the household chores. It was challenging for me to manage both household activities and work at the same time. When I originally told my husband that I wanted to work for Ekal Arogya as a Frontline Health Worker, he was hesitant at first. But I had always wanted to help individuals struggling for a fulfilling life, and this was my chance. Despite numerous protests, I decided to take this opportunity and join Ekal.

I was always uncomfortable and afraid to talk in public. I didn’t have much experience in the medical field either. However, the team of doctors and specialists thoroughly described every area of healthcare to us and explained the fundamental procedure. For the first time, I was grateful to be a part of these innovative and interesting workshops with such experienced doctors. I gained a lot of confidence after joining Ekal. Ekal provided me with a unique identity. People from my village began to recognize me as a result of my efforts.

My husband, too, was incredibly proud of me and my accomplishments. When I didn’t have access to transportation, he took me to conventions and health centers. Now that I have acquired a scooter, I have mastered the art of self-driving. I never imagined I’d be so self-assured and courageous in my life. I am extremely grateful to the Ekal Arogya Foundation for providing the opportunity to contribute to the delivery of high-quality healthcare services in rural areas through Telemedicine.

Kamal Nikule, Health Worker, Arogya Sampada

I’m Kamal Nikule, I currently reside with my parents in Ghotpara a remote village in Nashik. I am married with a 4-year old daughter, but I have been living alone for quite some time. My husband was unable to support our family. He eventually couldn’t afford to provide us with the most necessities for our life. Every day, he grew more resentful of me, and eventually, he chose to disown me. I returned home and informed my folks of everything that had happened. With all the pressure from society, it was difficult at first, but I kept my cool. It’s been three years since my husband left me, and I’ve never looked back. I needed a job to make ends meet and provide my daughter with the life she deserved.

One day I was approached by the Intelehealth family to work as a Community Health Worker under the ‘Arogya Sampada Telemedicine’ project. I immediately agreed to work for a cause. Intelehealth has been important in assisting me in my quest to become self-sufficient and independent. They have been working hard to make life easier and more comfortable for those who live in rural areas and have little or no access to quality and affordable health care services. Intelehealth has provided me with a fantastic opportunity to advance in my life and protect my future. I am honored to be a member of such a prestigious organization.

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A Pro-Woman Life: Empowering Women Healthcare

Posted on March 10, 2022March 15, 2022

Health is an essential aspect for the enhancement of human resources as well as the quality of human life. Now, when we focus on the health of women in the country, it has something profound for primary health and education of the children and the economical wellness of households, along with the women themselves. Women in the rural sector experience inferior healthcare access compared to the women in the urban sector. Several rural regions have limited numbers of doctors and licensed practitioners, especially for women’s health problems.

In India, 70% OF INDIA’S TOTAL POPULATION RESIDES IN RURAL REGIONS and males significantly outnumber females, an imbalance that has increased over time. The typical female advantage in life expectancy is not seen in India and this suggests there are systematic problems in women’s health care.

Taking a Dive Down into the most prevalent Women Health Issues in the Country

Hike in the Women Mortality Rates

Indian women have high mortality rates, particularly during childhood and in their reproductive years. India’s maternal mortality rates in rural areas are among the world’s highest. From a global perspective, India accounts for 19% of all live births and 27% of all maternal deaths. Women in poor health are more likely to give birth to low-weight infants. They are less likely to be able to provide food and adequate care for their children. In rural areas where women are less educated and economically deprived, their health condition is worse.

Violence against a Woman affecting her Mental & Physical Health

Research by Usha Prabhakar published in 2003 shows that the effects of violence can be devastating to a woman’s reproductive health, as well as to other aspects of her physical and mental wellbeing. In addition to causing injury, violence increases a woman’s long-term risk of several other health problems, including chronic pain, physical disability, drug and alcohol abuse, and depression. Women with a history of physical or sexual abuse also have an increased risk for unintended pregnancy, sexually transmitted infections, and adverse pregnancy outcomes.

Mother bearing Underweighted and Malnourished Child

Numerous studies indicate that malnutrition is another serious health problem for Indian women. The negative effects of malnutrition in women are compounded by heavy work demands, poverty, childbearing and rearing, and the special nutritional needs of women, resulting in increased susceptibility to illness and consequent higher mortality.

An unhealthy mother gives birth to an unhealthy child. According to the NFHS, Indian children have among the highest incidence of malnourishment in the world. More than half (53%) of all girls and boys under 4 years were malnourished, and a similar proportion (52%) was stunted. An estimated 16 million abortions happen in India each year. The majority of these abortions (73%) are medication abortions.

[Data Source: National Family Health Survey]

How has Telemedicine impacted Women’s Healthcare in the Country?

In many parts of the world, it’s a challenge for women and girls to travel to a doctor’s office or pay for a doctor’s services once they get there. More often, many victims of domestic violence are hesitant or afraid of coming out and being open about the issues they are suffering, hence, a virtual source like telemedicine service acts as a support mechanism.

At Intelehealth we have found that such barriers are reduced after the introduction of telemedicine services via our telemedicine app. It is an effective approach to handle geographic and cultural difficulties in countries facing similar problems.

Intelehealth’s Initiatives towards the Acknowledgment and Elimination of such Core Issues

We at Intelehealth have also focused on the dynamics of healthcare programs and initiatives that focus on addressing the issues about women’s health in the country such as reproductive, maternal, sexual, newborn, adolescent, and child health.

Intelehealth collaborates with grass-root NGOs, INGOs, State Govts. and hospitals to provide the right kind of telemedicine solution & implementation support; training & health information to the frontline health workers and enable them to deliver quality healthcare to every individual who does not have sufficient health care resources in their respective regions.

Intelehealth responds to this critical need for women’s healthcare through empowering women, young people, and children. Here is a brief about what we are working towards:

IBIS Vikalp Sansthan has set up a helpline (1800-309-4120) for women to provide information about safe abortion, sexual and reproductive health. The helpline aims to provide general information about female pregnancy, birth control, sexually transmitted infections, and services for women undergoing abortion or experiencing domestic violence, with a primary focus on safe abortion practices for women. “Today, I am a much stronger woman than ever. I urge survivors of domestic violence and sexual harassment, to call on the helpline (1800-309-4120) and seek support. You are not alone. We are here to listen to you and help you in every possible way” – Shamina, a domestic violence survivor now working as a counselor with the Vikalp helpline

We at Intelehealth believe in the vision of Universal Health Coverage – that one should be able to receive the health services they need, when and where they need them, without facing a financial hardship (WHO). Our mission is to “deliver quality healthcare where there is no doctor”. This vision & mission requires the collective efforts of an entire ecosystem. We aim to be a catalyst to empower existing health programs to do more through well-designed user-centered technology.

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Doorstep delivery of essential healthcare services in rural areas through Hand in Hand India telehealth

Posted on March 10, 2022March 10, 2022

12-year-old Khusboo Kumari from Kalidih village, Jharkhand suffered burns all over her foot during a freak bonfire accident.

Unfortunately due to poor economic situation, villagers fail to give importance to their health. Khusboo and her family avoided visiting the doctor due to the travel distances to far-flung hospitals and costs of medication and consultation. Around the same time of this incident, Hand in Hand India telehealth was launched. A telemedicine initiative providing maternal & child care and primary healthcare services and making it accessible to the rural population where there is no doctor.Anita Minj, a health worker working under the hand-in-hand telehealth project while doing home-visits, visited Khusboo’s house. As the nurse noticed her wound, she immediately decided to refer to a doctor in a city hospital as this was a critical case. Owing to the family financial crisis and poverty, Hand in Hand bore all the medical costs and also provided food for 10 days.

Khusboo – “I thank Hand in Hand for saving my life. They diagnosed my condition at the right time and referred me to a good doctor, we otherwise wouldn’t be able to afford. There are no hospitals or doctors in our village, but due to door-to-door visits by these doctors, my burns were diagnosed at the right time. Due to medication and timely diagnosis, my foot is healing gradually. I can now stand on my foot and walk comfortably”

Health worker Minj(white coat) at Khusboo’s house during her home to home visit

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NISHTHA Swasthya Sampark Helpline- Caring for people with post-COVID illnesses

Posted on February 24, 2022March 9, 2022

Post-COVID complications could be disturbing your mental health, read how this beneficiary received complete support from the helpline

NISHTHA Swasthya Sampark Beneficiary Testimonial

I contracted COVID-19 during the second wave, however, my symptoms were mild. As was the norm prevalent at that time, I had to isolate myself at home in my small village in Palamu district, Jharkhand. Home isolation was challenging as I was away from my family whilst also managing household chores and cooking for myself. Being alone was only making me feel all the sicker. During my isolation, I had severe stomach aches, chest pain, excess sweating, and gastro issues. Due to the lack of doctors in the village, I had spoken to a few doctors whose details I got thru references, however, their medication didn’t work.
I felt all the more isolated and it took a toll on my mental health. I then decided to look for COVID-19 care-related helpline numbers when I came across NISHTHA Swasthya Sampark helpline that provided free teleconsultation by a remote doctor. I immediately called the helpline and I was connected to a remote doctor. The doctor queried about my name, address, age, and the health issues I was facing and carried out a thorough diagnosis. The doctor suggested a couple of exercises, asked to drink plenty of water, eat nutritious food and meditate.
I began following the doctor’s advice. What amazed me through this entire process was that I received multiple follow-up calls from the NISHTHA Swasthya Sampark helpline checking on my health status and my well-being. Seeing the rising number of infections, deaths of young and old couples with being isolated, I feared for my life. But with this helpline, I was totally relieved and received immense support from the NISHTHA Swasthya Helpline team. It just felt like a family member checking on my health status which helped me recover soon.
“I thank all those involved in launching the NISHTHA Swasthya Sampark helpline for this excellent initiative and for helping people in isolation. I feel much better today. They were there for me when I needed emotional support the most”

Remote doctor shares his experience in consulting covid recovered patients suffering from post covid complications.

Dr. Arvind Singh – Working under NISHTHA Swasthya Sampark telemedicine platform

I am a physiotherapist based in Jharkhand and President of Arogya Foundation of India, Dhanbad Bagh. During the second COVID wave, there was a rise in post covid complications amongst recovered patients. To address this issue, we started consulting patients as remote doctors for the NISHTHA Swasthya Sampark helpline – a helpline for post-COVID care. This helpline was launched by the Govt of Jharkhand in partnership with USAID-NISHTHA.
I have been working on this helpline for the last 2 months and have attended multiple calls with regards to post- COVID breathing problems, muscular weakness, emotional and physiological problems. Being a physiotherapist, I aim to improve patients’ quality of life and ensure that their lives are back to normal.
In these months I have attended to multiple patients calling in with breathing problems & spondylitis issues. For those with breathing problems, I demonstrated breathing exercises virtually, while those with spondylitis issues were shown different yoga exercises and postures. I also attended to patients who suffered facial and hemiparesis (one side body paralyzed) paralysis. These patients were anxious about their health. I showed them specific exercises for their paralysis and also counseled them to boost their confidence.
During my follow-up calls with the patients, I received plenty of positive feedback about the helpline. They were satisfied with the helpline’s services. Patients were also happy with the treatment they received.
“The NISHTHA Swasthya Sampark helpline has helped many COVID recovered patients who needed constant care during their post covid recovery. I was trained virtually on the features of the app and on connecting with patients through this tech-based platform. I thank all the stakeholders involved in launching this helpline that can help patients who are in dire need of immediate care and treatment”

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Ekal Arogya Helpline – Free COVID-19 consult, COVID-19 vaccine information & general illness helpline

Posted on February 23, 2022March 10, 2022

PATIENT STORIES

Neeraj Singh, a resident of the Balaghat district in Madhya Pradesh was unwell for a couple of days. He was unable to receive immediate treatment due to lack of doctors in his village. Around this time, Arogya Foundation Of India & Ekal Abhiyan India with the support of Intelehealth launched Ekal Arogya Helpline – A free doctor teleconsultation helpline for COVID-related queries and general illnessesNeeraj shares his experience using the Ekal Arogya helpline and how he has fully recovered with the help of free teleconsultation by a remote doctor without travelling to a far-flung city hospital that saved a lot of his money and travel time.

Covid-19 fears forcing many to give vital treatments a miss: Since the onset of the pandemic, many people have been avoiding crucial medical treatment for the fear of contracting Covid-19 at hospitals. Sudha Singh, a resident of Lucknow went through the same ordeal for one month. She had typhoid symptoms, however she feared visiting the hospital due to contracting COVID19. It was around this time that Arogya Foundation Of India & Ekal Abhiyan India with the support of Intelehealth launched Ekal Arogya Helpline – A free doctor teleconsultation helpline for Covid related and general illness queries. Sudha narrates her experience in using Ekal Arogya helpline and how she has fully recovered with the help of teleconsultation.

This pandemic has affected all strata of society in different ways. Today, as we honor our National Doctors, here is a story of Dr. Manju Gupta who faced huge challenges in getting required medical care for her Covid19 infected family members inspite of having good connections within the medical fraternity and hospitals. Reflecting on her struggles, she empathized with what the rural population would be going through. So she came forward to volunteer as a remote doctor for the Ekal Arogya helpline project to help treat, advice, and care for rural patients in her quest to make a difference!

Punith, a resident of Hassan district in Karnataka was unwell for a couple of days. He was unable to receive immediate treatment due to lockdown in the state due to which travelling to the nearest city hospital 14kms away was difficult. Around this time @arogya_foundation & @ekalabhiyaan with the support of Intelehealth launched Ekal Arogya Helpline – A free doctor teleconsultation helpline for COVID-related queries and general illnesses. Punith narrates his experience using the Ekal Arogya helpline and how he has fully recovered with the help of free teleconsultation by a remote doctor that saved a lot of medical and travel costs as well as travel time.

REMOTE DOCTOR STORIES

I am the National President of Ekal Arogya Yojna and currently serving as a volunteer doctor with Inteleheath on the Ekal Arogya Helpline project. This helpline is a great initiative for people who need consultation on COVID-19, vaccine information and general illnesses in multiple languages. As I am based in Gujarat, I have attended to Hindi, Gujarati and English-speaking callers. I have been volunteering on this project for the past 1 and a half months and have attended around 100 calls. I am attending to patients who have issues related to covid symptoms, post covid care, and vaccine-related information. I have advised patients who showed COVID symptoms to do necessary tests, advised home quarantine patients to move to a hospital for immediate treatment whose oxygen levels had dropped.One of the many calls I attended was from a mother with a 10 months old baby who had heart issues (Atrial Septal Defect). The helpless family narrated their fear and worry about how they ran pillar to post visting multiple hospitals for opinions but they were not satisfied with the doctor’s suggestions. Around the same time, they heard about Ekal Arogya helpline and contacted us. I was the remote doctor attending to this family as they expressed their worry about the baby’s health issues. I comforted them and patiently explained to them the entire diagnosis and suggested that the baby get operated to avoid further complications. I also referred them to municipal hospitals in Patna and Ranchi for the best treatment. The family was convinced and agreed to visit one of the hospitals for further treatment. I will be following up with the family for any further help needed.

Dr. Raghunandan Mehta – National President, Ekal Arogya Yojana (AFI) & Volunteer Doctor, Ekal Arogya Hepline

“I feel satisfied as a doctor when the patient’s family is convinced with my diagnosis and the case moves further. I appreciate the efforts of team Intelehealth for this amazing, innovative doctors app that is helping so many patients at no cost. The app training given to me was flawless and I found it very simple to use. The team has always been there to support me whenever I had any problems in using the app. I also feel that such helplines will help retired and senior doctors who are unable to travel to hospitals and clinics for consultation. They can make use of this helpline from the confines of their homes and attend to patients especially those in the rural areas who need immediate attention and avoid burdening primary and tertiary hospitals”

Dr. Mehta tele-consulting patients via Ekal Arogya Helpline

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Strengthening the last mile reach of eSanjeevani in Jharkhand

Posted on February 22, 2022March 10, 2022

Intelehealth & Transform Rural India Foundation contributes to the National Health Mission (NHM) by working with the Government to build a successful implementation model and a more user-centered technology for the eSanjeevani telemedicine platform launched by the Ministry of Health and Family Welfare (MoHFW, Government of India). Intelehealth works as an implementation partner to the State Government of Jharkhand for the training of health workers and doctors, mobilization of leadership, community advocacy, monitoring, and evaluation leading to a successful deployment of eSanjeevani in the state.

In addition, we provide technical advice to the tech platform by addition of new features for low bandwidth/offline compatibility, better training of health providers, improved security practices, improved data dashboards, and more reliable system performance. The SoPs and technology developed in this project will be used for national replication of eSanjeevani Platform implementation for amplified impact.

The platform has enabled over 25000 consultations for many health issues faced in rural areas. The project is currently working in five aspirational districts – Khunti, Gumla, Loherdaga, Simdega, and Ranchi.

NEONATAL HEALTH

Jangi Devi’s 2day old baby recovers from rashes post-diagnosis

Jangi Devi, from Gumla district in Jharkhand was distressed when her 2-day old newborn got red rashes all over her body including her face and trunk. So the troubled mother seeking a solution to her baby’s rashes visited the nearby Health & Wellness Centre, which was working under the eSanjeevani telemedicine program. The Community Health Officer (CHO) connected Dr Nalanda Singh via video consultation for a proper diagnosis. Dr Nalanda did an intensive investigation of the case by asking Jengi Devi relevant questions. From her investigation, Dr Nalanda learned that the newborn was being wrapped in a blanket rather than soft warm clothes and would have to continue to do so until certain rituals were completed.

The mother wanted to protect her baby from the rituals but due to family pressure and a rigid mindset of elders, she had to give in to their decision. Dr Nalanda decided to speak to the baby’s grandmother to influence or change this conservative mindset. Dr. Nalanda counseled the baby’s grandmother and explained the health problems it could lead to due to wrapping the baby in a blanket. Dr Nalanda also prescribed some medication but emphasized on ensuring the baby wears soft warm clothes. The grandmother was convinced and followed the doctor’s instructions. In two day’s time, the grandmother herself came back to the HWC with joy and told the CHO that the baby has recovered. She thanked the doctors and CHOs for their selfless efforts and also the counseling provided.
The elated baby’s mother attended a campaign against neonatal problems within the village and educated other women about the issue. She also spoke at length on breaking away from a conservative mindset in order to provide a healthy life for the baby. She advocated the importance of eSanjeevani’s telemedicine program within the village that would provide early diagnosis for illnesses, free of cost instead of traveling to city hospitals.

CHILD HEALTH

Beneficiary(small kid in red t-shirt) teleconsulting with a remote doctor at the HWC under the eSanjeevani telemedicine program, Khunti district (Jharkhand)

Poor road connectivity, lack of health facility centres have always been one of the major concerns in rural areas. This makes access to quality healthcare services for villagers difficult. In Khunti district (Jharkhand), a differently-abled child from one of the villages fell from his bed causing an injury on his lips that needed immediate medical attention. The village had no nearby medical facility or doctors for emergency first aid treatment. The mother and the child would have had to travel by bus to a city hospital but unfortunately, the bus that travels to the city once a day was left by then.

However, owing to the implementation of eSanjeevani a telemedicine initiative in the district, the mother could bring the child to the nearest Health and Wellness Centre (HWC) for treatment and immediate care instead of traveling to far-flung city hospitals. The Community Health Officer (CHO) provided first aid to the child and initiated teleconsultation with a remote doctor for a further treatment plan. The remote doctor prescribed necessary medications and the child is on the road to recovery. Telemedicine enables timely, affordable as well as quality healthcare treatment without having to travel long distances resulting in saving of time and money.
Intelehealth & Transform Rural India together have partnered with Govt. of Jharkhand, NHM Jharkhand & CDAC to enable telemedicine services in the underserved communities of the state.

MALARIA

Priya Kumari (right) identity changed at eSanjeevani Health & Wellness Centre, Gumla ,Jharkhand

While appearing for my B Ed exams in a district in Jharkhand, I was running a very high fever. I took a basic paracetamo<

l for a few days but the fever didn’t subside. Worried about my health and the ongoing pandemic, I did a blood test. The reports came in 2 days and I showed them to a local doctor, who diagnosed me with Malaria. She gave me a 3-day injection course and medication. I followed her advice and completed my medication course, but the fever kept recurring. Post my exams, I went back to the same doctor who then asked me to get admitted. I was put on a drip for a couple of days due to increased weakness. I ended up spending so much money on medication and hospitalization, but still, I was not feeling fine.

I then went to my mother’s house which was a little away from where my in-laws were staying. My sister Pratibha Singh who is working as Community Health Officer under the eSanjeevani program asked me to visit the health and wellness centre. So I visited the HWC where a remote doctor teleconsulted me and gave an in depth diagnosis. The doctor prescribed a few medications and in a week’s time, I was feeling much better. The fever had gone and I had a good amount of energy

“I am grateful to the eSanjeevani team for launching this project in rural areas where people have poor access to quality healthcare. In Spite of spending thousands of rupees in traveling to hospitals, medications and OPD’s, I didnt get well whereas at eSanjeevani AB-HWC, not only was the consultation free of cost, but I also recovered in a week’s time”

NON-COMMUNICABLE DISEASES

Rajendra Mahli at eSanjeevani HWC, Jharkhand

Rajendra Mahli from Jharkhand visited the nearest Health & Wellness Centre (HWC) under the eSanjeevani telemedicine program in Gumla district for his COVID-19 vaccination. The Community Health Officer (CHO) at the HWC noted his medical history where he complained of weakness, non- healing ulcers in the axilla (armpit), profuse perspiration, and giddiness. The CHO immediately did a regular sugar test and checked his BP too. His sugar was on the higher side. The CHO identified that the patient needed immediate treatment and referred the case to a remote doctor for proper diagnosis and consultation.

A video consultation with doctor was arranged. The doctor upon checking Rajendra’s medical history advised him to only do the vaccination once his sugar is within a comfortable range. The doctor prescribed a few tests and medications for a month. Rajendra did a thorough test where the results detected the prevalence of Type 2 diabetes. The doctor suggested a diet plan, rigorous exercise, and prescribed medications.

Rajendra visited the HWC after a few days for follow-up and did a test again where his sugar level had come down. He did not complain about the puss that was oozing out from the ulcers or giddiness. He kept coming in for regular follow-ups to the HWC, where he showed gradual improvement and eventually managed to take his vaccination.

Intelehealth & Transform Rural India together have partnered with Govt. of Jharkhand, NHM Jharkhand & CDAC to enable telemedicine services in the underserved communities of the state.

EMPOWERING DOCTORS TO GIVE BACK

Dr. Divya Singh, Medical officer at the Rajendra Institute of Medical College, Ranchi is currently working as a remote doctor under the eSanjeevani-OPD program

I always wanted to be a pediatric doctor. I completed my master’s from Rajendra Institute of Medical College and Hospital, Ranchi and started work as a Medical Officer at the same college, consulting patients and teaching medical students part-time. In 2013 when I was in Delhi for a seminar, I met with an accident that led to paraplegia (injuring the spinal cord that paralyses the lower limbs) which resigned me to a wheelchair for the rest of my life.

This devastated me and I feared for my future. I was on rigorous physiotherapy for a while. As time passed, I always saw a blurred vision of my dream. This helped me stay strong and not give up. I said to myself, my health condition shouldn’t be an excuse in treating patients. Hence, I customized my car at my own expense and travelled to the hospital to treat patients and teach students. It was not easy as I had to make multiple visits to the college office for partial reimbursements, approached the staff to adjust my working schedule roster so on and so forth. The college has been very supportive as I am the only doctor with a special case.

During my spare time, I love reading books and painting. I have written and published my own book ‘Girl with wings on fire’, which is on my struggle post by accident. I hope that it will motivate many people to pursue their dreams inspite of adversities. Over time my passion for teaching grew and treating kids gave me a sense of joy; just being around them and seeing them smile made me happy.

Dr. Divya Singh being helped by college staff into her customised car

Last year, as the pandemic struck and the lockdown was imposed, the college approached the medical staff to get enrolled as doctors for eSanjeevani OPD, Jharkhand. eSanjeevani-OPD is a direct-to-patient app for basic illness, medical and follow-up consultation. This project made my life easier as I could stay home and tele-consult patients. I have been working on this project for the past one year and have consulted almost 3,000 patients with 70% mild cases and 20% tertiary cases that needed special attention were referred to a hospital for further treatment. I not only treated children but also tele-consulted as a general physician and helped the poor with the right diagnosis.

“I am thankful for this project. It has enhanced my confidence and boosted my morale. Working from home has helped increase my productivity and save travel time as I strive to deliver quality consulting services to the needy who are most vulnerable during this pandemic”

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‘Vikalp Helpline’ helps survivors of domestic violence and sexual and reproductive health challenges.

Posted on January 28, 2022March 10, 2022

Read how Shamina, a domestic violence survivor fulfill her calling by working as a councellor with the Vikalp helpline

I, Shamina, am working with Vikalp Helpline as a counsellor. This helpline provides information & counselling to girls and women facing domestic violence as well as information on sexual and reproductive health.
I am a domestic violence survivor. I was beaten by my in-laws a few years into my marriage. I had no support from my family and I was afraid to voice my concerns. I was unaware of any legal recourse possible to combat this abuse. I often wondered how many women like me go through this each day. Since then, I decided I will work for an organization that helps women and young girls raise their voices against sexual harassment and domestic violence. Today under the Vikalp Helpline, I counsel so many young girls and women every day. They share their anguish, emotions and worries. I counsel them to speak out and voice their concerns, provide legal-related information. This helpline has empowered me to help others in every possible way. Many women who I have counselled through our helpline, have called back and shared positive results. I feel so happy that I managed to help them and make them stronger. Talking to these survivors and helping them out gives me a sense of peace and relief that I can fight my own battles.

Initially, we worked offline, maintaining case documents, pulling up old files for follow-ups etc., but with Intelehealth’s support, our work is now hassle-free, we save a lot of time in making notes instead we just feed in the information on the app and can access any document with just a touch of a button or screen. I am grateful to the people who have launched this helpline; it is a dream come true. Today, I am a much stronger woman than ever. I urge survivors of domestic violence and sexual harassment, to call on the helpline (1800-309-4120) and seek support. You are not alone, we are here to listen to you and help you in every possible way.

Shamina spreading awareness about Vikalp Helpline in Udaipur

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Arogya Sampada – A COVID19 care & Information related to Covid vaccination helpline

Posted on January 28, 2022March 9, 2022

I am a resident of Parbhani district in Maharashtra. My close relatives were due to take their first vaccination dose but few days before their vaccination, they showed Covid-19 symptoms. On testing, their results came positive. They completed their 14 day quarantine period and were curious to know when it would be possible for them to take their vaccination. I helped them in finding out on the internet, but there were different reports about vaccination post covid. This led to a lot of confusion and they were not sure about getting vaccinated.
Around this time we found out about Arogya Sampada, a free teleconsultation helpline launched by Intelehealth for COVID-19 and vaccine related queries. We called the helpline and then we were connected to their remote doctor. The doctor guided us and gave us authentic information where we decided to follow his advice.
“We thank Intelehealth and their initiative for setting up this helpline which helped us in connecting with doctors and clearing all out doubts I would recommend citizens to use Intelehealth’s helpline services for authentic information”

Pankaj Ghodke (Resident of Parbhani district,
Maharashtra)

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