While trade and big business goes global, healthcare has followed suit. With more than 100,000 Apps and health-related websites now connecting patients with doctors on-line, questions are being raised about the absence of a global regulatory body as well as the legality and problematics of on-line diagnosis…
For the mobile-first, digitally-centred generation, online doctor consultation makes sense in terms of ease of access, affordability and convenience. The rise in broadband and wireless connectivity, coupled with growth in smartphone users have spawned more than a 100,000 apps worldwide, which help patients connect to a specialty doctor for a virtual consultation.
Virtual consultations have wiped out geographical limitations and time lags in making a doctor available in all-emergency and non-emergency situations. Access to a 24×7 on-call doctor, reduction in health care bills and efficient utilisation of time has clearly changed the doctor-patient paradigm.
Technology has also shortened emergency room queuing, enabling doctors instant access to patients’ health records which makes on-line consultation feasible. According to a recent study, e-consultation and mobile health solutions may have helped African countries save more lives than traditional international healthcare aid.
Patients also use the service to seek multiple professional opinions on medical diagnosis.
Online doctor consultation platforms are either country-specific or cater to a larger consumer base sans boundaries. For example, the app, Hello Doctor, is available in ten African countries, offering online doctor consultation, free and updated healthcare information and advice in rural areas to diagnose and monitor symptoms of diseases.
There are others, like Babylon, which started in the UK, with the view to now expand into East African nations.
India-based Doctor Insta, which offers face-to-face video consultation has over 100,000 registered users is also considering international expansion.
According to a recent report by market research firm Verify Markets, online healthcare platform in the US is expected to witness a CAGR of almost 50 percent, with revenues forecast to exceed AUD 4.7 billion by 2022.
Services in Australia has grown at an average rate of 150 percent every five years since 2000.
Expenditure in digital healthcare in mainland China has also grown to the extent that Boston Consulting Group forecasts the market will expand from AUD 4 billion in 2014 to AUD 35 billion by the end of 2017.
Virtual doctors are also registered now with the Centres for Medicare and Medicaid Services (CMS) in the US, with many assigned a service provider reimbursement code for ‘non–face-to-face health care services’ for patients suffering with chronic conditions.
The model of online consultations in advanced countries has laid out a roadmap for emerging markets, while at a nascent stage, it is largely restricted to doctor scheduling and app-based consultations. According to a study by the Associated Chamber of Commerce and Industry in India, online scheduling and consultation is expected to grow to AUD 43 million by 2020 from its current value of AUD 20 million.
Practo, one of the leading health service providers in India claims it receives over 4 million doctor searches every month.
While virtual consultation has its advantages, some problematics include in-experienced doctors who don’t have the exposure to work under experienced doctors; there are also complaints that some doctors use the platform to direct patients to their own practice by purposely offering only partial or ambiguous diagnoses as a way to convert the patient to a face-to-face consultation.
Questions around patient privacy and security may also be a concern. The quality of care offered on a platform is determined by patient confidentiality, with the sharing of personal information such as laboratory tests, scans, video recordings requiring mandatory data encryption.
Advocates for virtual consultation consider it to be one of the biggest healthcare innovations of our generation. Speciality services include access to doctors in paediatrics, dermatology, orthopaedics, mental health such as depression and addiction, sexual health consultation, lab result analysis, as well as chronic care management.
Detractors to on-line consultation are plenty, who argue that proper diagnosis is not possible, which may lead to administration of incorrect prescriptions. Questions around liability abound – if something goes wrong, is the platform or the doctor liable? In many countries, physicians are not allowed to give prescription-only drugs to patients without direct contact with the patient.
To this end, the Irish Medical Organisation has requested its Government stop health insurers offering customers access to doctors via phone or video conference. The IMO claims such services pose a serious risk to patients.
Most developed economies using on-line consultation have chalked out their own set of guidelines to regulate mobile and web-based doctor consultations, however, the lack of a global uniform regulatory body governing online medical consultations across countries, the issue of liability arising due to a patient/doctor dispute continues to be a challenge that is yet to be resolved.