Health institutions across the country have been hit hard by the COVID-19 pandemic and, as a result, patients are unable or unwilling to visit hospitals fearing the risk of virus transmission. In such a context, online medical services, commonly called telemedicine, have emerged as a valuable means for patients to consult doctors without the need for in-person visits. Telemedicine is not a new phenomenon and in Nepal too, it has been in use for quite some time, helping people, who live in remote areas, access to specialist healthcare services. But the coronavirus pandemic has thrust it into the spotlight and greatly expanded its utility and relevance. For starters, it enables virtual consultations which allow doctors to triage patients without potentially exposing them to the coronavirus in the hospital.

This is especially important for senior citizens and terminally-ill patients who will be able to get the care they need from the safety of their own homes. Telemedicine is also hugely beneficial for the corona patients who are under home isolation. Online check-ups eliminate the need for them to be brought to the hospital or for a health professional to be physically present with them; hence, reducing the possible spread of the virus. Essentially, telemedicine helps reduce the number of patients in hospitals which, in turn, helps free up staff and resources for those who are in serious need of them. Telemedicine has the potential to address increasing patient volumes during this pandemic.

But let us remember that telemedicine is a supplement to and not a replacement of in-person healthcare. It is great for consultations and triaging but many diagnostic tests and treatment require hospital visits. Also, in telemedicine, doctors can only go by what the patient tells them. They cannot check the vital signs or observe the physical conditions of the sick person. Doctors only have a few tools at their disposal. Such remote clinical services are also highly dependent on telecommunication infrastructures which are either unreliable or entirely absent in many parts of the country, when talking about Nepal. Also, the reimbursement and payment structures are something which have not been considered properly yet. There is also a need of national guidelines in place to support innovation in telemedicine.

Nevertheless, telemedicine has very real benefits, especially during the current pandemic and it should be promoted. Guidelines and structures as discussed above should, no doubt, be formulated but the more urgent requirement is for hospitals and health service providers to drive up their investments in telemedicine-compatible hardware and software and increase training for their personnel. Hospitals should focus on developing their own systems that connect to and facilitate the other pre-existing systems like their in-house system of record-keeping.

Off-the-rack solutions like video-chats and use of social media may not be suitable as long-terms methods because of privacy and security concerns. Telemedicine might have reached a tipping point during the COVID-19 pandemic. The momentum that has gathered now might as well sustain even after this crisis is over. So, the stakeholders should start developing national and local telemedicine mechanisms to carry this service for the long term. But, at the same time, the focus should also be on advancing and expanding traditional health facilities because virtual medicine cannot replace in-person healthcare.