Telemedicine Services at Rawalpindi Medical University: An Initiative to Optimize Healthcare of the Patients During COVID-19 Pandemic

COVID-19 is very distressing to the whole world as increased
vulnerability of the human population to the novel corona virus
has severely affected national and international traveling...


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people. This methodology has become promising in modern days by the application of telemedicine services in various health plans [4]. Likewise, other historic emerging and re-emerging infectious diseases, corona virus infection has also come up with solutions despite of frequent challenges. This disaster has given an insight to our healthcare professionals for continuation of healthcare services through adoption of telemedicine. This technology will certify optimal healthcare services delivery to the general population with minimal transmission of infection [5]. High load of transmissible infection has provoked attention towards Telemedicine as the need of time [6]. Governor  at Holy Family Hospital on 27 th March 2020 that is one of the teaching hospitals of this University. This telemedicine center is a part of chain of telemedicine centers instituted all over the Punjab comprising of 150 mobile phone lines through free UAN Calling number (0304-1112101) and video consultation via a web portal "doctors247.online" [8]. A fully operational digital infrastructure with broadband internet set up was installed for smooth functioning and integrity of telemedicine. So, in addition to video consultancy with qualified doctors round the clock, patients' counseling through voice call was also enabled to assist the public who were devoid of internet services at their residence. The telemedicine service initiated at Holy Family Hospital, Rawalpindi are intended not only to identify the COVID-19 patients, guide for prevention and refer suspects but also to manage other health related issues faced during current lockdown scenario. Use of standard scoring sheet by doctors to score the problems of calling patients facilitated in apt referral. Hence, this technology of distant healthcare management exceedingly lessened the risk of viral transmission.  Table 1. Of the total 888 callers, 643 were males while 245 were females. Majority of callers were in 21-30 years age group as shown below in Figure 2.

Subjects & Methods
Presenting complaints of callers listened and catered accordingly at telemedicine center of RMU are depicted below in Table 2

Discussion
Telemedicine services are of great significance in continuation of healthcare delivery in response to outbreak of infectious diseases worldwide. They not only lessen the dissemination of infection among people by avoidance of crowding in healthcare settings but also facilitate provision of needful information for containment [9]. With the advent of wireless broadband technology, healthcare consultation through voice calls and video consultations has resulted in two way comfort [10]. Telemedicine is primarily meant to manage the cases distantly. It is not only anticipated to manage healthcare by recommending appropriate therapy but also intended for health promotion, education and disease surveillance [11]. In current study, commencement of telemedicine services at are also confronted with the burden of managing infectious cases that contribute to avertable mortality. The only way out under such unavoidable circumstances is to set up telemedicine platform for optimization of healthcare [12]. Even Centre for Disease Control and Prevention has declared the obligation of telemedicine to manage healthcare of the patients amid COVID-19 pandemic [13].
Similar to the benefits of telemedicine services realized in our region, telemedicine amenities were also verified to be advantageous internationally for both public and health workers specifically in Italy where hospitals were labeled to be as mainstream for transmission of COVID-19. Consultation of presenting complaints with doctors through video links and smart phones were confirmed to aid greatly in lessening the transmissibility of infection [14].  [16]. Despite the lockdown imposition, people continue roaming unnecessarily. However, punitive actions were taken by concerned authorities of some countries against people not staying at home and hiding history of international travel amid COVID-19 pandemic [17]. This governmental approach adopted by most of the countries is surely very effective to tackle the problem intelligently. Although telemedicine proved beneficial in healthcare provision during lockdown and managed to reduce workload on health facilities, but one problem faced globally in perspective of telemedicine was difficulty in management of serious health conditions that could not simply be managed without hospitalization. Telemedicine services therefore demand modification in terms of diagnostic facilities and triage for those patients who necessitate inpatient care [18].
Telemedicine amenities should periodically be updated for timely provision of diagnostic and triage services to mitigate the risk of infection during future epidemics [19].

Conclusion
Leveraging telemedicine in health sciences institutes is of paramount significance specifically during catastrophic situations for continuity of healthcare. International travelers were aware of the significance of the quarantine as need of time. Apart from health care, other real life issues can better be addressed in telemedicine through adequate counseling and facilitation.