So far 2,953 patients have been given online consultation. (Express photo)
Less than 20 days is what it took programmers racing against a surging pandemic to launch India’s largest public sector teleconsultation service – eSanjeevaniOPD. And the effort that realised this mammoth task was put in entirely by software engineers working out of Punjab.
It was soon after the lockdown was announced that a team of C-DAC (Centre for Development of Advanced Computing Mohali started working from home on the eSanjeevaniOPD to facilitate direct, long-distance patient-doctor communication. It was rolled out on April 13 and so far 13 states have come onboard with designated doctors from state health departments to provide online consultation.
C-DAC, Mohali, had first worked on an indigenous telemedicine technology in 1999, which had resulted in Sanjeevani — a platform for health related communication among doctors and government hospitals. But as COVID-19 presented another challenge, they used this experience to develop the online OPD in record time.
“Our people worked for 19 days non-stop to convert the earlier version of our technology to eSanjeevaniOPD. We began to operate on April 13. We are presenting patients before doctors virtually. Since general OPDs are closed in major hospitals, the doctors through eSanjeevaniOPD are bridging the gap,” said Executive Director, C-DAC, Mohali, Dr Praveen Kumar Khosla.
“A digital transformation has taken place and it is a turning point for telehealth,” he added.
C-DAC is a research and development organisation under the Ministry of Electronics and Information Technology with offices in 12 cities across India. After its Mohali centre launched the Stay Home OPD — esanjeevaniopd.in — over 600 doctors from 13 states have been trained through video conferences to use the portal, and so far 2,953 patients have been given online consultation. At least, 70 doctors were online on Saturday.
The eSanjeevaniOPD can be accessed smoothly by anyone with a a computer with Internet connection. A patient has to register on the portal, generate a token, wait for the turn and soon he or she gets connected to a doctor. However, the majority of states on eSanjeevaniOPD portal are currently only providing general consultations. A patient can upload health records and is sent an ePrescription at the end of the session. The optimal use is not possible through a smartphone, but C-DAC is planning to launch an mobile phone application soon.
“Sanjeevni has been a flagship telemedicine technology of the Government of India. We did not have much to look up to way back in 1999 when the government assigned us the task to develop indigenous telemedicine technology. It was launched in January 2003 as Sanjeevni. It was a store-and-forward model and three hospitals – AIIMS, Delhi, PGI, Chandigarh and SGPGIMS, Lucknow – were connected. It was a doctor to doctor technology,” said Project Director, Dr Sanjay Sood.
The state-wide implementation of this project among district and tertiary hospitals for communication among doctors began later. Around 300 such institutions were connected across India, including in Punjab and Himachal Pradesh, and even overseas in at least four underdeveloped countries. When the Union government launched Ayushman Bharat insurance scheme in 2018, the C-DAC was asked to bring eSanjeevni to the 1.55 Lakh health and wellness centers at village level to connect the community health officers with the doctors in real time. Around 3,000 centers have been brought under eSanjeevani till date.
“We were still implementing the project for the subcenters in rural areas when the ongoing situation arose. Since, non-COVID requirements of patients have been affected, we were asked to develop the patient to doctor facility. We were in lockdown too and this new avatar of eSanjeevaniOPD has been created while working from home. We began working on it around March 24 and launched on April 13 in the first set of four states,” said Sood.
Andhra leads in teleconsultation
Andhra Pradesh has been at the forefront of online OPD service as many of the state’s doctors were already trained under the project for the health and wellness centers. About 66 per cent (1969) of consultations till date have taken place from Andhra, which was first to join along with Maharashtra, Assam and Uttar Pradesh. The state is followed by Maharashtra and Punjab – which was eighth to join – with more than 200 consultations till date.
Punjab went live on the platform on April 25 and runs the service from Monday to Saturday from 10 am to 1 pm. It had conducted 222 consultations till Saturday evening by specialists. Around 103 doctors have been trained for use of eSanjeevaniOPD and mostly are consulting the patients from district civil hospitals, which have telemedicine nodes.
“The patients, who have doubts about going directly to hospitals for minor hospitals and are tech savvy, have used the service. The teleconsultation obviously cannot replace the actual consultation. The patient here has the option to include three files of previous medical history. There have been encouraging results from patients in these difficult times,” said Punjab health department’s nodal officer Deepinder Singh.
A large team from C-DAC is training the doctors for use of eSanjeevaniOPD and at least eight more states soon are set to join the platform. The C-DAC is in contact with the doctors through WhatsApp groups to ensure that the doctors do not face any problems. Doctors send screenshots of their screens in case of any hiccups and the issues are addressed in real time, said those involved with managing the portal.
“Social distancing has made adoption of telemedicine by its users really swift …The pandemic caused a paradigm shift for all stakeholders in healthcare. OPDs may not be opening soon. It has provided opportunity to both doctors and patients to use technology for health services. Many are reluctant to visit the hospitals and eSanjeevaniOPD comes to their rescue,” added Sood.