Diagnostic concordance of telemedicine as compared to face-to-face care in primary health care clinics in rural India: a randomized crossover trial

CONCLUSIONS: Provider-to-provider telemedicine, where nurses at Health and Wellness Centres connect with remote physicians to provide care for patients they would otherwise have referred to a tertiary facility, is a feasible and safe intervention. Telemedicine is less reliable than in-person care but a safe and effective alternative where in-person care cannot be provided. We found it most effective for managing high-burden primary health conditions such as hypertension, diabetes, and remote antenatal care. The use of a digital assistant to facilitate the collection of an evidence-based medical history can result in more efficient teleconsultations, support asynchronous consultations and greater adherence to clinical protocols. However, we cannot conclude if the use of the assistant increases the quality of the outcome of the consultation and this needs to be further explored. Training for remote physicians and nurses on the limitations of telemedicine and the indications for referral could improve the quality of care. Telemedicine has significant benefits, including improved healthcare access for women, reduced costs for the patient, and improved health system efficiency by reducing overcrowding at secondary & tertiary facilities and reducing the risk of COVID transmission at facilities. Further research is needed to assess this approach's long-term outcomes, provider and patient satisfaction, and financial sustainability.PMID:37130015 | DOI:10.2196/42775
Source: Rural Remote Health - Category: Rural Health Authors: Source Type: research