In an era of rapid technological advancements, the healthcare system is undergoing a profound transformation that was unimaginable just two decades ago. The emergence of digital health technologies has given rise to telemedicine and remote patient monitoring, offering a lifeline to both patients and healthcare providers, particularly in cases where the cost of treatment is exorbitant, access to healthcare is limited in rural areas, or time is of the essence. Telemedicine consultations (TMC) not only save time and reduce the burden of travel but also have the potential to deliver outcomes that are as effective, if not more so, than traditional in-person consultations. As technology continues to evolve, the modernization of healthcare becomes not just a possibility but a necessity.
Challenges of Traditional Tuberculosis Treatment
Traditional treatment of Tuberculosis requires regular check-ups, commitment of personal time, and resources. Self-administered TB programs show a failure rate of 35% to 58% worldwide. The recommended directly observed therapy (DOT) ensures a patient adheres to the administration of doses in front of a trained and certified healthcare worker. Although DOT shows an increase in treatment completion rates and causes fewer relapses, the time of commitment and resources is invariably higher.
Tuberculosis is a preventable and treatable disease, relapses in patients are fatal since over time TB weakens the body. Further, every TB patient who fails to complete the treatment is at a huge risk of spreading the disease. The challenge in front is to make treatment time and cost-effective.
Challenges of directly observed therapy (DOT)
DOT, though highly successful, comes with its share of challenges. DOT requires a trained person, other than family members of the patient, to meet patients at designated times and watch them swallow medicines in front of them. Apart from time and cost commitment, patients find DOT to be intrusive to their privacy, requires them to reschedule or block their working time, and is a long-term tiring experience.
The emergence of Video-based directly observed therapy (V-DOT)
The use of telemedicine in TB patients has brought in favourable results. In V-DOT, patients are called at a prearranged time, the patient identifies himself/herself and swallows the dose during the call. The date of treatment, time of dose, and patient details are saved for future use.
A study from India showed that 76.8% of participants preferred V-DOT over directly observed therapy. Another study with participants who had active TB showed that adherence to treatment over V-DOT was 95%. Patients found V-DOT to be less intrusive and time-effective. Overall satisfaction with V-DOT was very high.
Cost benefits of telemedicine and remote monitoring
The average time required to complete directly observed therapy is 1 hour whereas V-DOT took mere 3 minutes. Telemedicine allows doctors and patients to interact verbally and visually. In places with no electronic set-up, the one-time charges of setting up electronic gadgets were easily covered by saving the cost of traveling. The biggest beneficiary of telemedicine is people who live in remote areas. Patients who reside in rural areas can gain direct access to excellent healthcare services in the hands of experienced professionals just through a phone.
Key Takeaways
Telemedicine has its disadvantages. If a patient is non-compliant then the effectiveness of treatment becomes scarce. To constructively use telemedicine and remote monitoring in TB, a strict rule-based patient selection and resolution of language barrier is a must. Nevertheless, telemedicine offers an opportunity to reduce the workload of healthcare professionals and provide end-to-end treatment, especially in remote areas while being cost-effective and easy to use.