INTRODUCTION
India is a nation with a steady growth rate in its population over the previous few years with a rapid increase in urbanization with as many people as possible, moving into cities. Even after such rapid urbanization, most of the people of India still belong to rural areas. With such an increase in population, the pressure of providing necessities for living a quality life also increases, which includes many aspects like providing health care and education. Technological advancements have made some great efforts to deliver such necessities to society at large. Telemedicine is one of the technologies used to deliver and provide healthcare services remotely. With further reading, you will get to know about various challenges and remedies provided for the same by the use of such technologies and how Judicial Precedents and Legislation developed the idea of using the same over the years.
RURAL INDIA & CHALLENGES
Rural India in its literal meaning includes that part of the population living in rural areas. As per the Economic Survey (2022-23), approximately 65% of India’s population lives in the rural areas[1]. Rural India can also be termed as the ‘backbone of the nation’, has significant challenges, some of the critical ones are:
Employment: In rural areas, the main source of income (employment) comes from the agricultural sector but it doesn’t mean that every person can be employed. Due to this unavailability of employment to all, people start migrating from rural areas to urban areas in search of employment opportunities which will ultimately lead to overcrowding in urban areas.
Infrastructure: Ineffective or inadequate infrastructure concerning obtaining information regarding opportunities for one’s development, newer technologies, policies or facilities provided by the Government.
Health: The health sector in rural areas is one of the biggest challenges for rural India. There are many factors which constitute health being such a challenge. Such factors include; unobtainable access to clean water for drinking purposes, improper sanitation and latrine facilities with poor drainage systems, leading to deterioration of health among all the people living in those rural areas. All these factors will later on constitute to increase in levels of child mortality and other significant problems that might be solved if given proper treatment at the right time.
TELEMEDICINE
It is impossible to provide health support to every rural land where there is poor infrastructure and not much knowledge for the same, or to avail medical support they have to go far away from their place of living. As per World Health Organization (WHO), telemedicine means providing medical or healthcare services by healthcare professionals via communicating through emerging technologies for communication and information for sharing valuable information for the proper treatment as well as for the promotion of wellness to places where distance is the major determinant[2].
Telemedicine provided the patients in rural areas a quick access to healthcare experts. It made it possible for the medical professional to virtually visit such patients. It is one of the most cost-effective and time-saving mechanisms.
LEGAL ASPECT
Although there are no such specific laws for the governance of telemedicine in the market in India that doesn’t mean that the whole of the practice is invalidated. In the year 2020, the government issued ‘Telemedicine Practice Guidelines’ under the Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulation, 2002[3] which provided the framework for the practice of the same[4]. However, the court further clarified that the fact that these are not laws as such doesn’t mean that they are not legally binding. Due to this emerging nature of issues about telemedicine, the framework has been provided under the name of ‘guidelines’ that need to be followed for the time being.
The case of Deepa Sanjeev Pawaskar and Another Vs State of Maharashtra[5], was one of the cases where telecommunication by the Doctor led to the death of one of their patients. The patient was at the stage where she delivered a baby, a day earlier and had complaints regarding vomiting the very next day. The doctor gave all the advice and prescribed medications without proper diagnosis over the phone and discharging the patient without a thorough examination and his non-presence, all these were taken into consideration and the Bombay High Court held Doctor’s act was negligence towards his duty his bail was rejected.
The jurisdiction for these telemedicine services in the country comes under the Ministry of Health & Family Welfare (MoHFW) and the Department of Information Technology.
National Digital Health Authority of India (NDHAI) was established with a vision of securing quality services regarding health for Indians via cost-effective and secure use of ICTs. To ensure a much safer transmission of data during the practices regarding telemedicine, MoHFW has developed and revised a set of Electronic Health Records (EHR) standards in 2016[6].
In such a vast area of Rural India, telemedicine helps in ensuring speedy and easy access to all the people living in those rural areas where distance is the major factor in not getting proper treatment at the right time. This, availability of a basic living of a quality life, is also backed by Article 21[7] which ensures the right of life and personal liberty hence the practice of telemedicine even without proper legislation, is not invalidated as it is in furtherance of things that constitute as a right over one’s life under Constitution of India.
CONCLUSION
A major advantage of telemedicine in rural India is the enhanced access to specialized medical care. Residents in rural areas, who often lack access to specialists because of their remote locations, can now connect with experts in urban centres without having to travel. This is especially important for managing chronic illnesses, mental health conditions, and emergencies, where prompt treatment is essential.
Telemedicine has significant potential to transform healthcare delivery in rural India by improving accessibility, affordability, and quality of care. However, to achieve this potential, it is essential to make concerted efforts to enhance technological infrastructure, train healthcare professionals, and educate the rural population about the advantages and applications of telemedicine. By addressing these challenges, telemedicine can become a fundamental aspect of healthcare in rural India, ensuring that everyone has access to necessary health services and no one is left behind in the pursuit of health and well-being.
Author(s) Name: Divyang Kishwan (Guru Gobind Singh Indraprastha University, Dwarka)
References-
[1] Youth for India, ‘Insights: Challenges & Problems in Rural India & What to Do?’ (2022) <https://insights.youthforindia.org/challenges-and-problems-in-rural-india/> accessed 10 July 2024
[2] Aparajita Dasgupta and Soumya Deb, ‘Telemedicine: A New Horizon in Public Health in India’ (2008) 33 Indian Journal of Community Medicine 3 <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2782224/> accessed 10 July 2024
[3] Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002
[4] Satvik N Pai and others, ‘Understanding the Medico-Legal Aspects of Telemedicine in India’ (2023) 15 Cureus <https://www.cureus.com/articles/173699-understanding-the-medico-legal-aspects-of-telemedicine-in-india#> accessed 10 July 2024
[5] Deepa Sanjeev Pawaskar & Anr vs State of Maharashtra [2018] (Bombay High Court)
[6] Vinoth G Chellaiyan, AY Nirupama and Neha Taneja, ‘Telemedicine in India: Where Do We Stand?’ 1872 <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6618173/ > accessed 10 July 2024
[7] Constitution of India, 1949
