What’s up, doc: Live chat is catching on, but how far should you take it?

When Gopal Agarwal, a 55-year-old businessman from Noida, was bitten by a large insect at home recently, he didn’t rush to an emergency ward; he just logged on to his laptop.

“A friend had told me about E-Clinic and it took me just 10 minutes to create an account on their website and consult a doctor via video chat,” he says.

The doctor suggested an ointment; Agarwal paid Rs 400 plus taxes, and he did it all from the comfort of his home.

EClinic247 is among a host of new websites offering online diagnosis and treatment, a doctor’s opinion in minutes — and a second opinion within hours at extra cost.

Consultations are available via video, phone or live chat, with costs per consultation ranging from Rs 199 to Rs 400. Some, like Doctor Insta, also offer an annual subscription fee for a family of four, at flat rates that start at Rs 1,000.

“In India, it’s tedious for a patient to get to a doctor, even in the cities. Time is one issue; traffic, timings and convenience are others,” says entrepreneur Amit Munjal, who set up and heads Doctor Insta. “Doctor Insta was set up a year ago to bridge that gap — and hopefully reduce the self-medicating that Indians are notorious for, where we just head to the local chemist and ask him what he would recommend.”

There are, of course, questions about the accuracy of online diagnoses too, and the issue of how much you ought to trust the verdict of a doctor you have never met.

“We are very strict about quality checks,” says Jeyandran Venugopal, founder and CEO of EClinic247, which is two years old. “All our doctors are certified, with an active license to practice medicine in the country. We also do background checks to confirm that they have a degree from a recognised institution.”

It’s a good option if you want a specialist’s opinion on a mild condition—a common cold, a dermatological issue, a small cut or wound, says Dr Neeraj Tulara, specialist in internal medicine and infectious diseases at Mumbai’s super-specialty Hiranandani Hospital. “But for serious diseases or even orthopedic or gynaecological issues, you must see a doctor in person, because you cannot always rely on the patient’s narration of a problem. A doctor must be able to corroborate the patient’s account with his or her own examination in order to diagnose an ailment with greater accuracy.”

INSTANT ACCESS

There are serious areas of healthcare where an expert opinion, even long-distance, can be invaluable, however.

“There is a sea of people who do not know any specialists and usually don’t have any option of seeking a second opinion. They follow their doctor’s advice blindly. We need to empower patients,” says Dr Kavita Singh, a UK-based cancer surgeon and founder of a start-up called Healo Medicine.

Dr Singh has had been travelling to India regularly for 20 years to provide consultations. “I felt the need to guide people and decided to start this project. I have a team of 100 specialists from around the world, who are available to help patients make correct decisions about their treatment based on the latest developments in medical sciences,” she says.

Currently, the facility is available to patients living in Delhi-NCR, and doctors can be contacted via email, telephone or video link, via www.healomedicine.com, at a cost of about Rs 6,000 per session.

“Gradually we will also open kiosks in more remote areas, so people can call in,” says Dr Singh.

Healo also offers paid membership to small doctors, especially in Tier 2 or Tier 3 cities, so they can request guidance or support.

In addition to second opinions, there are also services that offer to create a central database of your test results and maintain your medical records.

medECUBE, launched last year, has an offering called DR.SCAN (short for, Discovery, Records & Alerts, Second Opinion, Coordination, Access and Navigation).

The aim here is to eliminate all friction points and even enable patients to get second opinions from experts at major global centres for specialised treatment.

“medECUBE is an aggregator layer, offering to make life easier by hand-holding patients through various processes,” says Dr Dilpreet Brar, founder and MD of medECUBE.

Subscription costs Rs 25,000 annually.

HealthCareAtHomeIndia, meanwhile, has been offering technology-driven home-based medical services since 2013.

“The concept of homecare services is very popular abroad and we aim to replicate the same in India. During the past three years we have provided service to about 3 lakh patients across the country,” says Gaurav Thukral, senior vice president and business unit director at HCAH.

The company offers a multitude of services, ranging from routine procedures like injection administration to home chemotherapy, home ICU services and even pre- and post-natal maternity services.

WHY THEY MATTER

India has the second largest geriatric population in the world. Currently, 9% of Indians are over 60 — roughly 103 million people. This number is expected to go up to 300 million by 2050, which means one in five Indians will be a senior citizen, making home-based care a sort of necessity.

Also, non-communicable diseases including cardiovascular disease, diabetes, chronic obstructive pulmonary disease and cancer cause about 50% of deaths in India.

“The market was always there for home-based care; now it has become more organised,” says Thukral.

Which is not to say that the convenience comes with a glitch-free guarantee.

“Such a company or doctor can be taken to court, just as a hospital or medical practitioner can be, if the patient is not satisfied. If a doctor hasn’t examined the patient physically then chances of a wrong diagnosis or miscommunication increase. Though we haven’t received a case of this nature yet, the way such services are catching on, we might soon get one,” says Dr Girish Tyagi, member of the Delhi Medical Council.