Telemedicine - A Contribution To Employee Health

With the implementation of lockdown, all clinics across India were required to temporarily shut down. Though it was an important measure to prevent the transmission of COVID-19 infection and save the lives of vulnerable people like the elderly, people with chronic conditions like diabetes, hypertension, chronic respiratory diseases, and heart conditions, this measure had left a lot of people with chronic conditions that required regular follow-ups with no access to their doctors. People suffering from acute health care issues had no brick and mortar healthcare facility to go to and the issues were left unaddressed. The only option was to visit an emergency room and the experience of visiting an emergency room is not very pleasant and no one wants to go through the stress, especially when the health issue doesn’t require one to seek urgent care.

Telemedicine hence proved to be a boon and people were able to avail advice from the doctor at the comfort of their home without travel and contact with crowds. The government responded in a timely manner and released the telemedicine guidelines so that providers can quickly get themselves ready to provide remote access to their patients. The pull from the consumers was significant enough that many healthcare settings started telemedicine consultations. 

ekincare - Helping organizations fight COVID through telemedicine

ekincare, a corporate health benefits platform, was one of the early telemedicine providers to the corporates helping them improve the health of their employees. ekincare provided free telemedicine services to employees of more than 600 companies and their dependents and witnessed 221% increase in online doctor consultations. 

ekincare enabled COVID symptom checker for users on its mobile application and rendered medical guidance based on the symptoms and the preexisting medical conditions. A user can also request a call consultation with a doctor which was provided within 1 hour of time. Information about state health helpline numbers and the guidelines for eligibility for testing for COVID -19 infection helped in avoiding unwarranted visits to these facilities at the beginning of the pandemic, at the time when the information was not readily available. 

Insights from all the metrics collected

• 64% of the total consultations 4029, were taken by men and 36% by women. 52% were taken by people in the age group of 21 to 30, 30% were taken by people in the age group 31 to 40 and 5% were in the age group 41 to 50 years. 5% were above the age of 50 years and 7% were below the age of 20 years (parents took consultations for children).
• 83% of consultations happened between 9 am and 9 pm. 17% of consultations happened after hours between 9 pm and 9 am.

While most people were worried after experiencing a symptom of COVID-19 infection, many people had anxiety that they might be having a COVID -19 infection, but later felt assured when the situation was explained to them in a methodical and a logical manner. All their questions were answered and proper guidance was provided for the prevention of COVID infection and symptoms to watch out for. If required, advice for COVID testing was also given in a few cases. The overall satisfaction rating of the users was 4.5. 

Other health consultations taken by employees

• Other issues addressed during CHAT consultations were majorly consisting of upper respiratory infections. Remedial measures were suggested along with a prescription for symptomatic medicines. Here too, medical education and awareness building was the key for users to feel assured. 
• Dermatological conditions were the next most common consultations. Acne, hair fall, fungal infections, eczema were some of the medical conditions and with the onset of summer, folliculitis and miliaria were an increasing concern.
• The next common area of medical problems was the gastrointestinal system. Gastritis, reflux disease, constipation, hemorrhoids, anal fissures, flare-ups of irritable bowel syndrome are some of the medical conditions that were high in frequency, and many could be traced to stress, and lack of minimal exercise. In this case, simple lifestyle changes and OTC medicines were dispensed.
• Weight gain was another major concern for many people with the disruption of exercise routines and meal schedules. Nutrition advice along with virtual fitness sessions provided by ekincare during this period when the gymnasiums were closed, was the right combination to motivate people and help them take control of the problem.
• Other chronic conditions like Diabetes and thyroid diseases that require frequent laboratory testing and a doctor to follow up the lab results, and advise regarding the adjustment of medication doses.
• Another important area that saw an increase in consultations was psychological issues like anxiety and stress reaction. Worry, inability to focus, tremor, and sometimes chest pain and shortness of breath were the presenting symptoms; further probing into medical and psychological history revealed underlying feelings of hopelessness, uncertainty about the job, disruption of routines, and interpersonal conflicts as main reasons for stress and anxiety. Some required a referral to a psychologist and some needed counseling and guidance by the doctor about maintaining routines, relaxation techniques, etc. 
• Similarly, insomnia was a common condition and dealt with accordingly with a lot of counseling about sleep hygiene and other measures. EAP (Employee Assistance Program) enabled by ekincare to corporate employees was easily accessible and the counseling by psychologists was provided in a confidential manner.
• Musculoskeletal problems like back pain and arthritis;  genitourinary problems like UTIs in women, sexual issues in men, and renal colic in both were seen.
• Ear, nose throat problems along with eye issues were on the rise too and some warranted a physical visit to a hospital.
• Many women consulted regarding gynecological issues like a missed period, contraceptive advice, and other common medical problems and men consulted for male sexual issues. Many young women were apprehensive about getting pregnant during COVID times.
• Pregnancy-related queries were addressed so that women can avoid a hospital visit whenever possible. Many frantic mothers consulted with worry about delaying vaccinations for a few days, and their questions were answered.

COVID related queries were put forth in 4% of the consultations taken by people for other medical conditions and were not having COVID related symptoms.

Overall for doctors at ekincare, it was a fulfilling experience providing more than 100 consultations a day, dispensing the much-needed advice during COVID times when neighborhood clinics were closed and hospitals operated only for emergencies.