“VIRTUL CLINICS : A NEW REALITY IN CHANGING

HEALTHCARE SCENARIO POST COVID-19”

Thesis Submitted to the NIPER Hyderabad in Partial Fulfilment for the Award of the
Degree of
Master of Business Administration
in

Pharmaceutical Management
by
Gaurav Songara
PM/2019/408

Under the supervision of

Dr. B. Lakshmi

Dept. of Pharmaceutical Management

NIPER Hyderabad

NATIONAL INSTITUTE OF PHARMACEUTICAL EDUCATION AND

RESEARCHHYDERABAD
 Declaration

I hereby declare that the dissertation work entitled “Virtual Clinics: A New Reality in
Changing Healthcare Scenario Post COVID-19” is based on the original work carried
out by me at Pulse Pharmaceuticals Pvt.Ltd and NIPER Hyderabad, under the
supervision of Dr. B. Lakshmi, Assistant Professor NIPER Hyderabad. I also affirm that
this work is original and has not been submitted in part or full, for any other degree or
diploma to this or any other University or Institution.

Gaurav Songara
Date:
III
 NIPER LETTER HEAD

Certificate

This is to certify that the dissertation work entitled “Virtual Clinics: A New Reality in

Changing Healthcare Scenario Post COVID-19” submitted by Gaurav Songara

with Regn.No. PM/2019/408 in partial fulfillment for the award of Master of Business
Administration (Pharm.) in NIPER Hyderabad. This work is original and has not been
submitted in part or full for any other degree or diploma to this or any other University or
Institution.

Dr. B. Lakshmi Dr. B. Lakshmi Dr. Srinivas Nanduri

Guide HoD Dean

IV
 Acknowledgements

It gives me an immense pleasure and pride to express my deep sense of gratitude and
respect for my teacher and guide Dr. B. Lakshmi Director, Dr. Shashibala Singh
Departmrnt of Pharmaceutical Management, NIPER Hyderabad or his evergreen expertise
and inspiring guidance throughout the period of my work. I am indebted to him for
enlightening me on the finer skills of dealing with synthetic problems. He is the one behind
giving me a decisive turn and significant boost to my career. I consider myself one of the
fortunate people to be associated with him.

-Niperaite

V
Contents

S.No. Title Page No.

Abstract 1

Title of the Chapter

1. Introduction 1-4

2. Literature Review 5

3. Objective of the work 5

4. Present Work/Results and Discussions 6-9

5. Conclusion 10

References 11

VI
ABSTRACT
The project “Virtual Clinics : A New Reality in Changing Healthcare Scenario Post COVID-
19” is about studying the telemedicine, the study of its demand and understands critical
Challenges and obstacles in it. The report consists of the detailed information of telemedicine
its primary research and survey reports. Different opinions by doctors across India are
considered in it. In the conclusion I have found that across India that doctors are considering
telemedicine as a platform for providing health Care service to patients. There are some
challenges in the use of telemedicine in health Care service sector. I have also mentioned
some advantages and disadvantages of telemedicine in the report. This report mainly focuses
the opinion of doctors toward the usages of telemedicine in healthcare providence.

INTRODUCTION
Virtual Clinic:

A virtual clinic is a planned contact by the Healthcare Professional Responsible for Care with
a patient for the purposes of clinical consultation, advice and treatment planning. It may also
be referred to as a telephone contact, telemedicine, teleconference or video link. 11 percent of
US consumers using telehealth in 2019 to 46 percent of consumers now using telehealth to
replace cancelled healthcare visits and up to $250 billion of current US healthcare spend
could potentially be virtualized.

Potential for Telehealth and virtual care

 On-demand virtual urgent care

 Virtual office visits
 Near-virtual office visits
 Virtual home health services
 Tech-enabled home medication administration

Services for the healthcare users

 Consultation from the convenience of patient’s home

 Uploading patient’s medical records for possible consultation
 Email alert will be sent to patients whenever a doctor replies
 Payment of consultation fees is possible
 Online visits-especially useful for patients living far away in other city/country.
 Assures confidentiality
 Accessible any time any where

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History of telemedicine:
The development and history of telehealth or telemedicine (terms used interchangeably in
literature) is deeply rooted in the history and development in not only technology but also
society itself. Early forms of telemedicine achieved with telephone and radio have been
supplemented with video telephony, advanced diagnostic methods supported by distributed
client/server applications, and additionally with telemedical devices to support in-home care.
In the 21st century, with the advent of the internet, portable devices and other such digital
devices are taking a transformative role in healthcare and its delivery
1800s to early 1900s
As technology developed and wired communication became increasingly commonplace, the
ideas surrounding telehealth began emerging. The earliest telehealth encounter can be traced
to Alexander Graham Bell in 1876, when he used his early telephone as a means of getting
help from his assistant Mr. Watson after he spilt acid on his trousers. Other instances of
telehealth during this period came from the American Civil War, during which telegraphs
were used to deliver mortality lists and medical care to soldiers.
From the late 1800s to the early 1900s the early foundations of wireless communication were
laid down. Radios provided an easier and near instantaneous form of communication. The
use of radio to deliver healthcare became accepted for remote areas. The Royal Flying Doctor
Service of Australia is an example of the early adoption of radios in telehealth.
In 1925 the inventor Hugo Gernsback wrote an article for the magazine Science and
Invention which included a prediction of a future where patients could be treated remotely by
doctors through a device he called a "teledactyl". His descriptions of the device are similar to
what would later become possible with new technology.
Mid-1900s to 1980s
When the American National Aeronautics and Space Administration (NASA), began plans to
send astronauts into space, the need for Telemedicine became clear. In order to monitor their
astronauts in space, telemedicine capabilities were built into the spacecraft as well as the
first spacesuits. Additionally, during this period, telehealth and Telemedicine were promoted
in different countries especially the United States and Canada.
In 1964, the Nebraska Psychiatric Institute began using television links to form two-way
communication with the Norfolk State Hospital which was 112 miles away for the education
and consultation purposes between clinicians in the two locations.
In 1967 one of the first telemedicine clinics was founded by Kenneth Bird at Massachusetts
General Hospital. The clinic addressed the fundamental problem of delivering occupational
and emergency health services to employees and travelers at Boston's Logan International
Airport, located three congested miles from the hospital. Over 1,000 patients are documented
as having received remote treatment from doctors at MGH using the clinic's two-way
audiovisual microwave circuit.
In 1972 the Department of Health, Education and Welfare in the United States approved
funding for seven telemedicine projects across different states.

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 1980s to 1990s – maturation and renaissance
Telehealth projects underway before and during the 1980s would take off but fail to enter
mainstream healthcare. As a result, this period of telehealth history is called the
"maturation" stage and made way for sustainable growth. NASA provided an ATS-3
satellite, to enable medical care communications of American Red Cross and Pan American
Health Organization response teams, following the 1985 Mexico City earthquake. The
agency then launched its Sate Life/Health Net programme to increase health service
connectivity in developing countries. In 1997, NASA sponsored Yale's Medical Informatics
and Technology Applications Consortium project.
The first interactive telemedicine system, operating over standard telephone lines, designed
to remotely diagnose and treat patients requiring cardiac resuscitation (defibrillation) was
developed and launched by an American company, Med Phone Corporation, in 1989. A year
later under the leadership of its President/CEO S Eric Wattle, Med Phone introduced a
mobile cellular version, the MDPhone. Twelve hospitals in the U.S. served as receiving and
treatment centers
2000s to present
The advent of high-speed Internet, and the increasing adoption of ICT in traditional methods
of care, spurred advances in telehealth delivery. Increased access to portable devices, like
laptops and mobile phones, made telehealth more plausible; the industry then expanded into
health promotion, prevention and education.
In 2002, Dr.G.Byron Brooks, a former NASA surgeon and engineer who had also helped
manage the UTMB Telemedicine program, co-founded Teladoc in Dallas, Texas, which was
then launched in 2005 as the first national telehealth provider.
In the 2010s, integration of smart home telehealth technologies, such as health and wellness
devices, software, and integrated IoT, has accelerated the industry. Healthcare organizations
are increasingly adopting the use of self-tracking and cloud-based technologies, and
innovative data analytic approaches to accelerate telehealth delivery.
In 2015, Mercy Health system opened in Mercy Virtual, in Chesterfield, Missouri, as the
world's first medical facility dedicated solely to telemedicine.

The Post Covid-19 Era

More than a decade ago, virtual health was celebrated as a game changer in the healthcare
industry. But while the technology made virtual health possible, providers, payers, and
consumers have been slower to adopt than was anticipated. As discussed in “Telehealth: A
quarter-trillion-dollar post-COVID-19 reality,”1 COVID-19 has pushed providers, patients,
and payers2 over the tipping point into widespread adoption beyond traditional applications.
Our virtual health definitions are across three categories.Telehealth, Digital therapeutics, and
Care navigation. During the pandemic, adult primary care and behavioral health showed
smaller declines in total visits than surgical/ procedural specialties. These smaller declines
may reflect the fact that more primary care and behavioral health visits can be accomplished
by evaluation and management only4 than those in the surgical specialties. These differences
in specialties suggest an opportunity to continue to open the aperture to other virtual health
technologies, such as remote monitoring, which could allow both primary care and specialty
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care practices to expand their virtual patient interactions. Prior to COVID-19, a 2019
McKinsey survey of health system leaders revealed that virtual health adoption was highly
concentrated in synchronous telemedicine, with limited investment in the full suite of
available virtual health technologies. Leaders cited remote monitoring as a key area for future
investment. Given the pace and magnitude of current disruptions to care delivery, forward
looking health systems could consider using the next six months to materially scale broader
virtual health offerings to create real competitive advantage.

COVID-19 has caused a massive acceleration in the use of telehealth. Consumer adoption has
skyrocketed, from 11 percent of US consumers using telehealth in 2019 to 46 percent of
consumers now using telehealth to replace cancelled healthcare visits. Providers have rapidly
scaled offerings and are seeing 50 to 175 times the number of patients via telehealth than they
did before. Pre-COVID-19, the total annual revenues of US telehealth players were an
estimated $3 billion, with the largest vendors focused in the “virtual urgent care” segment:
helping consumers get on demand instant telehealth visits with physicians (most likely, with
a physician they have no relationship with).⁵ With the acceleration of consumer and provider
adoption of telehealth and extension of telehealth beyond virtual urgent care, up to $250
billion of current US healthcare spend could potentially be virtualized. This shift is not
inevitable, it will require new ways of working for a broad set of providers, step-change
improvements in information exchange, and broadening access and integration of technology.
The potential impact is improved convenience and access to care, better patient outcomes,
and a more efficient healthcare system. Healthcare players may consider moves now that
support such a shift and improve their future position.

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OBJECTIVE OF THE WORK

 The aim of the study is to identify the key barriers to onboard doctors into virtual clinic
without compromising the quality healthcare to the patients.
 To increase maximum number of doctors to onboard with OPD platform.
 To conduct a survey on the virtual clinic marketing after post covid-19.
 To find the preference of the people to onboard with virtual clinic.
 Awareness of virtual clinic &to onboard doctors with OPD platform.
 To comprehend the impact of COVID-19 on health care experts.
 To understand the challenges and barriers faced by the health experts in providing
services to patients especially during the pandemic situation.
 To analyze and interpret the data as well.

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PRESENT WORK METHODOLOGY

6
DATA COLLECTION

Total Known Specialties: 150

Locations: 240 Doctors

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ANALYSIS OF RESPONSES

 120 Responses are positive

 Most of The Doctors Opened during Lockdown Except Seniors or Retired.
 Very les percentage of doctors using virtual platform most of them use WhatsApp and calls.
 Patients Count was reduced during Lockdown Main Reason was Transportation accessibility.
 Most of the Doctors responded it will take more than 6 months to become new normal.
 Ease of use, Virtual education and network issue was main problem for patients to not to use
virtual platform.

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RESULTS OF BEHAVIOURAL ANALYSIS OF DOCTORS

 Most of the Female Doctors talked well and gave response.

 Afternoon 1pm to 3pm most doctors do lunch and allow for response.
 First 30 seconds of call easy to find `Doctors will give response or Not.
 Our introduction decides doctor will give response or not.
 Doctors get convinced easily by more and more reminders.

LEARNING OUTCOMES

 Learned the art of communication skills.

 The survey has given insights regarding the role of virtual clinic which can be used as a
tool especially during the pandemic situation.
 Mainly virtual clinic helps during any infectious diseases Mainly airborne.
 The survey helped us to know the public infrastructure health care, as well challenges
faced by the health experts in providing service to the patients.
 The survey also helped us in understanding the perception of covid-19 as well the impact
of new normal.
 The survey also helped us to understand and analyze the psychology of patient as well
doctors to the covid-19
 Mainly the survey helped in understanding the time Management skills, where we will be
given appointment from the respective doctor to ask the doctor the questionnaire.

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CONCLUSION
 The survey helped me understanding the importance of virtual clinic mainly during the
pandemic situation.
 It also helped me to realize the importance of technology, digitally driven world where
technology helps us to connect with the world, through internet connection.
 The survey helped me in analyzing and interpreting the data
 It also helped me to understand the psychology of patients as well doctors with regard to
covid-19 and about the impact of way forward to health care.
 The survey has also helped in understanding the importance of primary and secondary
research.
 The survey also helped to analyze and understand the health care infrastructure across the
world, where many of the states in the country are switching on to telemedicine and virtual
clinic.
 Finally, I would conclude that even though there are many challenges with virtual clinics
like internet connection, education, technology related awareness to reach to remote areas,
but I would say this pandemic would help the country as well the world to reshape the
health care infrastructure as well to switch on to telemedicine and various virtual clinic
platforms and Finally covid-19 provides an opportunity to reshape health care services.

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References:
• https://recentscientific.com/review-research-literature-telemedicine-services
• https://www.sciencedirect.com/science/article/abs/pii/S1386505616301307
• https://altarum.org/sites/default/files/uploaded-publication-files/TELEMEDICINE-
State%20of%20Affairs_030615
• https://healthmanagement.org/c/healthmanagement/IssueArticle/telemedicine-post-
covid-19
• https://ijhpr.biomedcentral.com/articles/10.1186/s13584-020-00414-0
• https://www.ajmc.com/view/telemedicine-and-its-role-in-revolutionizing-healthcare-
delivery
• https://www.expresshealthcare.in/covid19-updates/digital-health-platforms-
telemedicine-shall-be-integral-to-healthcare-in-post-covid-world-shobana-
kamineni/424326/
• https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-09301-4

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