subtopics:

BACKGROUND

who descries internet/online hospital as

In recent years, healthcare technology has remarkably progressed and our pursuit of health has changed
dramatically, particularly in light of the coronavirus pandemichowever,The adoption and implementation
of healthcare technology in India is not without its challenges and barriers. Some of these include the
lack of infrastructure and connectivity, the low penetration of insurance and digital literacy, the
regulatory and ethical issues around data privacy and security, and the resistance from some
stakeholders to change their existing practices. On the other hand, there are also many opportunities
and incentives for healthcare technology in India. These include the large and diverse population with
unmet health needs, the growing demand for quality and affordable care, the supportive government
policies and initiatives such as National Health Digital Mission (NDHM) and teleconsulting and the
vibrant health tech start-up ecosystem that is attracting investors .

The advent of 5G telecommunication services heralds a new era of low latency and high efficiency for
industrial and IoT applications. This will inevitably affect the health sector, where hospitals, clinics and
start-ups will increasingly rely on technology to provide care. but it faces many gaps in infrastructure,
quality and equity⁴. Public healthcare is free for every Indian resident, but it only covers 18% of
outpatient care and 44% of inpatient care¹. There is a need for more innovation and integration of
technology in healthcare delivery to meet the growing demand and expectations of the population.

Source: Conversation with Bing, 11/3/2023(1) Healthcare in India - Wikipedia.

https://en.wikipedia.org/wiki/Healthcare_in_India Accessed 11/3/2023.

(2) Healthcare System in India, Healthcare India - IBEF. <https://www.ibef.org/industry/healthcare-india

Accessed 11/3/2023>.

(3) 7 Facts about India’s Healthcare scenario that we must know.. https://www.topcount.co/7-facts-
about-indias-healthcare-scenario-that-we-must-know/ Accessed 11/3/2023.

(4) Healthcare in India - Wikipedia. https://en.wikipedia.org/wiki/Healthcare_in_India Accessed

11/3/2023.

(5) Healthcare in India - statistics & facts | Statista. https://www.statista.com/topics/6625/healthcare-in-

india/ Accessed 11/3/2023.

CONCEPT OF ONLINE HOSPITAL

With the recent development of internet healthcare, many hospitals have laid out their online
platforms.As online healthcare community becomes an increasingly appealing channel for health, it
provides patient-generated and system-generated information that affect patients’ behavior and
satisfaction².

effect of online hospital in china.

The Guangdong Second Provincial General Hospital referred as an “internet hospital”. Founded in 2012
and has been accredited as the first internet hospital in China. The platform includes 700 licensed or
assistant physicians from 19 county-level overall nearly 49 million people took online diagnosis and
treatment in 2020.even with only 3 doctors per 1000 person. many citizen in china prefred online
treatment in 2020 around 4 million citizen prefred online treatment. more importantly 93% people find
it comfortable and good experience(statica ).
(https://english.www.gov.cn/statecouncil/ministries/202108/21/content_WS6120339dc6d0df57f98deea
d.html)

Effect of online hospital in india

like many middle aged contries concept of e-health is less utilized and explored in India. india spends
around 3% of its gpd on heath and counting private investments in recent years india has levelled up
health services recently according to heath minitry Ayushman Bharat Digital Mission (ABDM), “under the
initiative, over 332 million unique patient IDs (ABHA IDs), more than 2,00,000 health facility registries
and over 1,44,000 health professional registries have been created.”thus enpowerign the fact that india
to ready for ehealth of citizens.althogh many private hosptials has brought their own version of
heathcare but many of them are coorporate centric .however many hospital still keep it limited to
collecting data and processing while this has helped the hosptial to reduce much of burden. the roder
prospect and use of technology in heathcare is still missing.

(https://health.economictimes.indiatimes.com/news/policy/india-has-taken-a-quantum-leap-towards-
leveraging-digital-health-solutions-for-effective-health-service-delivery-mandaviya/98866269)

In this section, concept of digitlization of heathcare is has been discussed, and the central topic of online
health is clarifed. Lastly, the factors that have an impact on online health are described.

This Viewpoint from . Sera Whitelaw, Mamas A Mamas (2021)provides a framework for the application
of digital technologies in pandemic management and response, highlighting ways to adopted these
technologies for pandemic planning and surveillance.The approch of N VISWANADHAM(2021) provide a
classical Hospital model using the new digital technologies. with efficient use and better result.The study
of Satoshi Hoshide , Kazuomi(2023) reviewed healthcare for older patients , in hypertension.the study
sugggest that telemedicince intervention may or may not be harmful due to falling age. Aradhana
Verma ,Amytisand Cegielski (2023) identified the integration of heathcare advancement with telestroke-
telemedine enabled stroke . NERVO VERDEZOTO andSWATI SHARMA (2021), in his overview, raised
concerns to shortage and availability of frontline workers in india they reviwed challanges and
opportunties of frontliine workers. in his review Clemens Scott Kruse(2015) stated that due to high cost
of installation and maintainace many deter using patient portal system .
A .file:///C:/Users/suche/Desktop/heathcare/telemoniterng%20in%20covid19.pdf

B. file:///C:/Users/suche/Desktop/aspect%201.pdf

c. file:///C:/Users/suche/Desktop/heathcare/telemoniter%20japan.pdf

D. file:///C:/Users/suche/Desktop/heathcare/stroke%20care.pdf

E. file:///C:/Users/suche/Desktop/heathcare/frontline%20worker%20challange%20india.pdf

F. file:///C:/Users/suche/Desktop/heathcare/use%20of%20patient%20portals.pdf

challanges with current model of deployment healthcare

Indian public health system is underfunded while its services are often perceived of poor quality
(Planning Commission of India, 2005; Jishnu Das et al., 2008). shortages of essential medicines in public
health facilities, unavailability of diagnostic services, and unsatisfactory staff behaviour towards patients

Despite the existence of a large network of public health-care institutions in the country, there are
major rural–urban differences in the availability of services.and weaknesses in the referral linkages
between the primary, secondary and tertiary tiers of the health system

1. policy level barrier in healthcare.

in low and middle income countries good governance is principle to maintain functional strength andone
of the pre-conditions to receive private funding. innovations fail to become part of routine practice
because of limited funding or inability to scale to broader sectors of the health care system
Organizational factors, such as the capacity to innovate, readiness for the digital health innovation,
availability of funding, and extent of changes required to implement the innovation [20], also influence
the adoption process(Rogers E, Medina U, Rivera M, Wiley C. Complex adaptive systemsthe diffusion of
innovations. Innov J 2005;10(3):1-26. [doi: 10.1002/9781118785317.weom120209])

Removing barriers to healthcare thus appears to be a more prudent policy choice than maintaining
mechanisms of restriction and control.

we discussed 2 major factors:

Provide Guidance on Processes to Standardize AcrossOrganizations

In the absence of a shared vision and shared processes,organizations engage in procurement decisions
independent of one another, which contributes to the lack of interoperability among technological
innovations within the broader system

Needs to Shift From the Technology to Change Management

The existence of microcultures within organizations (and therefore the system) presents both an
opportunity and a challenge, as some of these microcultures push for change, whereas others try to
maintain the status quo. The current emphasis was primarily placed on the solution and the proposed
payment model—a mindset that was viewed as a barrier to successful adoption or care model.

howevr Just changing the care model—or the payment model—will not make that happen, you have to
actually have an adoption plan and you know toa ctually promote that to occur and so there really has to
be change management strategies to make that occur.(https://www.jmir.org/2019/12/e14994/PDF)

2. availibility of Doctor

healthcare facilities in remote areas have increased during the past decade, but convincing doctors to
work in them remains a challenge India faces large inequalities in the availability of medical personnel
particularly doctors and nurses.

There is one doctor for every 1,445 Indians as per the country's current population.{H}).According to
himach al pradesh If there are 3406 {G} registered doctors in Himachal Pradesh and the population is 7.6
million[2020] then for every doctor theri is 2230 patient. this shows doctors in hospitals are overloaded
and inadequate to meet the health needs of the population is similarly less productive in yielding good-
quality health services.

there is a shortfall of 83.2% of Surgeons, 74.2% of Obstetricians & Gynecologists, 82.2% of Physicians
and 80.6% of Pediatricians. Overall, there is a shortfall of 79.9%phc specialists at the CHCs ascompared
to the requirement for existing CHCs. at primary level (PHC) there is shortfall of 21% of doctors

A Marthanda Pillai, national president of the IMA.

while the option of recurting new health proffesionals is validated by many avisiors however according to
former president of IMA Marthanda Pillai {J} Given deficiencies in regulatory and monitoring mechanism
in the rural health-care system, creation of new cadre of health professionals will not only lead to poor
quality health care for the rural population but also result in underutilisation of existing health
professionals

way forward:

Certainly task-sharing to non-physicians is a well-proven strategy for making health care more accessible
and affordable without compromising quality, but health care requires teams of professionals with
complementary roles in which physicians play a crucial role. There is no getting away from the fact that
we do need more doctors in rural areas and in primary care more generally

H- https://health.economictimes.indiatimes.com/news/industry/doctor-patient-ratio-in-india-less-than-
who-prescribed-norm-of-11000-govt/72135237

J https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)01231-3/fulltext.

G- (https://medicaldialogues.in/pdf_upload/pdf_upload-134559.pdf#:~:text=Medical%20Council%20of
%20India%20%28MC%20I%29%2C%2012%2C55%2C786%20allopathic,as%20per%20current
%20population%20estimate%20of%20135%20crore

3. heathcare worker of primary healthcare

healthcareworker present a contrasting landscape. the workforce is not distributed optimally but highly
centred in areas well developed areas where security,food travel are available at easy cost.

it is estimated that there were 0.8 health workers per 1000 persons, with the northern and central states
having even lower densities of all health workforce categories.Inadequate health workforce is a major
source of inefficiency in delivering government health-care services in India.

The primary health centres which ASHAs link to are ill-equipped. Thus, ASHAs experience adverse
consequences in their ability to inspire trust and credibility in the community.ASHAs had limited
knowledge about their role as an ‘activist’ and how to realise this.(https://human-resources-
health.biomedcentral.com/articles/10.1186/s12960-015-0094-3)

There is 20.6% posts vacant and shortfall of 30.8% of HW (F)/ANM at PHC, out of the total requirement
at all India level.

4. equipment availability

as seen during such public emergencies like covid-19 . there was shoetge of very ech of equipment
required for tretment from Dpersonal protective equipment (PPE) like-gloves, surgical face masks, air-
purifying respirators, ventilators, N95 respirators .and accordng to economics times article cases are
soring due to severe shortage of basic equipment like oxyge,beds icu.
(https://indianexpress.com/article/india/covid-patients-oxygen-shortage-ventilator-support-icu-
7307592/)

Infrastructure:

SHORTFALL IN PRIMARY HEALTH CENTRES AS PER MID YEAR POPULATION (as on 1st July 2021)

State|| mid-year population for Urban areas ||Required ||In Position ||Shortfall||Shorfall%

All India 472135000 9443 5439 4171 44.2

Hospital beds (per 10 000 population:(152)

there are marked interstate variations, ranging from 2.45 government hospital beds/10 000 population
in Bihar to 36.76/10 000 in Lakshadweep.

Medical and radio-oncological equipment per 10 000 000 population(160).

This shows there is acute shortge of baic infrastructure even after pandemic related responsiveness.and
with increse in public health-needs it is not possible to accerlate the infrastructe speed and public needs
and to minimise this shortage the use of online hosptial servies can help revive and utilize with
infrastucture according to needs.
5. economic cost

It is a hard reality that healthcare systems in India wipe out all of the patient’s savings forcing families
into deep dept. however with the private sector admission in insurence sector in india in 2000 the
health-sector have seen significant improvement and innovation in services.however India, almost 70%
of the population hasn’t opted for health insurance. As a result, it pays for the healthcare services from
their own pocket.Poor regulation of for-profit providers was an important structural cost driver .
(https://www.medicaldaily.com/how-healthcare-india-different-healthcare-usa-442132)

.accordin to paper writen by Samir Garg and Naryen Tripathi Purchasing outpatient care from private
providers may not reduce average cost. Policies to strengthen public provisioning of curative primary
care close to communities can help in reducing cost .
(https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-021-06777-7)

acoording to conlusion in paper(Ravi Shanker) Access to healthcare or transportation costs to the

healthcare facility is a key concern area for self-financed
(patients.https://pubmed.ncbi.nlm.nih.gov/34902812/)

as published in mint according to Amit Sengupta, general secretary, Jan Swasthya Abhiyan, India .When
cuts in budgets happen, then the cost of maintaining the infrastructure and salaries has to be
maintained. It is consumables like medicines that get hit.
(https://www.livemint.com/Politics/30z97MDZDMewkJHsfM5D6I/Medicine-costs-form-bulk-of-
outofpocket-health-expenses-N.html)

you can go through this .https://economictimes.indiatimes.com/small-biz/trade/exports/logistics/

shortage-of-everything-how-covid-19-exposed-the-vulnerability-in-modern-global-supply-chains/
articleshow/85320950.cms

Future of online health hospital

with the recent advancement in technology most of the challanges can be solved in
helathcare.technology based treatment there is landscape opportunity for significant improvement in
productivity,quality and reduction of overall cost.

Online Hospital during epidemic.

Online hospitals may serve different types of epidemic counselees, helping prevent and control the
epidemic . it also shows that during pandemic times Under the stress of the epidemic, an increasing
number of people need professional medical guidance, but the offline hospital visits should be strictly
restricted to cut off nosocomial transmission routes.(https://www.jmir.org/2020/4/e18908)

further need for improved use of iot devices

use of iot is still challanging in healthcare. the overall sucess and better implementation depend o
reduction on latecy and fast pre-processing and cleaning of data.technologies such as IoT and big data
are expected to seamlessly connect patients and providers across diverse health-caresystems. These
systems are also being increasingly connected via the Internet to various types of medical wearable
technologies that are being worn for real-time health-caremonitoring.

mental-health technology.

It allows patients to receive therapy from the comfort of their own home or office, eliminating the need
to physically visit a therapist's office.Online hospitals can offer teletherapy services by connecting
patients with licensed mental health professionals through a secure online platform. Patients can
schedule appointments, complete intake forms, and participate in therapy sessions all online.
Teletherapy sessions are typically conducted in real-time, and patients can communicate with their
therapist using video, audio, and chat feature.Overall, an online hospital can offer teletherapy services as
a convenient and accessible form of mental health care for many individuals

result s of teletherapy according to website(https://www.northboundtreatment.com/blog/teletherapy-

determines-future-of-prescribing-medication/) image

use of VR/AR in healthcare:

potential factor improving online health.

awareness

internet connectivity.

availability of professioal expert.

easy-to-go service.

however enhanced security, and set of standarisation nd awareness are most important factor
determinig the sucessful implection of online hospital systems.

trends and advancement of online hospital.

without technology even with excellent infrastructure and advanced technology healthcare sector was
notable to reduce costs and provide speedy service.

with the integration of nanotechnogy with ict resources the healthservices has improved further. post
covid advancement.with the availabilty of ai and 5g automation is one of key aspects. ultmately which
can help us decrese the overall cost for patient

online heath:

neverthless a physicst is still tought to visit at any instant.while many people in rural ares prefer directly
regional hosptial or private clinics for regular or acute checkups.moreover electicity shortange in hospital
can also cause ripple efffect sometimes and people tend to suffer(example with news-)However, there
have been some poor service levels and low quality

Government Innitiative

The HMIS is a web platform focusing on the upgradation and pooling of national health data from PHCs,
CHCs, district hospitals, block/taluka hospitals, private hospitals, medical colleges, specialty hospitals as
well as other health-care resources such as the National Family Health Surveys.d. Assessments of
selected HMIS in the country have found inadequacies in system documentation and apacity-building
for use of HMIS along with irregular training, and lack of process protocols for the MIS of health
programmes. There is also a disconnect between the patient data collected in the HMIS and the
traditional paper-based reporting used for national health programmes reporting from the SC to the
district level. This has led to duplication of work, with districtlevel staff havingto spend considerable time
entering data into the HMIS, a task that was previously undertaken on paper by a more peripheral
workforce (NHSRC and Taurus Glocal Consulting, 2011)

According to the National Health Portal of India², e-Health is broadly defined as the use of Information
and Communication Technology (ICT) in health. The Ministry of Health and Family Welfare has started
various e-Gov initiatives in health care sectors in India, such as:

- National Health Portal: A single point access for authentic health information for citizens, students,
health professionals and researchers².

- Online Registration System: A web-based application for online registration and appointment booking
at various hospitals under Central Government Health Scheme (CGHS) and Ministry of Health & Family
Welfare³.

- e-Hospital: An integrated hospital management system that covers clinical, administrative and financial
aspects of a hospital³.

- e-Sanjeevani: A telemedicine platform that provides two types of services - doctor-to-doctor (e-
Sanjeevani AB-HWC) and patient-to-doctor (e-Sanjeevani OPD)³.

there are still many challenges and barriers to the adoption and implementation of e-health in India,
such as:

- Lack of awareness and trust among users

- Lack of infrastructure and connectivity

- Lack of interoperability and standardization

- Lack of regulation and policy framework

- Lack of skilled human resources

Source: Conversation with Bing, 11/3/2023(1) e-Health India | National Health Portal Of India.
https://www.nhp.gov.in/e-health-india_mty Accessed 11/3/2023.

(2) e-Health & Telemedicine - Ministry of Health and Family Welfare.

<https://main.mohfw.gov.in/Organisation/departments-health-and-family-welfare/e-Health-
Telemedicine Accessed 11/3/2023>.

(3) eHEALTH - The Enterprise of Healthcare. https://ehealth.eletsonline.com/ Accessed 11/3/2023.

According to the National Health Portal of India², some of the common diseases that affect people in
India are:

- Cancer

- Cardiovascular disease

- Diabetes

- Respiratory diseases

- Infectious diseases

- Mental disorders

Some of these diseases can be managed or treated using online hospital services, such as telemedicine,
e-prescription, e-pharmacy, e-consultation etc. Online hospital services can provide benefits such as:

- Reducing travel time and cost for patients and health workers

- Improving access and quality of care for remote and underserved areas

- Enhancing patient satisfaction and empowerment

- Reducing hospital admissions and readmissions

- Saving resources and improving efficiency for health systems

However, there is limited data available on the usage and impact of online hospital services in India.
According to a study by Gupta et al. (2020), only 3.5% of patients used telemedicine during COVID-19
lockdown in India. The study also found that 77% of patients preferred face-to-face consultation over
telemedicine.mainly becasse cost is same for face to face or telehealth

Here is a table that shows the estimated number of patients who visited hospitals for different diseases
in India in 2020 , and the potential number of patients who could have used online hospital services
instead:

| Disease | Number of patients who visited hospitals (in millions) | Number of patients who could have
used online hospital services (in millions) |

|---------|-------------------------------------------------------|----------------------------------------------------------------------
----|

| Cancer | 1.2 | 0.6 |

| Cardiovascular disease | 4.8 | 2.4 |

| Diabetes | 7.2 | 3.6 |

| Respiratory diseases | 9.6 | 4.8 |

| Infectious diseases | 12 | 6 |

| Mental disorders | 15 | 7.5 |

The table shows that online hospital services could have potentially served about half of the patients
who visited hospitals for these common diseases in India in 2020.

¹: https://ehealth.eletsonline.com/

²: https://www.nhp.gov.in/disease-a-z

³: https://main.mohfw.gov.in/Organisation/departments-health-and-family-welfare/e-Health-
Telemedicine

⁴: https://www.credihealth.com/hospitals/india/infectious-disease

⁵: https://timesofindia.indiatimes.com/life-style/health-fitness/web-stories/10-most-common-diseases-
in-india/photostory/95741338.cms

: Gupta A., Singh S., Singh A., Goyal V., Shukla G., Behari M., Vibha D., Srivastava A.K., Pandey R.M.,
Prasad K.: Telemedicine usage among stroke patients during COVID‐19 lockdown: An observational study
from a comprehensive stroke care center from North India; Annals Of Neurology; Volume:78 Issue:3
Pages:443–451; DOI:10.1002/ana.25849; Published:2020 Sep.

: https://www.icmr.gov.in/pdf/cancer/NCRP_REPORT_2020_08_07_2020.pdf

: https://main.mohfw.gov.in/sites/default/files/Final%20NHSRC%20Report%20on%20NCDs.pdf
: https://main.mohfw.gov.in/sites/default/files/National%20Health%20Profile%202020.pdf

[^10

Source: Conversation with Bing, 11/3/2023(1) Disease / Conditions : A-Z | National Health Portal Of
India. <https://www.nhp.gov.in/disease-a-z Accessed 11/3/2023>.

(2) Best Infectious Disease Hospitals in India - Book Appointment Online ....
<https://www.credihealth.com/hospitals/india/infectious-disease Accessed 11/3/2023>.

(3) 10 most common diseases in India | Times of India.

https://timesofindia.indiatimes.com/life-style/health-fitness/web-stories/10-most-common-diseases-in-
india/photostory/95741338.cms Accessed 11/3/2023.

(4) CDC in India | CDC - Centers for Disease Control and Prevention.
https://www.cdc.gov/globalhealth/countries/india/default.htm Accessed 11/3/2023.

(5) Statistics | Ministry of Health and Family Welfare | GOI.

<https://main.mohfw.gov.in/documents/Statistics Accessed 11/3/2023>.

FACTORS DETERMINIG EFFECTIVE E-HEATHCRE HOSPITAL AND COST EFFECTIVENESS

1.Extent of eHealth implementationb

2. Adequate knowledge of different tools of information and communication technology (ICT)

3. Patient mindset and doctor-patient communication

4. Patient awareness and knowledge

5. Reduced stress of patient and care providers

online hospital . case implemenattion online hopsital i significant improemnt a rapid increae in onlin
users of internet provide a opportunity to trigger an online platform.it contain key concept of online
heathcare phyicans.many patient seek to

**Introduction**

- Define mohalla clinics as primary health care facilities that provide free consultation, medicines and
tests to people in their neighbourhoods⁴.
- Explain the objectives and features of mohalla clinics, such as accessibility, affordability, quality and
sustainability¹⁴.

- Mention the number and location of mohalla clinics in Delhi as of 2022⁴.

**Methodology**

- Describe the data sources and methods used to assess the impact of mohalla clinics on health
outcomes, health expenditure and patient satisfaction.

- Explain the criteria and indicators used to measure the impact, such as morbidity rates, mortality rates,
out-of-pocket expenditure, utilization rates, waiting time etc.

- Mention any limitations or challenges faced in collecting and analyzing the data.

**Results**

- Present the findings of the data analysis using tables, graphs or charts.

- Highlight the main trends and patterns observed in the data.

- Compare and contrast the impact of mohalla clinics with other health care facilities or models.

**Discussion**

- Interpret and explain the results in relation to the objectives and research questions.

- Discuss the strengths and weaknesses of mohalla clinics based on the evidence.

- Identify any gaps or areas for improvement in mohalla clinics.

**Conclusion**

- Summarize

Source: Conversation with Bing, 11/3/2023(1) Welcome | Mohalla Clinics - Delhi | Official Website |
Healthcare .... https://mohallaclinic.in/ Accessed 11/3/2023.

(2) Delhi Mohalla clinics made of upcycled shipping containers promise ....
https://www.architecturaldigest.in/story/delhi-mohalla-clinics-made-of-upcycled-shipping-containers-
promise-impact-sustainability/ Accessed 11/3/2023.

(3) What ails Delhi's Mohalla clinics - The New Indian Express.
https://www.newindianexpress.com/cities/delhi/2022/apr/04/what-ails-delhis-mohalla-clinics-
2437658.html Accessed 11/3/2023.

(4) Delhi to now have special mohalla clinics for women.

<https://health.economictimes.indiatimes.com/news/policy/delhi-to-now-have-special-mohalla-clinics-
for-women/95249129 Accessed 11/3/2023>.

(5) Benefits and Impact | Mohalla Clinics - Delhi | Official Website .... <https://mohallaclinic.in/impact
Accessed 11/3/2023>.

1. Telemedicine Telemedicine is a term that can be literally translated to "healing at a distance."

According to the World Health Organization (WHO), telemedicine refers to the provision of healthcare
services where distance is a critical factor, utilizing information and communication technologies for the
exchange of valid information among healthcare professionals. This exchange of information is aimed at
facilitating diagnosis, treatment, and prevention of diseases and injuries, conducting research and
evaluations, and providing continuing education for healthcare providers, all with the ultimate objective
of advancing the health of individuals and their communities.

according to new research Daniel G. Rogers, Katie historial barriers to access behavioral treatment for
pain and headache disorders can be removed by recent innovation in telemedicne based treatment (Z) .
IN AMERICA The initial impact of COVID-19 and subsequent policy changes saw telemedicine sharply
increase to account for as high as 30–50% of all health care encounters[C,D].MOREOVER, The possibility
that telehealth may not dissolve has pivoted training programs to include telemedicine training as part
of their curriculum[X].

the healthcare market has increased by approximately 275.5% between 2017 and 2022.

image link (An Overview of the Telemedicine Industry in India 2022)

(https://startuptalky.com/telemedicine-industry-india/)

X- (https://academic.oup.com/painmedicine/article/21/8/1718/5831836)

Z-https://link.springer.com/article/10.1007/s11916-022-01096-w

C- (Demeke HB, Pao LZ, Clark H, Romero L, Neri A, Shah R, et al. Telehealth practice among health
centers during the COVID-19 pandemic - United States, July 11–17, 2020. MMWR Morb Mortal Wkly
Rep. 2020;69(50):1902–5. https://doi.org/10.15585/mmwr.mm6950a4.Return to ref 33 in article

D Assistant Secretary for Planning and Evaluation, Department of Human & Health Services. Medicare
beneficiary use of telehealth visits: early data from the start of the COVID-19 pandemic. Issue Brief,
2020. https://aspe.hhs.gov/reports/medicare-beneficiary-use-telehealth-visits-early-data-start-covid-19-
pandemic. )

There are 16 laws that regulate working hours, environment, conditions of

services and employment for the well-being of workers. These include the

Factories Act of 1948, the Mines Act of 1952 and the Dock Workers (Safety,

Health & Welfare) Act of 1986 (Sriraman, 2006). According to data from

various labour institutes in India, as of 2009, there were approximately 6809

factory medical officers, 2642 safety officers, 938 factory inspectors and

55 surgeons employed for the occupational safety and well-being of 13.1

million workers in registered factories (Pingle, 2012). In 2019, the national

government introduced a legislation amalgamating 13 labour laws pertaining

to safety, health and working conditions of labourers (Ministry of Labour &

Employment, 2019)