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      Identical Telemedicine-Enabled Clinics in Three Different Geographies: Our Learnings

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          Abstract

          Background

          Scarcity of primary care is felt most in underserved communities. Telemedicine (TM)-enabled clinics bridge the gap in such scenarios. There was a need to understand how the same TM model would work in different settings.

          Aim

          The aim was to study outcomes in three identical TM-enabled clinics in different geographies so as to understand how to scale up clinics in future.

          Setting

          Three totally different sites were chosen: a rural village with low socioeconomic status, a rurban (rural-urban) prosperous village, and an urban slum. The clinics planned was identical. The process of establishment, training, recruitment and treatment guidelines were the same. Any deviation was noted.

          Methodology

          Data were gathered through public health survey, interactions with villagers and local leaders, medical examination of individuals, feedback from patients, and household survey to understand the socioeconomic status of the community.

          Main outcome measures

          The article attempted to study how different social, cultural, and economic settings affected the outcome of identical TM clinics.

          Results

          TM, though accepted in different settings, was not sufficient to meet the healthcare needs of the community. These needs were related to the social and economic characteristics. Public health initiatives along with TM were most beneficial. In the underserved areas, infrastructure posed challenges to implementing TM, and ‘Last Mile Care Delivery’ was essential to create the full impact of TM.

          Conclusion

          TM-enabled clinics along with last mile care delivery are the key to improve healthcare in underserved communities. Further research into customized TM models for different geographies would help in providing the best care.

          Limitations of the study

          The study period was 4 months. The study was in one state of India, so the applicability of the findings to other states/countries may vary.

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          Most cited references5

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          Housing standards: a glossary of housing and health.

          This glossary has been designed to provide definitions that take account of different disciplinary and policy traditions and to consider the aspects of housing that provide scope for possible concerted research and action.
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            Telemedicine: is it really worth it? A perspective from evidence and experience

            Background This paper summarises a series of presentations on telemedicine given at a UK eHealth Week conference session in 2016. The formal evidence base for telemedicine is equivocal, but practical experience suggests that implementations of technology that support telemedicine initiatives can result in improved patient outcomes, better patient and carer experience and reduced expenditure. Objective To answer the questions ‘Is an investment in telemedicine worth it’? and ‘How do I make a telemedicine implementation work’? Methods Summary of systematic review evidence and an illustrative case study. Discussion of implications for industry and policy. Results Realisation of telemedicine benefits is much less to do with the technology itself and much more around the context of the implementing organisation and its ability to implement. Conclusion We recommend that local organisations consider deployment of telemedicine initiatives but with a greater awareness of the growing body of implementation best practice. We also recommend, for the National Health Service, that the centre takes a greater role in the collation and dissemination of best practice to support successful implementations of telemedicine and other health informatics initiatives.
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              The primary care paradox – new designs and models

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                Author and article information

                Journal
                TMT
                Telehealth and Medicine Today
                Open Academia
                2471-6960
                23 April 2021
                2021
                : 6
                : 10.30953/tmt.v6.253
                Affiliations
                Department of Community Medicine, Doorstep Health Services, Pune, India
                Author notes
                [* ]Correspondence: Suchitra Mankar. Email: suchitramankar@ 123456gmail.com
                Article
                253
                10.30953/tmt.v6.253
                464f3986-f753-4470-8d8e-0f63d15ff549
                © 2021 The Authors

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( https://creativecommons.org/licenses/by-nc/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for any purpose, even commercially, provided the original work is properly cited and states its license.

                History
                Categories
                SPECIAL ISSUE

                Social & Information networks,General medicine,General life sciences,Health & Social care,Public health,Hardware architecture
                telemedicine,rural health,underserved communities,social issues,last mile care delivery,primary healthcare

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