Author: admin

Introduction
The Tele-consultation product of company Unarv Telemedicine and Healthcare Services (P)Ltd. is called Unarv Telemedicine Service and it has been available since 2020. The solution providers value care delivery the most. Their business model is B2B. They provide only web based applications for the doctors.

Size of Healthcare Provider

a. Individual Clinician

b. Nursing Home/Small Hospital (less than 100 beds)

Level of Specialization

a. Primary

Expert Panel Evaluation

Doctors have to provide their availability to consult on the platform. EMR and tele video part is disconnected, two separate logins. EMR is complicated, multiple clicks required. This platform has 24*7 availability of doctors on the platform. Patients could chat with doctors on this platform. They are directed to wait for the support staff and support staff matches the patient with the available doctor. Support staff is available 24*7 to help patients.
Doctors interact with patients in synchronous chat and patients require pre-registration. Prescriptions and all clinical notes are written as plain text, there is no template or format. Each prescription has the doctor’s name and details as signature (e signature).
The consent implicit consent for the use of the platform and no consent for consultation is taken. No HCIT standards as required by EHR-SI 2016 and NDHB.

Solution Maturity Level

a. TPG compliant: 3a

b. Feature complexity: 3b

Introduction

The Tele-consultation product of company Your Health-Key is called Your Health-Key and it has been available since 2016. Their business model is B2C and also has white labelled products. They provide only mobile based applications for the doctors. They also provide mobile applications for patient portals.

Size of Healthcare Provider

a. Clinics

b. Hospital

Level of Specialization

a. Primary

b. Secondary

c. Tertiary

Expert Panel Evaluation

Doctors can interact with patients only in asynchronous manner as doctors can not write notes while writing notes while doing consultation. Doctors cannot prescribe medicine when the tele-consultation is going on. Notes can be written only after disconnecting the call or video. The solution provides chat as mode interaction and sharing of clinical notes. Voice record facility for consultation is there for patients to share concerns, and patients can share reports during chat as attachment. Doctor is required to open a new tab and type a prescription with the facility to copy from chat. Prescription is e-signed. Follow up facility is not there. This solution does not support even basic clinical workflow of teleconsultation. Multi party calls are not there. Video recording of the consultation is not possible.

Cancellation and refund options are available. Refunds are possible even if the patient is not satisfied with the consultation. It is a mobile application Integrated with an inhouse developed vital monitoring device. Other vital devices are not integrated. The data from this vital monitoring device is automatically captured in the patient application. No standards are integrated. No HCIT standards as required by EHR-SI 2016 and NDHB.
Patient fixes appointments after searching the department and then the doctor. Patient gets to view the complete profile of the doctor prior to the consultation.

A Dependent can fix an appointment on behalf of the patient, but cannot join the call along with the patient. Video consultation was not demonstrated during the demo. Chat option is kept open even after the consultation for the patient to clarify any doubts which the patient might have after the consultation. Solution does not support multilingual options. Patients can give feedback to the doctor after the consultation.

Additional features
The mobile solution also supports integration only with the inhouse developed vital monitoring device.

Solution Maturity Level

a. TPG compliant: 3a

b. Feature complexity: 3a

Introduction
The Tele-consultation product of company World Health Partners is called Althea and it has been available since 2008. The solution providers value achieving the clinical outcomes the most. Their business model is B2B .

Size of Healthcare Provider

a. Individual Clinician

b. Small clinics for providing virtual OPD

Level of Specialization

a. Primary

Expert Panel Evaluation

The application is easy to use for patients. Patients are required to enter details while taking appointments and based on those details entered doctors are shown provisional diagnosis of the patient. Doctors can interact with patients in both synchronous and asynchronous manner. The solution provides multimode interaction i.e. Video and audio. This solution supports basic clinical workflow in terms of writing subjective details and objective clinical diagnosis along with assessment and planning. Doctor’s side application provides features for writing prescriptions and being on the call simultaneously. Doctors can enter details using ICD10 diagnosis and based on data entered relevant investigations and medications are suggested. Prescription generated does not not include doctor’s signature.

The solution is easy to use and provides quick data entry by facilitating pre configured notes. Trend charting available for doctors. Multi party calling is not there. Second opinion module addition is possible (referral system). Platform facilitates specialty specific fields (customisation option) for prescription writing. The solution has provision to exchange data. It is claimed that the solution has ICD-10 for clinical finding. Platform has in-build capability to support the Drug database interface. Patients have the facility to upload documents and enter vitals which doctors can access.
In terms of compliance, application providers have mechanisms associated with the platform to validate registration details of doctors with the help of a support team. Platform has an implicit consent mechanism. Platform provides UI in 16 languages using Google API. The patient can enter details during the appointment and take help of platform rules to provide suitable information.

Platform has an admin role to support in managing consultation schedules. Patients are having features to rate and provide feedback about doctors. It is also having usability for functionally illiterate patients.

Additional features
16 language based on google converter
Integration with devices at home
CDSS

Solution Maturity Level

a. TPG complaint: 3a [Partial]

b. Feature complexity: 4 Partial

Introduction

The Tele-consultation product of company Vytal Healthtech Pvt Ltd is called Vytal Connect and it is available since 2016. The solution providers value convenience of the user the most. Their business model is B2C and also has the option of white labelling the product. They provide only mobile applications for the doctors and patients.

Size of Healthcare Provider

a. Individual Clinician

b. Clinics

Level of Specialization

a. Primary

Expert Panel Evaluation
This solution supports basic clinical workflow in terms of writing subjective details and objective clinical diagnosis along with assessment and planning, including writing treatment / medication and other investigations as and when required. Doctors can interact with patients in a Synchronous manner. The solution provides multimode interaction i.e. audio, video, chat and link sharing. Doctors could interact with patients using audio/video call while simultaneously taking notes i.e. noting clinical conditions, writing prescriptions and entering data concurrently. Platform supports specialty specific assessment notes templates for obstetrics/ gynecology and orthopedics in addition to basic templates. Doctors can generate prescriptions using this platform having doctors’ signatures embedded in the header and footer. Doctors can also share scanned prescriptions with signatures. The consent is explicit for every encounter. Doctors can record consultation using the platform and an audit trail is maintained in the backend. Doctors are verified using their government ID before registration is done in the solution. Application providers also do manual verification of doctors using multiple channels. Doctor’s details are mentioned in the platform for patients to access. Payment gateway is integrated with cancellation and refund facility. Proprietary EMR is integrated which has a drug database with drug to drug interaction. No health data entry standards are supported.

The patients have to register with the help of the appointment booking process for patients.
There is no separate admin role in mobile application for basic subscription, but in premium models admin role is supported for follow up message and other admin functions. Patients can search using keywords for a doctor’s speciality, symptoms and treatment.

Solution Maturity Level

a. TPG compliant: 3b

b. Feature complexity: 3b

Introduction

The Tele-consultation product of company Uber Diagnostics Private Limited is called Cardiotrack and it has been available since 2014. The solution providers value clinical outcomes the most. Their business model is B2C and also provide the option of white labelling the product. They provide only mobile based applications for the doctors. They also provide mobile applications for patient portals.

Size of Healthcare Provider

a. Individual Clinician

b. Clinics

c. Nursing Home/Small Hospital (less than 100 beds)

Level of Specialization

a. Primary

b. Secondary

Expert Panel Evaluation

This solution is suitable for pre and post medical examinations for insurance. In this asynchronous data communication is supported as they are targeting rural and remote regions. Payment process not there. Data is broadcasted to doctors on the network and then any available doctor can look through and respond.

They demonstrated cardio-track devices by showing videos of working with rural clinical and grameen healthcare that utilizes cardio-track devices. EMR capturing is not designed as per the clinical workflow. Two separate applications: reception level (technician and administrator) and doctor level applications. Nurse at home or primary care clinic and can enter data manually or capture with digitally integrated devices. software runs on the phone screen, ecg and other details captured are stored on the device once recording is done. The doctor can see that ecg and give an opinion on the ECG report (8:30 am-10:30pm). They provide online training of staff and videos. Hindi, English, and Kannada language training are supported for onboarding but application is available only in English. Consent mechanism is not there, prescription is manually done (hand written). Analytics to predict tachycardia and bradycardia on the waveforms of ECG. – Specific application for cardiology capturing of ECG waveform.

NO standards have been implemented recommended by EHRIS-2016 and NDHB. 9 am to 9 pm can connect doctors in 60 sec (calling this as a value proposition).

Additional Features
Remote monitoring and rule based prediction
IoT device integration

Solution Maturity Level

a. TPG compliant: 2

b. Feature complexity: 3b

Introduction

The Tele-consultation product of company Trova TechNologies Private Limited is called MED.LIVE and it is available since 2016. The solution providers value convenience of the user and care delivery the most. Their business model is B2C (SAAS), and also have option of white labelling the product.

Size of Healthcare Provider

a. Clinics

b. Nursing Home/Small Hospital (less than 100 beds)

c. Hospital

Level of Specialization

a. Primary

b. Secondary

c. Tertiary

Expert Panel Evaluation

The solution has features to support clinical consultation workflows for doctors during teleconsultation. The application is easy to use for patients. The solution is also usable by people not having smart phones for tele-consultation.

Doctors can interact with patients only synchronously. The solution provides multimode interaction i.e. Video, Audio, Chat, Link sharing. Doctors could interact with patients using audio/video call while simultaneously taking notes i.e. noting clinical conditions, writing prescriptions and/or entering data concurrently. Doctors could view reports of patients and mark the report shared by the patient. Doctors have an option to highlight certain data on patient reports during or prior to the consultation, which makes it easy for the doctor to explain during the consultation. The highlighted data is viewable by the patient during the consultation. Doctors can share his screen to show certain videos which the doctor might use to explain a particular condition to the patient. This option is available in the desktop option and not on a mobile option. white board there. Patients could also see the marking and comments by doctors. Dicom files also can be accessed and replicated across participants, annotation facility is available in xray and MRI. Doctors can keep notes during consultation (SOAP format). They actually use the EMR module of the hospital and prescription is sent using the hospital provided format and scanned signature is used. Prescription is sent to the hospital EMR and then they could share accordingly. Multi party consultation is possible by inviting multiple people by doctor. Doctor controls and navigates the entire consultation. Patient has the facility of inviting relatives by sharing the link. Tumor board for cancer consultation is possible.

The software is presented as a supportive teleconsultation platform and the patient data storage, capture and retrieval is expected to be handled by the external system (HIS/EMR). Support for integration to DICOM images and HL7 v2.3 is provided for viewing and retrieval of health records. It is claimed that there are few integrations done with external systems. The application is US HIPAA compliant. ICD-10 for diagnosis and Support for integration to DICOM. Consent form given by the hospital is hosted online and can be used for taking consent. Providers can take consent from patients for the use of telemedicine platforms for interactions otherwise it considers implicit consent for doctor-patient interaction. Recording of consultation is possible as per the requirement of the hospital Feedback options are also available and are customised to each hospital
The appointment form is integrated with the hospital EMR system, the admin module is there to manage appointments or doctors can manage appointments. or other. Patient side of the interface provides login and Patient also gets a link, and can be operated from the front office. Patients have the facility to upload documents and enter vitals which doctors can access. Patients are not required to download any application; only the link that is sent to the patient can be used to join the consultation / upload reports / invite one’s relatives. Platform also has IoT integration for capturing data that patients can use to share for more authentic monitoring.

Additional Features
SAAS
White Board Facility
DICOM
HIPAA complaint
Integration with EMR/HIS of hub hospital

Solution Maturity Level

a. TPG compliant: 3a

b. Feature complexity: 4 partial

Introduction

The Tele-consultation product of company Think Future Technologies Pvt Ltd is called Think Future Technologies Pvt Ltd and it is available from 2019. Their business model is B2B. They provide only mobile based applications for the doctors.They do not have a dedicated product for the patient.
There is also an option for whitelabelling the solution.

Size of Healthcare Provider

a. Individual Clinician

b. Clinics

Level of Specialization

a. Primary

It has been mainly deployed in urban and peri-urban regions.

Expert Panel Evaluation

The platform has an easy to use interface for doctors that support basic teleconsultation sessions along with specialty specific assessment notes template. Doctors can interact with patients in a synchronous manner, i.e., doctors can write notes simultaneously and refer previous notes on a separate tab for their personal reference. Doctors can share an image of a hand written prescription that can be uploaded using the platform. Platform provides a doctor white board and free text space to write prescriptions without any template. Using the e-pen doctor can do the signature on the prescription. The image of the prescription uploaded and the conversation with the patient is displayed as chat conversation to doctors and patients during consultation. Audit trail is maintained. Doctors can record consultation. Cancellation and refund facility is there.

In terms of compliance, the application provider has a mechanism associated with the platform to validate registration details of doctors either with the help of a support team or registration details provided by doctors. Doctor’s details are mentioned to the patient during consultation and while taking appointments. Explicit consent is taken from the user before every encounter including during registration and video call. Platform has a multilingual UI. This is a cross browser application. Admin role is separate and could be used for managing appointments. Queue management feature is there. Platform has an admin role to support in managing consultation schedules and provides a facility to initiate refunds to patients in case of appointment cancellation.

Patients can search for a doctor by name and speciality. The solution design ensures that the patient has control over past records in terms of sharing data across providers. It also provides a dependent account and family account facility. Smart phones are not mandatory for patients as they can visit remote healthcare centers using this solution. Open MRS and IoT device integration there. It was mentioned that solution is FHIR compliant.

Solution Maturity Level

a. TPG complaint: 3b

b. Feature complexity: 4 partial

Introduction

The Tele-consultation product of company Teslon Technologies Private Limited is called Carenation and it has been available since 2015. The solution providers value the care delivery the most. Their business model is B2B. They provide both mobile and web based applications for the doctors. They also provide mobile applications for patient and web based patient portals. They also provide white labelled product.

Size of Healthcare Provider

a. Individual Clinician

b. Clinics

c. Nursing Home/Small Hospital (less than 100 beds)

d. Hospital

Level of Specialization

a. Primary

b. Secondary

c. Tertiary

Expert Panel Evaluation

The solution has an easy to use interface for doctors and has features to support clinical consultation workflows for doctors during teleconsultation. The solution supports basic teleconsultation clinical workflow and specialty specific consultations also. This solution supports basic clinical workflow in terms of writing subjective details and objective clinical diagnosis along with assessment and planning, Including writing treatment / medication and other investigations as and when required. Doctors can interact with patients only in synchronous manner. The solution provides multimode interaction i.e. Video, Audio, Text/SMS. Doctor’s side application provides features of sharing prescription in formats like Using basic template as part of platform, Scan / image upload of prescription, speciality specific template for prescription writing. Platform has a feature that enables doctors to take an image of their handwritten prescription, preferably with the header having their details and it is shared with patients. Doctors providing specialty specific consultation can customize the application dashboard and layout as per their requirements. Platform supports writing prescriptions with basic requirements mandated by TPG guidelines that have scanned signature / E-signature and facility to integrate digital signature also. Platform enables doctors to record consultations. Application facilitates sharing case records (referral) by providers. Audit trail of every interaction and data documentation is maintained in encrypted format.

Platform enables doctors to record consultations. The solution has provision to exchange data HL7/FHIR. It is claimed that the solution has SNOMED CT, ICD-10 standards implemented at relevant places as recommended by EHRSI-2016 and NDHB along with security standards like Encrypted connection, access control, Digital certificate etc. Security standards like encrypted connection, access control, digital certificate etc. is implemented. Platform has in-built capability to support configurable Drug database formulary and Drug database interface, Indian or other country drug database or both.

The application is also easy to use for patients. Patient side of the interface provides login for booking appointments, keywords based doctor search facility. Patients are required to be registered with a hospital (or consulting doctor) and their ID is used for registration using this platform for teleconsultation. Platform could also support automatic triage based on initial symptoms entered by the patients.
Doctor picture, name and other details are shown to the patient at the time of appointment booking and during consultation. Patients can search for a doctor by name or search for a specialized doctor. In order to provide good consulting experience to patients, seamless appointments are there because of the waiting room facility. Platform has an admin role to support in managing consultation schedules and provides a facility to initiate refunds to patients in case of appointment cancellation.

Prescription is shared with the patient and uploaded in the patient’s account for future use. Patients can take appointments on behalf of their family members / loved ones. Platform also respects family members / loved ones autonomy as it gives them control over managing their records. Patients have control over sharing and accessing their records.

In terms of compliance, the application provider has a mechanism associated with the platform to validate registration details of doctors with the help of a support team. Platform also has the consent management mechanism and the provider can take consent from the patient for the use of their telemedicine platform. They also allow explicit consent for every doctor-patient interaction. They also provide features to providers to request the upload of consent and customize the consent form including – Multilingual translated consent, video consent.

Additional Features
SAAS financial model
Drug Database configurable
Implemented Security standards like Encrypted Connection, Digital Certificate
Voice Typing
Integration with EMR of hub hospital

Solution Maturity Level

a. TPG compliant: 3b

b. Feature complexity: 5

Introduction

The Tele-consultation product of company Telehealth For You Private Limited is called DigiMD and it is available from 2019. The solution providers value accessibility to healthcare by patients the most. Their business model is B2C. They provide both mobile based applications for the doctors and patients via google play store.

Size of Healthcare Provider

a. Individual Clinician

b. Clinics

Level of Specialization

a. Primary

Expert Panel Evaluation

Designed only for general physicians as a chat based basic mobile application platform allowing image sharing with doctors. Doctors have the option of sending voice notes. Usability for doctors is good because of convenience and simple UI as it is Easy to use. This can serve as a whatsapp alternative with limited functionality of text chat and image sharing. This allows doctors to separate personal and professional space for mobile based consultation, but is limited in functionality for clinical note taking and diagnosis, treatment documentation. There was no synchronous video consultation feature at time of demo. Allows voice typing using google API. Onboarding of users is by platform owners but there is no way for users at each end to verify in real time and authenticate. Doctors registration details are not available to patients. This platform is more suitable for follow-up consultation as design tries to leverage trust established between doctor and patient in earlier consultations. This could be customized based on the doctor’s need and gathering requirements from them and then testing, modifying and then releasing the product. This proposed plan makes the platform require adjustable efficacy from doctors.

From patients’ perspective this is basically designed as a replacement platform of whatsapp based chat, sharing images with doctors and could use this for follow up consultation. Patient could record and share the pre-recorded video with the doctor. This allows for asynchronous communication. No consent was taken from patients and download of application is considered as implicit consent.

Additional Features
Voice typing

Solution Maturity Level

a. TPG complaint: 2

b. Feature complexity: 2 partial

Introduction
The Tele-consultation product of Stellablue Interactive Services Private Limited is called MEDePAL. It was launched in the month of march 2020 after the declaration of the COVID-19 as a Pandemic. The value proposition offered by solution providers is the optimization and achievement of clinical outcomes. Their business model is B2C, and they also offer the option of white labelling. They provide both mobile (Android & IOS) and web browser based applications for the doctors as well as the patient and/or web based patient portals.

Size of Healthcare Provider

a. Individual Clinician

b. Clinics

c. Nursing Home/Small Hospital (less than 100 beds)

d. Hospital

Level of Specialization 

a. Primary

b. Secondary

Expert Panel Evaluation

The solution has an easy to use interface for doctors. Doctors have to define their schedule. Doctors have the facility to define calendar and schedule. Doctors have their own profile page on the platform and they are verified by the backend team. Assistant role of doctor can be defined. The doctor can see the photo ID of the patient. In this solution without payment (partial payment) appointment booking is possible also and doctors can control the booking schedule. The solution has easily navigable screens for optimising performance of doctors on the solution. Doctors can interact with patients in a synchronous manner only. The interaction can be multimode i.e. Audio, Video, Text/SMS and Email. Doctors can interact with patients using audio/video call while simultaneously taking notes i.e. noting clinical condition, writing prescription Note taking is elaborate history, finding, diagnosis and medication section and can be done along with video /audio calling. Doctors have private note sections and sections. They can draw images but screen sharing is not available. The frequent- prescribed list of drugs for doctors are available while writing prescriptions. Images of various organs and systems can be embedded in prescription, doctors can use a write pad to edit images . Speciality specific initial profiling questionnaire options are also customisable by doctors. Trend line of past data like vital is displayed. Bengali and Hindi language translation are available. They have a roadmap of working with NGO for remote areas, where the NGO provides the centre to do consultation.

ICD10 integration and also having a drug database (private company commercial company provided, they are not checking for restricted drug prescriptions). No FHIR integration at the time of demo. scanned signature upload to prescription was provided via platform.

For the patient, the interface provides login for booking appointments, keywords based doctor search facility, guided searching of doctors. Patients can search by specialization, name, by city and address specific (near address). Cancellation and refund there. Group ID option is there (group user or anyone you know can book appointments for them), patients can manage caregivers appointments, share data after authorization, minors can get appointments. Multiparty calls are allowed. Patients can pre-specify symptoms before going to consultation. and can upload a specific set of documents and authorize a single /individual doctor to access that records. The solution design ensures that the patient has control over past records in terms of sharing data across providers. Patients can control the sharing of the records between two doctors they have consulted using the platform.

Additional Features
Writing Pad for doctors(for images)
Trend line of past data

Solution Maturity Level

a. TPG compliant: 3a

b. Feature complexity: 4 partial