The word telemedicine has been bandied about a lot in the past three months, but for a startup like mFine, this phase has been a collective moment of reckoning since their inception in 2017. In the last two months, the company has seen a 210% increase in corporate partnerships, with a significant interest in virtual OPD consultations, mental health consultations and advanced screenings. Specifically, the most common requests are for tele consultations especially in gynaecology, paediatrics, mental health, OPD and home health checkups.

The platform has over 2.500 doctors from 500 hospitals and manages 10,000 transactions a day. With plans to add 200 corporates in six months, mFine understands the immense value in enabling doctors with technology tools in order to help more people in need.

So what’s it like being a specialist physician on an AI platform like mFine? INDIAai spoke to Dr. Raja Indana, diabetologist and Doctor Lead at mFine to understand what it takes to be a doctor in the new world, dominated by AI and analytics.

Dr. Indana, who has more than 15 years of experience as a physician specializing in diabetology, realized that as exciting as technology was, he was getting into uncharted waters with his new role at mFine as a content expert. “Around the time I joined mFine, I read some books on AI specifically AI Superpowers by Kaifu Lee & Deep Medicine by Eric Topol, which enhanced my interest in technology in healthcare and how medicine, specifically telemedicine, was evolving thanks to AI.”

COVID19 may have accelerated the interest and adoption levels in telemedicine. Dr Indana agrees that telemedicine has received a fillip during the ongoing pandemic but was making gradual inroads prior to March and hopes it will become the norm in medicine. “When the stethoscope was first invented in 1816, doctors at the time were reluctant to use it. Today, it is a part of a doctor’s identity. Similarly, telehealth will be a part of a physician’s identity in the future and the sooner the medical fraternity embraces it, the better.”

Telehealth – What Doctors Need and What They Don’t

The relative novelty of healthcare technology in India and lack of exposure to relevant literature makes it challenging for doctors to understand the impact of telehealth and its various benefits, unlike countries like China or USA where a raft of advancements in AI are being witnessed across many sectors including healthcare. “Doctors here mostly attend medical conferences or events organised by drug companies or medical research organisations – this is how they learn and enhance their knowledge. Conferences on healthtech and advancements in medical care using technology are only just emerging, and we need a lot more of those.”

For instance, he recommends following China’s Ping An Healthcare & Technology or the Good Doctor – a healthcare software company that offers a mobile platform for online consultations, hospital referrals, online health management and wellness interaction services. This platform reportedly manages up to 5 million health e-consultations every day, with rapid adoption and adaptability credited to the company’s ability to remain tuned to the public’s needs even during a crisis like COVID19.

After working closely with data scientists and technology experts at mFine, Dr. Indana strongly believes technology solutions must be developed along with those dispensing medical expertise. “Doctors will be resistant to laptops and desktops for a tele-consult. A mobile phone is almost an extension of one’s body, so a mobile interface with a patient works more effectively. With just one button, a doctor can do a tele-consultation with ease. Any healthcare technology innovation should be made keeping a mobile interface in mind since this is the future and will attract more doctors.”

Going Beyond The Regular Digital Experience With AI

Dr.Indana’s medical expertise with mFine began on content validation and verification, but as a leader of a team of doctors, he works closely with the cofounders to build a system that can “think like a doctor”. Several offerings mostly work on providing a doctor-patient interaction online, with additional elements like online payments or e-invoices that make the experience more seamless and comprehensive.

With mFine, Dr. Indana and his team are developing crucial content repositories that will help understand every patient that logs in to their platform. Aspects of emergency medicine like triaging and alert management for better compliance is being guided by AI & analytics.

Triaging is the process of the swift yet thorough assessment of patients based on the severity of their symptoms and conditions, which determines their medical priority. With the mFine app, a patient in an emergency medical situation with little assistance around, can immediately avail assistance to manage his condition. After entering basic details such as age, illness, symptoms, medical history etc, the AI engine identifies his underlying condition as one that demands immediate medical attention and directs the query to the inhouse medical team, allowing patients to receive the first level of emergency care. “With triaging protocol, time is of utmost essence. By enabling and empowering a patient to atleast procure basic medical attention, he might have gained precious time before he can get to a hospital. We do about 15-20 cases everyday, allowing the AI engine to understand faster and better what a triage situation is.”

He cites an example of a female senior citizen, who complained of extreme exhaustion and presumed it was a result of continuous loose stools. But when she presented herself on camera via the app, the doctor handling the consult immediately realized she very weak and appeared to be going into a state of shock. She was immediately taken to the hospital where they found out her kidneys were failing. She was admitted to the ICU and administered IV fluids. Within a day, she was moved to the ward – indicating a significant improvement in her vitals.

During the nationwide lockdown, mFine witnessed a surge in telemedicine cases. One notable case, Dr. Indana recalls, was a psychiatric consult. A patient who was a regular on the platform with their inhouse psychiatrist appeared exceptionally calm and quiet during a consult. During the consult, the doctor on-call wasn’t convinced of the patient’s unusual demeanour and asked him to walk a few paces. He noticed the patient’s gait was inappropriate and realized he needs immediate medical intervention. He was made to do a CT Scan and MRI, which revealed the patient was experiencing a neurological episode. Had it been left untreated, the patient could have slipped into hemiplegia, commonly known as paralysis.

Another crucial feature where AI is a huge help is alert management, which helps bridge the gaps in patient compliance. The app has a mandatory feature which takes information from the patient on their medical history and drug allergies. If a doctor prescribes medication that could cause that patient an allergic reaction, the AI engine immediately recognizes this and sends an alert to the doctor.

Reaching The Fringes With AI

While the platform has witnessed an eight-fold increase in online consultation in the past four months, mFine has also reported new signups from users in states like Jharkhand, Bihar, West Bengal and Uttar Pradesh, where doctor-patient ratios have been conventionally low. “With technology, there are endless possibilities in medicine. India has among the most skewed doctor patient ratios, especially in rural areas. Through telehealth, specialists can reach a larger population with ease. Moreover, AI engines at mFine are constantly upgrading to absorb vast amounts of information about the latest medical protocols, drug discoveries, and presenting it to doctors no matter where they may be located. Access to information like this is a boon to doctors and physicians in PHCs, who probably operate and consult based on outdated protocols,” explains Dr. Indana.

Dr. Indana feels younger doctors must take the mantle of technology adoption upon themselves and become role models or “influencers” to the rest of the medical fraternity, while senior doctors should open their minds to technology to view them as enablers, and not something that would diminish their experience and knowledge.

“User experience has changed, it doesn’t mean business is losing relevance. We must change our ways to embrace technology so it can help us serve people more effectively and efficiently.”