Challenges and Sustainability
Although many countries have attempted diverse methods to overcome the
challenges imposed by the pandemic, there is lack of evidence on
establishment of patient helpline systems in a low-resource setting.
Implementation of patient helpline systems in a low-resource context
involves unique challenges, including financial, logistical,
administrative and technological4-8.
Orchestrating the massive communication process was a challenge due to
unpreparedness of doctors, chaotic situation created by the increasing
number of cases and deaths on a daily basis, uncertainties of the
disease condition itself and fear psychosis created by the media.
Patients were distressed not only by their own illness but also by the
potential plight of their family members. The entire scenario created
the highest possible challenge in
communication8.
Training a diverse group of volunteers to work in a complex system was a
major challenge. Doctors were trained via an online training programme
and motivated to share knowledge among them through a dedicated social
media platform. This was a display of connectivism; the learning
paradigm of digital era10.
Sustainable coordination was a major concern. Doc call 247 service
consists entirely of volunteers ranging from specialists to medical
students. They can tune into the system as per their convenience by
‘opting in’ or ‘opting out. There is a roster system in place as well to
ensure that a particular number of doctors are available at a particular
time. Number of expatriate medical professionals also rendered their
services as volunteers to sustain the helpline transforming this
operation to a global telemedicine
project5,6.
Operating a SMS gateway for patient prioritization needs a dedicated
medical team stationed at an operational room to respond to the SMSs
received.
Therefore, this integrated system was a unique example of medical
voluntarism. People displayed global empathy; compassion and
collaboration for the benefit of people whom they have not met or were
not responsible for.
There were some concerns regarding confidentiality of medical
information sharing on the web and data security. The issues of
liability, jurisdiction and malpractice where medical advice without
face-to-face consultation or clinical examination took place, were
raised. Some healthcare professionals were reluctant to adapt to new
ways of working, resistant to a change in mind-set about the use of
technology to deliver health services and lacked willingness to work in
multi-disciplinary teams or to ask for a second opinion.