The second wave of the COVID pandemic overburdened hospitals in Nepal. During the peak of the second wave, Health Foundation Nepal (HFN), in coordination with the Ministry of Health and Population (MOHP), initiated a telephone-based consultation service to provide telemedicine service to COVID-19 infected client’s in-home isolation across the country. This was a unique system designed in a resource-limited setting as an immediate response to the COVID pandemic.
This is a retrospective study of 765 patient data collected during HFN’s telemedicine program from many service for COVID-19 and excludes patients who called for non-covid related information, including for pregnancy. The telemedicine service was available in a hotline that connected clients with doctors via an audio-only line. All the clinical signs and symptoms were reported 10, 2021, to July 10, 2021. This analysis includes all the patients who received the telemedicine by the client; for clients who did not know how to pulse an oximeter, instructions were provided either verbally or by directing to a photo or YouTube video link. A company named VoxCrow provided the technical platform. The patient data gathered on Google sheets during the tele-health project was imported and cleaned using Microsoft Excel. Data analysis was performed using IBM SPSS V23.0 software.
During the 60 days of telemedicine service, 4,966 calls were received and made through the hotline. A total of 765 individuals from 58 districts of Nepal received tele-consultation for COVID-19 disease from HFN. The majority of the clients (58%) were males between the ages of 31 and 40. 43% and 3.7% had family and travel history, respectively. Fever (45.4%) and cough (42%) were the most commonly reported complaints. Clients who were unvaccinated, smokers, and had comorbidities like diabetes and hypertension had severe COVID-19 disease. Among 235 clients with moderate to severe illness, 90.6% recovered without complications, 8.5% required hospitalization, and two died while receiving treatment in the hospital.
The study showed that telephone-based consultation could effectively be triaging, providing appropriate referrals, and treating clients at home in countries with inadequate healthcare infrastructure like Nepal. Telemedicine services like HFN improve healthcare access and support the judicious use of limited resources during healthcare emergencies like the COVID-19 pandemic.