Journal of Clinical and Diagnostic Research. 2022 Apr, Vol-16(4): LC21-LC26 21 21 DOI: 10.7860/JCDR/2022/51754.16209 Original Article Public Health Section Awareness and Skills of Modern Telemedicine Practice among Doctors in Kerala- A Cross-sectional Study INTRODUCTION The Information and Communication Technology (ICT) enabled medical services are developing fast in today's world, especially after the COVID-19 pandemic. They are cost effective and provide access to healthcare services for people in remote areas [1]. There are many possible reasons why implementation of telemedicine is a challenging [2]. In a country like India with large geographical distances and limited resources, providing health care can be challenging [3]. About 80% of doctors in India are located in urban area [4]. Patients living in rural areas can save expenses on long distance travel for obtaining consultation. In some instances, where only a routine follow-up check is required patients can consult doctors using telemedicine, without much inconvenience or impact to the family or caregivers [5]. Telemedicine can decrease burden on hospitals by decreasing re-admission rates. By using telemedicine services patients can communicate with doctors from the comfort of their own home and take care of themselves in certain instances following the doctor’s advice [6]. Telemedicine can give safety to patients, health care workers and doctors in situations where there is a risk of a contagious disease. The use of telemedicine services during this Coronavirus Disease 2019 (COVID-19) pandemic is a prime example [5]. Providing equal access to quality care and to digital health is essential for the overall development and improvement of health systems; hence, mainstreaming telemedicine in health systems can minimise inequity and barriers to access. Lack of clear-cut guidelines is one of the reasons why some doctors are reluctant to practice telemedicine. Most doctors in India are not aware of the guidelines for the practice of telemedicine, through video, phone, and internet-based platforms (web/chats/app). Gaps in legislation and the uncertainty of rules can pose risks for doctors, health care workers, and patients when using telemedicine services [5]. During the COVID -19 pandemic, to promote contact-less consultation Ministry of Health and Family Welfare (MHFW) Government of India published guidelines for practicing telemedicine on 25 th March 2020 [5]. The success of any new technology depends on many factors including the knowledge and understanding of the concept, skills acquired, attitude and the working environment by the concerned professionals [2]. Technology anxiety is one of the reasons doctors are reluctant to adopt telemedicine [2]. Telemedicine is an emerging technology in the health sector in India, so it requires study to know health professional’s awareness and skills towards telemedicine. Travancore - Cochin Medical Council (TCMC) on 31 st March 2020 in their circular (Order No: A1: 6898/2020/TCMC Dated: 31.03.2020) mentioned use of telemedicine in COVID -19 pandemics as “temporary measures” [7]. The TCMC also put forward a lot of conditions on how doctors should consult patient using telemedicine [7]. The COVID-19 pandemic has brought forth a renewed focus on the role of telemedicine services. Telemedicine seems to be an appealing option for patients and doctors for medical consultations in this pandemic time as there are severe movement restrictions throughout the state in an effort to control COVID-19. Even physicians who are in quarantine can make use of telemedicine services for consulting patients. Follow- up check-ups for patients will also become easier [5]. The new telemedicine guidelines by MHFW provides norms and protocols ANIL BINDU SUKUMARAN 1 , MANJU LEELA 2 , KANNAN SURESH 3 , HIMIKI SELVIN 4 , REGI JOSE 5 , SHILPA PRAKASH 6 , DIVIJA VIJITH 7 , PV BENNY 8 Keywords: Coronavirus disease, eHealth, Teleconsultation, Telehealth ABSTRACT Introduction: In this modern era of technology, Information and Communication Technology (ICT) has made a very big revolution. Telemedicine is an emerging concept in health care services in Kerala, its implementation has not been satisfactory and successful. It is cost effective and provides easy access to healthcare services for people anywhere and especially during pandemic situations like this. A study is required in the domain of awareness and skill of doctors to facilitate its adoption and implementation. There was an urgent need to devise means for patients to consult doctors during Coronavirus Disease 2019 (COVID-19) pandemic. Aim: To assess the level of awareness and skill among doctors practicing modern medicine during COVID-19 pandemic. Materials and Methods: A cross-sectional study was conducted among 535 modern medicine doctors of Kerala from June 2020 to May 2021, using a structured self-administered questionnaire designed for the study. The total scores of awareness and skill calculated and categorised as poor, moderate, and good. Data was analysed by Statistical Package for the Social Sciences (SPSS) version 20.0 software by IBM. The Chi-square test/ Fisher’s-Exact test was used as test of significance. Results: Mean age of the study participants were 40.44±10.66 years, with majority 326 (60.94%) been females. Among the 535 doctors participated, 68.22% had moderate skill, 27.85% have good skill and only 3.92% have poor skill. Years of experience of doctors ranged from 1 to 48 with mean of 13.47±10.46 years. In majority, 431 (80.56%) of the participants, had moderate awareness about the telemedicine practice. Poor awareness was present in 19 (3.55%) doctors. 46.54% believes that specific software training is required for practicing telemedicine. Conclusion: The study showed that 15.89% had good awareness, while 80.56% of the participants had moderate awareness about the telemedicine. Only 27.85% of doctors had good skill, while 68.22% had moderate skill. Even though, awareness and skill of doctors practicing modern medicine are favourable, more webinars or workshops are needed to improve their knowledge.