Table 5 Synthesis of challenges and possible solutions of telemedicine from qualitative findings

Challenges for telemedicine

Challenges to the clinicians

 • Unable to carry out the clinical examinations

 • Lost to follow-ups of the patients due to no response

 • Unable to get the desired investigations

 • Issues with getting detailed old reports if patients used to take treatment from somewhere else

 • Unable to do the inspection properly and see the reports on live camera

 • Difficulty in studying bulk of investigation reports on WhatsApp/mobile

 • Certain conditions requiring the physician’s attention are missed or overlooked

 • Difficulty in prescribing many psychotropic medications due to strict guidelines

 • Patients can not be explained their medical conditions just like in-person visits

 • Challenges in making the patient understand the physiotherapy treatment precisely

 • The hesitancy of the patients to show their private parts on the video camera

 • Breach of privacy due to wider circulation of private mobile numbers among people

 • E-illiteracy of patients

 • Non-response from patients at the scheduled teleconsultation time

 • Call by patients on odd times

 • Miscommunication

 • Medical disputes and conflicts

Challenges to the patients

 • Difficulty in registration and getting a timely appointment

 • Issues in getting follow-up dates

 • Postponement of dates for operations and follow-ups

 • Lack of timely response/communication from department/hospital

 • Non-response from doctors over the phone

 • Lack of communication by doctors after sending investigation reports

 • The doctors do not specify the dosage of medicines and do not answer the queries asked

 • Can not understand their condition just like in-person visits

IT/ infrastructure related issues

 • Poor internet connection on the patient side

 • Poor video/image quality

 • Unavailability of labs in remote areas

Possible solutions implemented by the doctors

 • By calling the patients to OPDs physically

 • By asking patients to send their photos and reports on WhatsApp number

 • By asking patients to send the recorded videos and photographs after giving them the necessary instructions

 • By convincing patients to be precise while sending the reports

 • By asking patients to get investigations done at a nearby lab and report telephonically

 • By giving them consultations beyond OPD hours

 • By giving sufficient time for counselling patients to mitigate their frustration due to e-illiteracy