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Opinion | Do health apps and telemedicine live up to the hype?

The pandemic has us using apps to connect with doctors, pharmacists, and therapists remotely, but there are times when the experience falls short of expectations.

Illustration photo created by freepik.

Before the COVID-19 outbreak hit Indonesia, I had never used a health tech app. Clinics of any sort were just a ride away, and I was skeptical about whether someone speaking to me through my phone would be able to offer a useful diagnosis. Might they miss something that could be caught during a visit to the doctor? Could a therapist still be impactful without a physical presence?

But various restrictions are now in place in Jakarta as we try to stop the virus in its tracks. The idea has been hashed out many times—if people are not out and about, if they are not coming into physical contact, then transmission can be stopped. In the Indonesian capital, we are discouraged from visiting hospitals except for medical emergencies, as health workers are caring for patients who are sick with COVID-19. The government said we can and should use telemedicine services in place of visits to clinics and medical facilities as long as we aren’t facing life-threatening conditions.

This includes mental health treatment. Due to physical distancing measures, mental health professionals are taking their counseling sessions online, either on their own platforms or via health tech apps. Mostly confined to my apartment, I have been feeling anxious for almost two weeks, so I decided to try talk therapy through one of Indonesia’s most used health tech apps.

Apparently, I wasn’t the only one with that idea. Most therapists who specialize in adult psychology had packed schedules, but I finally managed to book a slot last Thursday. The 45-minute session cost IDR 50,000, or USD 3.40—a half-price pandemic discount.

The consultation was done by typed chat, and I could send attachments like images or PDF files. The conversational flow is exactly what you’d expect if you were sitting in a therapist’s office, and the psychiatrist on the other end of my connection was offering decent service. But here’s the rub—typing out my problems didn’t carry the same emotional release as saying them out loud.

Screenshot of psych counseling chat session on health tech app.

This actually made it more difficult to articulate my problems. Normally, when seated across from a therapist, he would observe the patient and guide them to convey what’s on their mind, but text on a screen doesn’t have the same impact. By the time we reached the end of the session, I didn’t feel like I had received help to resolve my anxieties. There was a prompt for me to select whether I wanted to extend the session. I clicked no.

Aside from the awkwardness in text-based communication, the experience left me feeling like it wasn’t truly a therapy session—the psychiatrist couldn’t read my body language or hear the tones in my voice, or generally get a sense of how I feel in my own skin. These are the things that are missing in phone-based consultations. I have written about how we may shift to using telemedicine services more frequently when seeking non-emergency medical assistance in the future, even after the pandemic subsides.

But maybe the shift is possible if it carries some adjustments. I spoke with other users, who shared their experiences with and opinions of health tech apps.

Read this: Indonesian health tech apps see surge in downloads due to COVID-19

Triska Sarwono used the same app as I did twice in May after she had an allergic reaction. She didn’t want to visit a hospital for a walk-in consultation, so she downloaded the app and started using it. “It was a very smooth experience. I got connected with a doctor immediately, then sent a description and a picture of my skin. The doctor then prescribed allergy medication for me,” she told me.

Before this, Triska had some qualms about using apps like this one. But the snag-free experience has convinced her to keep it on her phone. “I will use it again even after everything goes back to normal,” she said. “The process is very simple and affordable. It only costs IDR 25,000 (USD 1.70) for a consultation, while for in-hospital consultations, we need to set a time, queue, and pay hundreds of thousands of rupiah [at least USD 10].”

Triska doesn’t use the app to order medicine because she says it’s still cheaper to buy directly from pharmacies. But another user, Aldimas Wisnuvidya, who has been on the app since 2018, told me that the over-the-counter medication he has bought through it—painkillers, for example—cost about the same. Like Triska, his experience with the app has been satisfying so far, and he said he’ll keep using it.

That’s all to say that when health tech companies say people will continue using their services even after the pandemic ends, it will likely be true, with some caveats. These features are still new, and the companies that made them are still figuring out which ones work, and which don’t. The shift seems like a valid change, but I’m not sure that it applies to mental health too.