Picture this: You wake up with a nasty cold that leaves you bed-bound, unable to visit a doctor. You pick up your smartphone and fire up an app that connects you to a doctor thousands of kilometres away. After you’ve described your symptoms and medical history, the doctor emails a prescription for free. The consultation out of the way, you open another app, order the required medicines and upload the emailed prescription. A few hours later, the drugs are delivered to your doorstep.

A slow proliferation of medical apps in India has made all this possible, raising the prospect of bringing basic healthcare to so many who are left behind. India, at present, has among the most rickety health systems in the emerging world. And even this is threatened with the Narendra Modi government reportedly planning a 20% cut in the central health budget.

In such a scenario, medical apps should be a blessing – but unfortunately they come with their own set of perils. This was evidenced recently when the e-tailer Snapdeal was found selling prescription drugs that only a licensed pharmacist can retail. The Maharashtra Food and Drug Administration officers, posing as customers, ordered these medicines and later discovered that Snapdeal had listed as many as 45 prescription drugs on the website.

In order to obviate these hazards, the Union Ministry of Health has begun formulating guidelines for online sale of medicines. But in the meantime, other websites and apps have come up that take healthcare directly to smartphone screens.

Online counter for over-the-counter drugs

1mg.com and medidart.com, for instance, home-deliver medicines, provided the orders are accompanied by prescriptions. However, if the order is for over-the-counter medicines, no prescription is required. Doctors and medical experts believe this isn’t such a good idea.

“It could be dangerous if you are buying medicines promoted by pharma companies and sold by e-commerce channels without knowing what’s right for you,” said Dr T Sundararaman, dean of the School of Health Systems Studies at the Tata Institute of Social Science and former director of the National Health Systems Resource Centre. “A retail pharmacist with whom you have a relationship could advise or even warn you against taking too many or wrong medications. That’s so far missing from online retail, where one can buy as many quantities as they desire.”

Sundararaman feels these websites could be useful for bed-ridden or aged patients who need to re-order old prescriptions. “If one is just getting a refill home-delivered, it is actually advantageous but we are worried that no regulation is leading to these tools being misused.”

Citing similar fears, the Indian Pharmacists’ Association wrote to the regulator Drug Controller General of India, arguing that even over-the counter medicines can’t be sold anywhere except at registered pharmacies. The association expressed fears that a loophole in any part of online sellers’ supply chains could lead to counterfeit drugs entering the market and harming many.

“There are a number of questions of how online stores can manage quality, etc,” Abhay Kumar, national president of the pharmacists’ association told MediaNama. “And when it comes to medicine you can’t really play with the lives of people. There are a lot of regulations from the manufacturer, to the distributor, to the wholesaler and there are a lot of checks involved. Drug inspectors conduct regular checks and regular samples need to be taken and report the same.”

WhatsApp a doctor

It is not just medicine sales that have gone online. Some apps aim to bring consultations with a doctor to your phone – among them MeraDoctor. This connects its users to a doctor remotely, allowing them a free 15-minute chat session where anything from a sexually transmitted disease to a common cold could be discussed.

The doctors on the app don’t prescribe medicines other than those available over the counter, but they do help patients understand their existing medication, tests and possible side-effects. As a mark of reassurance, the medical licence numbers of these doctors are displayed with their profile.

Still, there are concerns about this process. “If you are randomly connected to a doctor and he has no case history about you, then how is he supposed to understand your illness and know what works for you?” asked Sundararaman, while suggesting that these apps could prove worthwhile to assist doctors maintain a secondary stream of communication. “WhatsApp or telemedicine is useful when it’s just a routine follow-up for patients with long illnesses such as heart diseases. It could save both the doctor’s and the patient’s time if they can do it over phone but diagnosing someone on the basis of text messages could be dangerous.”

Those preferring a halfway approach can use Practo app to find a local doctor, arrange an appointment and even order an Uber cab for a ride to the clinic. Working like Tinder, the app allows the patient to pick a doctor after going through their profile, qualification and consultation fee.

While many praised MeraDoctor in the review section, a few claimed they never got connected to any doctor and finally gave up after waiting for a day for a response. Some Practo users claimed the app doesn’t allow negative reviews and that too many positive reviews of each doctor drew suspicion.