To the Editor: Telemedicine applications are broadly classified as synchronous or store-and-forward (asynchronous). Systematic reviews published previously have reported rapid decision making, shortened diagnosis time, faster patient management and diminished length of hospital stay [1, 2]. Most of these reports pertain to chronic adult care, emergency trauma management and laboratory uses from developed countries.

Physicians have been available over phone to patients; but there was always a fear of inadequate documentation, misinterpretation of advice, patient identity/confidentiality issues etc. [3]. It is interesting to note that a couple of years before the pandemic, the Indian judiciary had recommended very restricted use of telemedicine. Circumstances changed almost overnight; and with it came the need to adapt. Stakeholders have recently recommended guidelines for pediatric telemedicine practice [4]. Synchronous-videoconference-telemedicine in neonatal office-practice’ (SyNTOP) was made available from March 2020 in our centre, using a hospital-purchased app, that can be installed on any multimedia device. The video-consult was followed by an appropriate health decision documented on the electronic case-file. Decisions were one of: (a) drug prescription sent to the patients’ email or phone (home-delivery of drugs is offered by the pharmacy for feasible distances), (b) resolution of queries, (c) advice to report for physical examination. Fast-track well-child vaccination services after SyNTOP were a skip-the-line visit to the vaccination room. Contact was avoided with general reception queues, waiting areas.

We sought to analyse actual clinical success of SyNTOP (defined as proportion of babies who did not require a physical visit to any hospital over the next 48 h after teleconsultation). Total of 829 children availed the facility in the peak COVID period (March 2020-April 2021). SyNTOP was successful in 765 (92%). Acute illness was the reason for consult in 418 (51%); 363 (87%) of these as well, were resolved without an actual physical examination. Video-consultation is feasible in neonatal office practice, with safe documentation.