Enhancing ChatGPT for Telemedicine: Contextualizing AI for Indian Healthcare

Background: ChatGPT, a conversational AI developed by OpenAI, is increasingly being used by patients to access medical information. While it shows promise in providing general health guidance, its use in telemedicine settings—particularly in India—requires contextual adaptation. Objective: This article evaluates ChatGPT’s performance in responding to queries related to gastroesophageal reflux disease (GERD), highlighting its strengths and limitations, and proposes enhancements for its use in Indian telehealth systems. Methods: The authors assessed ChatGPT’s responses to GERD-related patient queries and examined the relevance, clarity, safety, and regional applicability of its advice. Observations were tabulated (see Supplementary Table 1) and thematically analysed. Findings: ChatGPT effectively distinguished GERD from related conditions, provided appropriate lifestyle suggestions, and occasionally flagged red-flag symptoms. However, it also used complex medical jargon, presented irrelevant diagnoses, and included emergency service references not suited for India (e.g., “911”). These gaps could mislead patients or cause anxiety if not corrected. Recommendations: The article outlines eight actionable improvements: real-time medical updates, structured history taking, pharmacological relevance, privacy compliance, simplified communication, referral and escalation pathways, support for AETCOM (attitude, ethics, and communication), and multilingual, region-specific customisation. Conclusion: ChatGPT can serve as a supportive tool in Indian telemedicine, provided it is refined to ensure safety, cultural relevance, and alignment with local healthcare infrastructure. With these enhancements, it may assist both patients and healthcare workers in improving digital health delivery.