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Revamping healthcare

India's IT potential and technology can help improve healthcare in the country.

 Agencies |  2017-11-02 18:41:54.0

Revamping healthcare

In recent years, the country has made significant strides in healthcare. Positive indicators include the under-five mortality rate, down from 126 in 1990 to 48 in 2015 and maternal mortality rate, also down from 560 to 174 during the same period. Infant mortality is also down from 3.2 million in 1990 to 1.1 million in 2015, a significant difference.

But we cannot afford to be complacent, especially when we see our less developed neighbours doing better on vital health parameters. For example – Sri Lanka, Nepal, and Bangladesh have under-five mortality rates of 9, 36, and 38 respectively against India's 48.
Technology is a boon when it comes to healthcare and innovations offer us an excellent opportunity to accelerate development. Making the most of the government's promised technical and financial support by riding the wave of technology, we can transcend healthcare innovation to newer levels.
There is a need to identify successful and cost-effective programmes and replicate them, wherever possible, through initiatives such as National Health Innovation Portal, replicable practices and innovations in the Public Health Care Systems Summit, and the provision of including these in State Programme Implementation Plans for funding under the National Health Mission.
Indian IT expertise has played a significant role in the global digital revolution. Why can't the same be harnessed to start an Indian health revolution? Prime Minister Modi's vision of digital India should be invoked to bring about better health facilities for every Indian citizen.
The Prime Minister's 'Digital India' initiative has eased online accessibility of services and also reduced delays, red-tapism and corruption. Today, the common man is making payments for day to day necessities including public services, online or through mobile telephones, saving time and money while also facilitating an improved quality of life.
Can't technology do the same for healthcare? After all, the PM's 'Digital India' initiative also includes the promise of providing broadband services to every village in India, to support implementing initiatives such as telemedicine and m-health services. But the juggernaut has been rolling very slowly. If the Bharat Broadband Network Limited (BBNL), the special purpose vehicle along with its implementing agencies, pull up their socks and work with greater zeal, the Prime Minister's dream of better health for all Indians in his 'New India' can be delivered.
As a matter of fact, all four of the PM's prime projects --Digital India, Start-up India, Make in India, and Swachh Bharat Abhiyan working in tandem, with the right technological push, can transform healthcare in India. Fortunately, there is no dearth of local and global players to back India, for a technology scale-up, especially in healthcare. They would be more than willing to partner with the Indian government in driving health technology forward. Indian and multinational companies could collaborate to provide enabling technology and medical devices under the 'Make in India' initiative.
Considering the challenge in grabbing this opportunity, there is a need to respond with service innovation. Overall, consumers and the society will reap the fruits of this technological and socio-economic development. There is no denying technology's tremendous potential to complement and accelerate effective implementation of better health care programmes. No wonder, states have been encouraged to include innovations in programmes under the National Health Mission. Innovations include both program innovation and product innovations. Service delivery including referral, governance, treatment, compliance, reducing the cost of care etc. are categorised under programme innovation, while medical devices, innovative technologies including healthcare IT, m-health, and telehealth/ E-health are clubbed under product innovation.
Technology is already assisting India to improve its health status by addressing some of its current challenges. It is coming to the rescue in both preventative and curative healthcare. For instance, to tackle the problem of the lack of physical activity and inappropriate dietary practices, people are depending on mobile applications to monitor their physical activity, calorie intake and also regulate corrective measures.
Lack of health awareness is today being overcome with useful health information on YouTube, smartphones, mobile apps, etc. The Electronic Family Health Record is being initiated in India to battle the problem of a lack of real-time health data. The shortage of doctors and specialists is being tackled through mobile technology-enabled apps for counselling, awareness generation, and e-consultations. Patient feedback and grievance redressal systems launched by the government too, use telephones and internet for monitoring quality and performance.
Technological Innovations Revolutionising Indian Healthcare
Family Health Folder
This initiative looks at the family as a unit and maintains health records for each member which can be linked as well as segregated for individual services like BP records, medicines prescribed, immunisation, antenatal care, postnatal care, listings etc. It can also be linked with the Electronic Medical Record (EMR) for continued care from the home to the hospital.
Electronic Health Records (EHR)
The government is working on EHR to ensure continuity and quality of care as this assists in recording disease episodes, interventions and core plans that allow data portability between different providers and between support systems such as HR, finance, logistics lab, emergency transport etc.
Free Essential Drugs
To widen the accessibility of free drug services, a web-based supply chain management system (e-Aushadhi) has been created to help improve the availability of drugs and eliminate drug stock-outs. This system allows online tracking of drug inventory. This initiative has been implemented by states like Rajasthan, Tamil Nadu, Andhra Pradesh, Odisha, and Jammu & Kashmir
Any Time Medicine (ATM)
At present, 25 per cent of PHCs in India are without doctors. To address this challenge, an innovation called ATM has been devised. ATM, piloted by National Health Systems Resource Centre, New Delhi, provides teleconsultation supported with mobile phone telephones and a generic drug vending machine. Pilot projects in four states are presently on. Medicine dispensing machines in Delhi use similar technology.
Yet another example for use of technology is 'Teleopthalmology, Teleradiology, and Telemedicine'. This has been successfully piloted in states like Tripura, Andhra Pradesh, Bihar, Himachal Pradesh, Maharashtra, and Assam. With this technology, images, and scans are sent to specialists for diagnosis and consultation for treatment, especially when the specialised treatment required is not easily available.
Automation of fund flow
Health programmes often suffer because of delays in fund transfer. Establishing a public fund management system with the help of technology has been a boon. Another initiative is with the automation of recording, verification, and calculation of payments so that they are smoother and faster and electronic fund transfer (EFT) can be made easily into the recipient's bank account. This technology is being utilised in Delhi, Rajasthan and Bihar for payment to the grass root level Accredited Social Health Activists (ASHA) who travel long distances to submit physically verified work records to receive payments, which are often delayed.
(Dr. Sanjiv Kumar is Director, International Institute of Health Management Research, New Delhi. The views expressed are strictly personal.)

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