opinion
Tele-Health
Taking it Beyond the Pilot Phase There are more than 540 million mobile phones in India, which can be used for pushing as well pulling information about preventive healthcare, as well as other healthcare services
Mobile interface is changing the generation, our society, our habits, the way we handle our daily lives and thus impacting every business. It is estimated that 92 percent of the US adults are on cell phones, one out of eight marriages in the US happen via internet, 80 percent of the world is under cell phone coverage and 80 percent of twitter is used on mobile. Word of mouth is transforming into the word of mobile. Anyone who ignores the role of mobile in his business is committing a great strategic mistake. Usefulness of mHealth is never debated;
usability is, and that is a big challenge for both the providers and users. If we are to overcome this hurdle, we must make the right start, and focus upon the areas of rural, geriatric and mental health. If we cannot do this, mHealth would never move beyond the pilot stage.
Ignorance is not bliss Most individual doctors are blissfully oblivious of what is happening in the field of mHealth and of the tremendous untapped potential this technology holds in bridging the urban rural health divide. Unless awareness is created and success stories highlighted, there will be no significant change. We will have more pilots in the mHealth arena than there are in the Indian Air Force!! We have a long way to go before a mobile phone becomes a hand held hospital, before refractive errors can be checked with it, before it is used as a microscope or before DICOM images can be manipulated, ECGs seen, heart sounds heard and the mobile from a patient used to connect bluetooth enabled sensors and a Body Area Network to a physician remotely. Storing mPHR and enabling access to drug interactions appears child’s play compared to this. Considering that worldwide, even in 2007, only 20 of the 50 documented mHealth projects were actually operational, serving less than 100,000 people, progress is certainly being made. Who could have predicted even two years ago that a mHealth summit in Nov 2010 in Washington would attract 2300 attendees, 200 speakers and 125 exhibitors from all over the world. However, less than 10 november / 2011 www.ehealthonline.org
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15-17 December, 2011 |
Mahatma Mandir, Gandhinagar, Gujarat
Chief Guest Narendra Modi Hon’ble Chief Minister Government of Gujarat
organisers
exhibitors
Co-organisers
Key Speakers Jay Narayan Vyas Minister of Health Government of Gujarat
Keshav Desiraju Additional Secretary Ministry of Health & Family Welfare, Government of India
Dr Ajay Singla Additional Secretary, Department of Health & Family Welfare, Government of NCT of Delhi
Anju Sharma Mission Director, NRHM, Gujarat
Dr S Vijayakumar Special Secretary (H & FW) & Project Director, TNHSP
Dr Ashok Kumar Former DDG and Director, Central Bureau of Health Investigation Government of India
Vijayalaxmi Joshi Former Principal Secretary & Commissioner, Department of Health & Family Welfare, Government of Gujarat
Sangita Reddy Executive Director Apollo Hospitals Group
Dr Girdhar Gyani Secretary General, QCI
Maurice Mars Prof of Telehealth Dept of Telehealth, Nelson R Mandela School of Medicine, South Africa
Dr Shakti Gupta Professor & Head, Dept of Hospital Administration, AIIMS
Dr Dharminder Nagar Managing Director, Paras Hospitals
Dr Sanjeev Bagai CEO, Batra Hospital & Research Centre
Amod Kumar MNH Project Director, IntraHealth
Babu A CEO, Aarogyasri Healthcare Trust, Government of Andhra Pradesh
Dr B S Bedi Advisor-Health Informatics, C-DAC, Government of India
Dr Balaji Utla CEO, Health Management & Research Institute, Hyderabad
UK Ananthapadmanabhan Past President, Kovai Medical Centre & Hospital, Coimbatore
And many more...
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for programme Enquiries Divya Chawla, divya@elets.in, +91-8860651643
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www.eINDIA.net.in
opinion
The immediate benefits of mHealth are enjoyed by patients who receive the service instantly and closer to home, but the institutions and organisations building the mHealth infrastructure and connecting all the other stakeholders benefit only at a later stage. These institutions need to be compensated in their early stages so that return on investment can be justified
percent of participants were medical practitioners. It appears that health is too serious a matter to be left to only doctors! Mobile network operators, IT specialists, software programmers, technologists and businessmen are playing a major role in mHealth compared to doctors. At least one mHealth conference takes place somewhere in the world every week. There is an imperative need to educate all the stakeholders of the potential of mHealth which could indeed be the answer we are all looking for.
Incentives for beneficiaries The three key players involved in the mHealth include the patient who is also the main beneficiary, the practitioner, and the service provider. To ensure that the three stakeholders work together to develop, promote and deliver healthcare service, mHealth applications must perform the following functions: delivery of health information services, facilitation of interaction between providers and patients, facilitation of the integration of healthcare industry-related business processes, local and remote access to healthcare information and support for employers and employees, payers and providers. Today there are many applications in the market that enable healthcare service delivery, impart education, and enable preventive healthcare. However, medical practitioners, patients, normal people and other stakeholders need incentives to use these mHealth applications. The immediate benefits of mHealth are enjoyed by patients who receive the service instantly and closer to home, but the institutions and organisations building the mHealth infrastructure and connecting all the other stakeholders benefit only at a later stage. These institutions need to be compensated in their early stages so that return on investment can be justified. A proper incentive system which benefits all involved parties would need to address the following issues healthcare service providers use different technologies and many times custom user interfaces. In order to motivate these service providers to come together on a single platform and share information with each other in order to create a unified healthcare system, it is highly important that these entities are properly incentivised to share the information. Critical drugs are rarely available in rural areas and some remote parts of the country. In order to create a robust supply chain that ensures continuous supply of medical drugs, an interconnected system needs to be put in place.
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november / 2011 www.ehealthonline.org
This system will include hospitals, patients, as well as pharma companies. The entities in this system need to be incentivised in order to have an interconnected flow of information that will enable them to share information among themselves. There are more than 540 million mobile phones in India, which can be used for pushing as well pulling information about preventive healthcare, as well as other healthcare services. However, an incentive system must be put in place so that people on the ground are encouraged to use these services and provide or access health related information. Medical practitioners are often reluctant to use technology for providing healthcare services. This is so because it requires extra efforts to familiarise themselves with these technologies. The United States has been experimenting with a scheme which provides doctors an extra compensation that uses technology for providing healthcare services. The same model can be experimented with in India. People in rural areas are often not able to afford any kind of medical insurance or enrol themselves for any kind of healthcare services. But these people can provide information regarding their immediate surroundings (using simple tools such as mobile messaging, etc.) which can be useful for mapping diseases on a national level, and enhancing preventive healthcare. These people need to be encouraged to participate and in return be compensated for their valuable service.
Tele-health as point-of-care Massive spending by itself does not guarantee proper and universal healthcare. Take the US for example: it spends over US$ 7000 per capita on healthcare, but still faces a number of problems. In order to ensure quality and universal healthcare, we need not only innovation, but also pro-activeness in healthcare delivery to address the issue. We will have to reduce healthcare costs, reduce the burden of chronic diseases and increase positive outcomes. Telehealth should be used as the de facto POC (point of care) tool for preventive care and follow up care in chronic disease management. The channels of delivery must not just be confined to doctors and hospitals but must also reach pharmacies and other channels nearer to the POC. Given the situation in developing countries, telehealth is the only economically viable way to address the elderly population, rural areas, preventive care, chronic diseases, and increasing healthcare costs within current limitations.