Adoption of e-Health
Today i was attending the Joint Round Table on Communication Policy – eHealth in India
I made a few comments and they were accepted by the Round Table, and will be presented to the Hon’ble Union Minister for Health , Dr Dinesh Trivedi & the Planning commission on Monday , 8th March 2010
My view was that if the government tied up with private players like TCS, Infosys , Cognizant ( or anyone ) and worked out a nationwide uniform solution for eHealth for the practising doctors and nurses , it could transform the healthcare system in many ways
- The government can bear the cost of the software ( Entire solution- i am not a techie so cannot spell the exact terminology !! ) and give it free to doctors who wish to get on this platform within the next three years . This will help a faster adoption of the EMR or the eHealth platform . After three years , the doctors will be charged for the program on the market cost . Here the disincentive will work as the incentive
- The government can negotiate the rate with the hardware vendors for doctors who wish to install the hardware. This way , the doctors will get a better deal
- This eHealth can start with 40 metros and finally drive down to smaller towns and finally to every doctors
- This will check fake doctors . As only registered / qualified doctors will be given login id / password . The patient can even identify the fake doctors
- This will get the government the actual number of doctors working in India in each geography. This will help government map the ‘gap’ areas and post government doctors in those areas or initiate PPP in those select areas on priority
- With the doctors details resting on the central database , i can simply SMS to a number and get the details of the nearest doctor to my pin code . Pin code mapping will get government and patient the correct picture of the practitioners in the area
- Patient database can be used for patient education and immunization of children in an effective manner . Since patient’s medical and allergy history will be available , the medication errors will minimize to a large extent and the treatment will become more outcome and compliance driven .
- Spurious drugs can also be tackled to some extent
- Medical history / patient record can be made mobile / universally accessible
- This will empower the patient for referral / changing his doctor . The patient might not be required to repeat the same tests if he changes the doctor in a short time , as all the tests might be available online for a similar treatment
My view is doctors are not adopting to EMR – eHealth, as most of the dealings are in cash and there is no record of how many patient the doctor sees per day. With this one uniform system , the government’s tax collection will zoom . Thereby making the entire policy change a zero sum game for the government . The government will make money by selling the software to doctors who come on this system after three years , and also by increased tax collection for recording each patient on the central database .
Worth adopting this !!
Rajendra Pratap Gupta
Email : office@rajendragupta.org
A Common Man's View Point (Blog) 
Hi Rajendra,
I appreciate your above listed views, they are technically feasible, worth adoption and have the potential to address some of the issues that Indian healthcare system has been facing since long.
It is worth inclusion that since IT solutions in healthcare have been in place for quite a while, meaning that even in developing countries, IT applications like eHealth/Telemedicine cannot be classified as innovations. During the course of preparation of a report on EHR adoption for HIMSS, we observed that India alone has over 500 telemedicine nodes and most of the hospitals in private sector are using IT in one or the other form. The result has been that these desperate, discrete IT applications/Information Systems in healthcare have lead to islands/pockets of IT implementations those have further lead to the formation of information silos. Furthermore, researchers and practitioners have indicated that eHealth & telemedicine are not being used up their true potential.
In light of the above I feel SOME POINTS (besides technical aspects like interoperability, data security etc) to be kept in mind while/before rolling out a large scale eHealth solution (based on a PPP model as indicated above) are: 1. Designing effective training programs for clinicians leading to a certification aligned with norms of CMEs 2. Identifying forward-looking and self-motivated clinicians who can act as leaders to handhold their fellow clinicians 3. A Govt. agency and a mechanism to closely monitor the use of these IT applications. etc
Looking forward !