Health Technology, Digital Healthcare
Article | August 16, 2023
Virtual care and telehealth are no longer seen as merely an innovative method of delivering healthcare; technology is now indispensable to protecting patients, staff, and PPE resources amid the coronavirus pandemic. In a recent Harvard Medical School blog, Lee H. Schwamm, MD, shared that “telehealth, the virtual care platforms that allow health care professionals and patients to meet by phone or video chat, seems tailor-made for this moment in time… The current crisis makes virtual care solutions like telehealth an indispensable tool.” He believes that the role of telehealth is vital to our country as “it can help flatten the curve of infections and help us to deploy medical staff and lifesaving equipment wisely.”
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Health Technology, AI
Article | July 18, 2023
Contents
1. Knowing The Basics
2. Importance Of EHR In A Rural Setting
3. Features That An EHR Must Have In A Rural Area
Today, we will discuss the crucial featuresof electronic health records (EHR) in rural hospitals. However, before listing out the key components, let us first understand what EHR is and how it can help the smooth functioning of medical treatment in a rural setup.
1. Knowing the Basics!
As the name suggests, an electronic health record is a computer file that stores a patient’s medical history, such as diagnosis, treatment, test results, etc. In short, an EHR is a digital version of a patient’s paper health record. It also includes previous appointments, billing details, and other general documentation. The need for an EHR popped up due to its easy and secure availability compared to patients' paper files. In addition, patients and doctors can easily access lab reports through an EHR that is updated in real-time and downloaded on any device with an internet connection.
2. Importance of EHR in a Rural Setting!
Healthcare Information and Management Systems Society (HIMSS) defines EHR usability as “The effectiveness, efficiency, and satisfaction with which specific users can achieve a specific set of tasks in a particular environment.' In essence, a system with good usability is easy to use and effective. It is intuitive, forgiving of mistakes, and allows one to perform necessary tasks quickly, efficiently, and with a minimum of mental effort.”
A patient's electronic health records can be beneficial in an era of digitization. It can improve patient care by minimizing the chances of medical errors, reducing test duplication, and making doctors and patients well-informed by fetching medical records anytime, thereby reducing delays in treatment.
3. Features That an EHR Must Have in a Rural Area
EHRs can prove beneficial in all areas situated far off by accessing the real-time, up-to-date data of patients’ health records and making timely decisions. When the distance between the clinics and specialists is more, an EHR report can easily be sent to look into a patient’s history before delivering treatment.
In a rural setup, EHR helps promote health awareness as patients' data can be monitored without needing to be physically present. Software-as-a-Service (SaaS) Solutions can be easily deployed in places with slow internet and help maintain a lightweight EHR that can support immediate patient care and easy documentation.
Next comes the option of configuration over coding. At the Rural Health Clinic (RHC), an EHR that the local IT team can handle would be of more use than one that may require a specialist’s check or additional coding. An EHR, equipped with the ability to configure and customize as per the clinic’s workflow, will give more control to the RHCs and enable them to function efficiently.
Another significant point of an EHR in a Rural Health Clinic will be the inclusion of applications that support instant communication, like Telehealth and patient portals. These applications enable direct consultation and virtual care of patients and specialists located far off, thereby reducing the dependency of RHCs on city or urban-based facilities.
When we are discussing rural hospitals, we need to look for an application that is both affordable and functional, as rural areas mostly struggle with problems regarding budget and resources. Hence, keeping this in mind, RHCs should install a cloud-based EHR that does not require buying servers or employing IT staff.
RHCs must use an EHR application with innovative analytic tools to access and develop reports for quick patient care decisions. In addition, the system must be able to pull large chunks of data and generate reports daily.
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Health Technology, Digital Healthcare
Article | July 14, 2023
The COVID-19 virus (C19) pandemic is turning out to be the event of the century. Even World War seems timid in comparison. We are in the 4th month of the virus (in non-China countries) and have gone past the lockdown in many places. Isn’t it time we re-think the approach? What if there is another wave of C19 coming soon? What if C19 is the first of many such events in the future?
Before we get into analysis and solution design, summarizing the C19 quirks:
While a large section of the affected population is asymptomatic, for some it can be lethal
There isn’t clarity on all the ways C19 spreads
It’s known to affect the lungs, heart, and kidneys in patients with weak immunity
It has been hard to identify a definitive pattern of the virus. Some observations in managing the C19 situation are:
With no vaccine in sight, the end of this epidemic looks months or years away
Health care personnel in hospitals need additional protection to treat patients
Lockdowns lead to severe economic hardship and its repeated application can be damaging
Quarantining people has an economic cost, especially in the weaker sections of society
If one takes a step back to re-think about this, we are primarily solving 2 problems:
Minimise deaths: Minimise the death of C19 and non-C19 patients in this period
Maximise economic growth: The GDP output/growth should equal or higher than pre-C19 levels
One needs to achieve the 2 goals in an environment of rising number of C19 cases.
Minimise deaths
An approach that can be applied to achieve this is:
Data driven health care capacity planning
Build a health repository of all the citizens with details like pre-existing diseases, comorbidity, health status, etc. The repository needs to be updated quarterly to account for patient data changes
This health repository data is combined with the C19 profile (disease susceptibility) and/or other seasonal diseases to determine the healthcare capacity (medicines, doctors, etc.) needed
The healthcare capacity deficit/excess needs to be analysed in categories (beds, equipment, medicine, personnel, etc.) and regions (city, state, etc.) and actions taken accordingly
Regular capacity management will ensure patients aren’t deprived of timely treatment. In addition, such planning helps in the equitable distribution of healthcare across regions and optimising health care costs. Healthcare sector is better prepared to scale-up/down their operations
Based on the analysis citizens can be informed about their probability of needing hospitalisation on contracting C19. Citizens with a higher health risk on C19 infection should be personally trained on prevention and tips to manage the disease on occurrence
The diagram below explains the process
Mechanism to increase hospital capacity without cost escalation
Due to the nature of C19, health personnel are prone to infection and their safety is a big issue. There is also a shortage of hospitable beds available. Even non-C19 patients aren’t getting the required treatment because health personnel seek it as a risk. This resulted in, healthcare costs going up and availability reducing.
To mitigate such issues, hospital layouts may need to be altered (as shown in the diagram below). The altered layout improves hospital capacity and availability of health care personnel. It also reduces the need for the arduous C19 protection procedures. Such procedures reduce the patient treatment capacity and puts a toll on hospital management.
Over a period, the number of recovered C19 persons are going to increase significantly. We need to start tapping into their services to reduce the burden on the system. The hospitals need to be divided into 3 zones. The hospital zoning illustration shown below explains how this could be done. In the diagram, patients are shown in green and health care personnel are in light red.
**Assumption: Infected and recovered C19 patients are immune to the disease. This is not clearly established
Better enforcement of social factors
The other reason for high number of infections in countries like India is a glaring disregard in following C19 rules in public places and the laxity in enforcement. Enforcement covers 2 parts, tracking incidents of violation and penalising the behaviour. Government should use modern mechanisms like crowd sourcing to track incidents and ride on the growing public fear to ensure penalty enforcement succeeds. The C19 pandemic has exposed governance limitations in not just following C19 rules, but also in other areas of public safety like road travel, sanitation, dietary habits, etc.
Maximise economic growth
The earlier lockdown has strained the economy. Adequate measures need to be taken to get the economy back on track. Some of the areas that need to be addressed are:
One needs to evaluate the development needs of the country in different categories like growth impetus factors (e.g. building roads, electricity capacity increase), social factors (e.g. waste water treatment plants, health care capacity), and environmental factors (e.g. solar energy generation, EV charging stations). Governments need to accelerate funding in such projects so that that large numbers of unemployed people are hired and trained. Besides giving an immediate boost to the ailing economy such projects have a future payback. The governments should not get bogged down by the huge fiscal deficit such measures can create. Such a mechanism to get money out in the economy is far than better measures like QE (Quantitative Easing) or free money transfer into people’s bank accounts
Certain items like smartphone, internet, masks, etc. have become critical (for work, education, critical government announcements). It’s essential to subsidise or reduce taxes so that these items are affordable and accessible to everyone without a financial impact
The government shouldn’t put too many C19 related controls on service offerings (e.g. shops, schools, restaurants, cabs). Putting many controls increases the cost of the service which neither the seller not buyer is willing or able to pay. Where controls are put, the Govt should bear the costs or reduce taxes or figure out a mechanism so that the cost can be absorbed.
An event like the C19 pandemic is a great opportunity to rationalise development imbalances in the country. Government funding should be channelized more to under-developed regions. This drives growth in regions that need it most. It also prevents excess migration that has resulted in uncontrolled and bad urbanisation that has made C19 management hard (guidelines like social distance are impossible to follow)
Post-C19 lockdown, the business environment (need for sanitizers, masks, home furniture) has changed. To make people employable in new flourishing businesses there could be a need to re-skill people. Such an initiative can be taken up by the public/private sector
The number of C19 infected asymptomatic patients is going to keep increasing. Building an economy around them (existing, recovered C19 patients) may not be a far-fetched idea. E.g. jobs for C19 infected daily wage earners, C19 infected taxi drivers to transport C19 patients, etc.
In the last 100 years, mankind has conquered the destructive aspects of many a disease and natural mishap (hurricanes, floods, etc.). Human lives lost in such events has dramatically dropped over the years and our preparedness has never been this good. Nature seems to have caught up with mankind’s big strides in science and technology. C19 has been hard to reign in with no breakthrough yet. The C19 pandemic is here to stay for the near future. The more we accept this reality and change ourselves to live with it amidst us, the faster we can return to a new normal. A quote from Edward Jenner (inventor of Small Pox) seems apt in the situation – “The deviation of man from the state in which he was originally placed by nature seems to have proved to him a prolific source of diseases”.
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Future of Healthcare
Article | October 25, 2021
In today's uber-fast-paced world, the human race, in general, has gotten highly comfortable running on all cylinders in the rat race of life, especially people in India. Our country is a land where opportunities are aplenty, and competition is ever-present, which makes every day life so tedious and constant that taking a breather is something that people can rarely afford. This has led to increasing cases of anxiety, depression, high blood pressure and insomnia. These cases rose to such high numbers that it gave way to one of India’s most prominent industry sectors: The Wellness Industry.
Though the industry captured global attention between 2015 and 2017, a study conducted by McKinsey & Company found that the wellness industry is currently valued at $1.5 trillion globally. This sudden boom can be attributed to the realisation that it is more important to remain healthy than getting healthy. Furthermore, the report, produced after analysing 7500 consumers in six countries (including India), has offered keen insights into consumer behaviour. When it comes to wellness consumers, their trends can be grouped into six categories:
Health: People are now investing in many remote medical devices that can constantly monitor their state of well-being. With the increase in popularity in digital wearables, telemedicine, and remote patient monitoring services, this trend is bound to increase.
Fitness: People are exercising more. Whether it’s jogging, going to the gym, investing in a pedometer, FitBit, etc., there has been a steady increase in people exercising more.
Nutrition: Dieting has always been a significant part of being healthy. An increase in dietary food, supplements, nutrition coaches can be observed in recent years.
Aesthetics: With a major chunk of India’s youth population getting invested in their social media, notably the pictures that they post, aesthetic well-being has seen a sharp increase. This includes investments in specific Athleisure clothing apparel (Nike, Addidas, Puma), skincare products (collagen supplements, face masks), and plastic surgery.
Sleep: Burning the midnight oil is counterproductive. There has been a steady increase in consumers willing to invest in sleep medications, specialised mobile applications that track their sleep and the state of their sleep, ASMR generating devices, White noise devices, and other products that can enable a consumer to maintain a healthy sleep cycle.
Mindfulness: Introspection, understanding the body and its processes to the molecular level, and figuring out ways to implement clarity of thought and methods for improving focus have been huge draws for the wellness industry. Furthermore, with central government’s schemes like AYUSH and the introduction of International Day of Yoga by the United Nations, this particular trend has seen enormous growth.
Impact of these trends on the future of Indian wellness industry
Organic Products: According to APEDA, India has become one of the largest producers of organic products. A growing number are actively investing monthly in organically grown produce, meat that is organically processed, oil that is wood-pressed or cold-pressed, cosmetics made from organic materials, and clothes made from pure cotton instead of manufactured materials. People becoming more conscious of what they put in their bodies has led to a steady increase in organic shops across India.
Exercise, Dieting & Nutritional Supplements: From using simple Calcium supplements and energy drinks to adhering to a strict diet regimen, today’s consumers are genuinely worried about falling sick. This has led to an increase in purchasing supplements. Another trend can be observed where an increasing number of consumers have started buying vitamin, Zinc, and iron tablets, to shore up immunity. Furthermore, Indians have begun consuming gluten-free cereal, cold-pressed juices, Kale products, Avocados, and other food products recommended to be healthier alternatives. Indians have also become BMI-conscious, and an increasing number of them have started to invest in gyms, yoga/cardio classes, exercise-wear, sports wearables, and other products that can enable a person to work out more effectively.
Constant Increasing Demand for Oxygen: Even before the second wave of the COVID-19 pandemic, getting access to 99% breathable oxygen has pure oxygen was a necessity considering the rising concerns of pollution in Indian cities. As per the ‘World Air Quality Report, 2020’ prepared by Swiss organisation, IQAir, 22 of the world’s 30 most polluted cities are in India, with Delhi being ranked as the most polluted capital city globally.
Moreover, people who indulge in extreme physical workouts exercise, or suffer from high-altitude sickness, need oxygen handy to maintain their wellbeing. In India, prominent wellness companies like UCS Wellness Pvt Ltd have made significant strides to ensure that every individual has access to oxygen through their innovative specially outfitted 18-litre aluminium-bottled oxygen cans of 18 litres under their brand gO2therapy. With the pollution rate showing no signs of slowing down, and the steady increase in demand for oxygen, it would be no surprise to find every household medical kit fitted with a portable oxygen cylinder.
Transitioning to Digital Platforms: With the increase in popularity of Telemedicine and Remote-patient monitoring, healthcare and the wellness industry are gaining an aggressive online presence. There are many online exercises/online videos, fitness apps, meditation apps, motivational apps, power coaches, and so much more. Indians find it easier to use these online tools combined with a digital wearable to keep their well-being in the best of conditions.
Investing in Social Media Influencers: With the increase in online dependence, the voice of social media influencers is soon to be gospel when it comes to maintaining a fit body and healthy mind. Much like how mainstream celebrities endorse various products, the wellness industry has seen great rewards in deploying online influencers to support their products. Typical examples can include a famous workout specialist advertises particular apparel, gadget, energy drink, or brand of Whey Protein distributors as part of their video.
Alternatives to Allopathy: In the Indian market, the wellness industry has seen a shift in paradigm where an increasing number of consumers opt for Siddha, or Ayurveda substitutes, instead of conventional medicine. This is seen more in the age group of 40+. This particular age group has patients with a long history of high BP, high cholesterol, and other ailments that require continuous monitoring and medication. They feel that the healthier choice is in traditional medicine or treatments like Panchakarma, Ayurveda, or Siddha. Conventional medication provides them with little to no side effects, which is the primary reason for its increasing popularity.
India is expected to become a wellness hub in the global community following a 12% growth per annum. The Make in India initiative is expected to bring in more investments and opportunities in this sector. The Ministry of AYUSH, with a separate department for Yoga, has been exempted from service tax. A budget of around ?3,400 crores has also been earmarked to be spent over the next five years to help set up and strengthen Ayush Wellness Centers under the National Ayush Mission. This has sparked an increase in startups and businesses focusing on the wellness sector.
Meanwhile, the global pandemic is also giving rise to a new consumer behaviour called wellness rebound where they are becoming more health-conscious and striving towards regaining their health soon after recovering from an illness. Considering the aftermath of the pandemic, the aggressive implementation of technology, and the constant consumer market in India, it can be inferred that the wellness industry will evolve and expand further with little to no backslide.
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