Attend Health 2.0 India at Bangalore on 7 and 8 February 2014

Health 2.0 India is back with it’s Third Annual Edition.


Health 2.0 India ”Simply Lead” 2014 conference is slated for 7th and 8th February at Bangalore.
The Event will showcase demos and presentations in;

1. - Designing an improved patient experience for a Billion people
2. - Trending – Startups, Funding and Accelerating Health 2.0
3. - Health 2.0 in the village
4. - Quantified self, wearable sensors and trackers
5. - Mobile health in real life
6. - Rise of big data and better decisions
7. - Pharma and better outcomes , etc.

Here is your chance to see all this healthcare technology from our very own Indian entrepreneurs and some international examples, in action at Bangalore on 7th and 8th February 2014.

You can get a 30% discount off the registration fees by using the discount coupon code: DIGMED2CON

 You can also mail me drneelesh@digmed.in  for details

See you at Health 2.0 @ Bangalore on 7th and 8th Feb.

Doctor Alert! Stop Giving Away Free Medical Advice on Telephones

Telephonic consultations are a fact of life for all doctors. We offer you tool to increase your branding and also charge for telephonic consultations via a simple My Teleconsult Card.

It has never been so simple before! We offer you a Personalized (with your profile snap) prepaid telephonic consultation card for your patients. We charge about 40/- to 80/- (depending on plan) for each 10 minute teleconsultation card (activation charges included). You can make 200% to 800% profit by fixing your own rate for each Ten minute telephonic consultation.

As a bonus, the same phone number can be used by your patients to book an appointment, at No Cost!!

You can easily check a demo by simply dialing  1206655300
You can start with our trial pack @ Rs. 999/- (plus Taxes) for Twelve Ten minute Prepaid teleconsult cards.
If you are interested in this service, kindly fill this online form or contact me at drneelesh@digmed.in

E.H.R Standards for India : GOI Report

Electronic health records are a summary of the various electronic medical records that get generated during any clinical encounter. Without standards, a lifelong summary is not possible as different records from different sources spread across ~80+ years will potentially need to be brought into one summary. To achieve this, a set of pre-defined standards for information exchange that includes images, clinical codes and a minimum data set is imperative.

Foreword to ‘ E.H.R Standards for India ’ by the GOI.

The Government of India, as it goes for the unveiling of National Health Portal, comes out with a definitive guidelines for E.H.R standards in India. The document takes a look at E.H.R standards to be followed throughout different medical provider institutions in India, so that medical data becomes portable and easily transferable. Its amazing to see how many ehealth companies have been stumped because of lack of such a document earlier. This might be good news for a number of companies which foolishly wait for standards to be finalized, instead of simply building the most Flexible, Secure, Doctor & Patient-friendly E.H.R they can.

More importantly , It takes a look at Data ownership.

It says “The health data is owned by the patient while the actual records are owned by the care providers who act as the custodians of the data. Adequate safeguards to ensure data privacy and security must strictly be adhered to at all times. Patients must have the privilege to verify the accuracy of their health data and gain access whenever they wish to do so.

Thankfully, Patients have earned their spot in our policy making. We know that products which do not have the patient interactions in mind will just not succeed. Now that we have a roadmap ahead, It’s a race to the finish for the nascent ehealth industry in our country.

You can download a copy of the document here.

The Inside Story of National Health Portal of India

National Health Portal of India has been on our minds for a long time. This is the inside story of working for the national health portal of India which is scheduled for launch on 1st October 2013, almost four years after it first came under consideration. It’s a very optimistic project and a wordle created from the project report showcases that very well.

First, some history and background.

Backed by the National Knowledge Commission, a working group committee sent its Project Report on setting and developing the national health portal for India in August 2010. The NKC proposed to launch the National Health Information Portal which would serve as a comprehensive source on health information in India. The portal plans to serve as a single point of access for consolidated health information, application and resources on the sector and aim to cater to a wide spectrum of users from citizens, to students, healthcare professionals and researchers.

The proposal also aims to create space for other portals, publishers, IT and non IT based interventions. It is envisaged that private enterprises would join the government in creating new tools and services with the help of all the Data to be collected via NHP. This is a humungous task by any standards and the progress on the portal has been understandably slow.

A recent meet at AIIMS organized by HIMSS India and attended by Dr. Suptendra Nath Sarbadhikari, Project Director, Centre for Health Informatics of the National Health Portal cleared the mystery surrounding the progress of National Health Portal. During the meet, a lot of time was spent on stressing the need for Uniform Data Standards to be adopted so that all EHRs across the country (private and public hospitals) can be connected to the national health portal. With the addition of Prof. Indrajit Bhattacharya, the team at the National Health Portal is now well positioned to take this project forward.

The meet highlighted 3 main topics of discussion;

1) Data standards and Interoperability

2) Mobile apps for content distribution

3) Social Media Help desk and social networking activities

In order to accumulate data from various state health departments, government hospitals and private hospitals, we need a common system for entering the health data. The GOI has not yet taken the effort to set up a recommended set of data standards which can be followed by all hospitals and institutes while storing data. Unless data standards to be followed are finalized soon, linking/ merging of diverse sets of healthcare data will be close to impossible in the future.

Mobile apps and device agnostic websites were identified as an important next step in the project. The project objective is also to improve health literacy of the masses in India. One immediate hurdle for the National Health Portal is the need for authentic and high quality content in multiple languages.  At this stage, It is not desirable that NHP spends its efforts and money creating original content for education of consumers and healthcare practitioners.Except for a core team (4 or 5) of graphic artists and subject matter experts to create interactive and visual media on a daily/weekly basis, the task of content creation could very well be outsourced. The NHP team can always validate the content after creation and before it is uploaded to the website. Besides, a lot of content is freely available from international sources like Centre For Disease Control (CDC) and World Health Organization which can be hot-linked on the portal. Professional content curation and dissemination via mobile apps will play a huge role in providing content for the National Health Portal.

Another important consideration at the NHP meet was the creation of a Social Media Helpdesk for the portal. Social Networking is the new fact of our connected lives today and the NHP plans to make full use of existing platforms like Facebook and Twitter to further its agenda. Social Networking would also be utilized via various health Forums planned on the portal. Social Media will be a key component of the content distribution strategy.

The National Health Portal will always be a work in motion. You, too, can have a say in how that happens. We have created a Facebook page for this project. You can join us on Facebook to share your views/suggestions as well as Tweet us your suggestions by using the hashtag #nhportal.  We will make sure all tweets and comments are forwarded to the right authorities.

This update has also been shared on India Health Network website.

Wearable Technology in Healthcare: Will It Take Root in India?

After self-quantifying apps, with the advent of Google Glasses, Wearable tech is soon going to be a big thing in healthcare.

The movement for self-quantifying patients is not too old. Many experts believe that self-quantifying patients are the logical next step  in evolution of person-centered healthcare. Physicians have found wearable self-quantifying by patients especially useful in management of chronic diseases like obesity, diabetes, heart disease, blood diseases, arthritis etc. With 7 of 10 patients seen in the US by physicians already quantifying themselves using apps and wearable tech, the wearable tech in healthcare market is only destined to grow bigger, at-least in the Indian metros initially. Indian cosmopolitans are just the types to take to this trend sooner (3 to 5 years) rather than later. The unmet demand of self-quantification market in India is presently catered to by a few start-ups like Diabeto (a mobile device),  and we are ready to see more such initiatives soon.

Take a look at some of the affordable wearable tech already present in the markets ranging from bionic lenses to display information, pedometers in shoes, watches as oxymeters, trauma resistant inner-wear and bras with sensors to monitor your heart.

Source: mashable.com via Paul on Pinterest

Indian Healthcare Industry in the 21st Century

 

 You better start swimmin' Or you'll sink like a stone,

For the times they are a-changin'

- Bob Dylan

Healthcare has been changing in drifts and shifts over the past few centuries and Nothing will ever be the same again.

Tim Berners-Lee (father of Internet) made the biggest financial sacrifice in recent times when he refused to patent his hyper text transfer protocol and instead threw it open for the Aam Aadmi. The times of the mai-baap Doctor are numbered. The patient has taken his rightful place as the center of the new healthcare ecosystem, with all other stakeholders working to woo that customer. The recent regulations regarding generic medications will only strengthen this position. Since patient, and not the doctor, will now make the purchasing decision, all stakeholders in this ecosystem (Pharma, labs, hospitals) need to reconsider their strategies and focus on the true consumer.

Many savvy Indian entrepreneurs have already smelt the coffee. Now, many stages of healthcare services can be accessed online. You can track your health using Smartphone apps and websites. When unwell, you can check your symptoms to arrive at a presumptive diagnosis online. It’s easy to search for a suitable physician in your geographical area who you might want to consult. Compare rates and services at various hospitals. Book your appointments. Receive your lab reports and prescriptions in the comfort of home. Join social support groups and get information about alternate treatments or therapies. Store all your health records digitally and get second opinions from anywhere in the world. Doctors can monitor their patients remotely and even tweak treatments from a distance. They can discuss treatments and obtain referrals in secure online platforms. The effect of Internet and social media is just too huge to be ignored.

To borrow an analogy from Jed Weissberg, MD, Senior Vice at Kaiser Permanente, the Choluteca Bridge is a metaphor for today's healthcare ecosystem. The Choluteca Bridge was built by the U.S. Army Corps of Engineers in 1930 with design strength to withstand the worst of hurricanes that affected the area. When Hurricane Mitch came in 1998, it destroyed 150 Honduran bridges, but not the Choluteca Bridge. Instead, the storm rerouted the Choluteca River. This rendered the huge, strong and beautiful bridge useless as it served no purpose in the changed environment.

The true potential of healthcare social media has not even been scratched on its surface yet. The focus on cloud computing and Big data can work wonders in the field of medical communications. At Digital MedCom solutions, we currently tag 30,000 Indian physicians via weekly emails and popular social media platforms. Our aim to have an active social database of all 500,000 practicing Indian physicians (or at least the approx. 250,000 active onliners) within the next 2 years is not as farfetched as it may seem. All the stakeholders in healthcare, except the patient, seem to be ignoring social media at present. Unless steps are taken to remedy this inertia, traditional healthcare industry is destined to go the Choluteca Bridge way.

Three Legal tips For Practicing Telemedicine in India

The Internet is now commonplace in India and Healthcare is set to benefit greatly by using internet for our huge and populous country. Telemedicine is one immediate aspect of the web which is set to take off because of the many benefits it provides in the Indian Scenario. A lot of deaths in India are because of treatable diseases like TB, Diarrhea, and Malaria. The doctor: patient ratio at 0.5 per 1000 is way below the desired average of at least 3.0 to 3.5 per thousand. A lot of patients just don’t get to see a doctor. A lot of doctors want to reach out to new populations. Universal Health Coverage will be doable much faster if we can induce Indian Physicians to adopt telemedicine.

But a lot of such Digital Medicine initiatives in India are held up by legal fears. Many of us doctors have no idea of where the law stands in regards to providing health consultations via the internet. For understanding of medico legal aspects of digital medicine, one needs to take a number of acts and regulations under consideration.

1) The Information Technology Act 2000 ;
2) Drugs and Cosmetics Act ;
3) Indian Medical council Act ;
4) Code of Ethics Regulations 2002

In essence, all regulations which apply on real life encounters can be transposed on virtual consults. Following are the three takeaways in non-legalese for Indian Doctors looking to utilize the Internet to better the quality and reach of care they provide:
1) Only medical practitioners registered in India and are allowed to provide medical consultation, prescriptions and treatment. This seems to rule out possibility of foreign doctors providing any web based consultation to Indian patients directly without involving any Indian registered practitioner.

2) Prescriptions created via electronic health records which are digitally signed are acceptable. Most all electronic medical records software provide the secure digital signature ability. There also seems to be no problem with hand written and signed prescriptions on paper which are scanned for digital use and archived for future reference.

3) Automated Prescriptions using Algorithms are tenable as long as the Doctor takes full responsibility for the prescription and accepts to be identified as the originator of the prescription.
Would love to have comments from experts on this.

Social Media To Be The Commonest Source Of Continuing Medical Education

Social Media is the commonest use of Internet. Everyone uses the internet to access their emails and Facebook accounts. A Google search engine is the gateway to all information for most of us. These platitudes of an everyday normal life also apply to physicians.

Communication technology has made things easy for doctors. Keeping up-to-date with medical advances has become an easy part of everyday life and not restricted to events like conferences or receiving prints of journal publications. Recent publications have highlighted the importance of social media in continuing medical education. In a recent large study, 70% of doctors were found to have accessed new medical content via social media every month.

Social media integrated medical content platforms like India Cardiology 2.0 and India Rheumatology 2.0 make it easier to read, share and discuss the latest studies and articles within the niche. Such platforms let readers (which in most cases are doctors) recommend and easily share the relevant study on their Facebook wall. Reader recommendations on the website are used to list the most visible studies. On such social media integrated medical content platforms, Readers can choose to stay updated via email (enewsletter) or via Facebook page or Twitter. So, for example, on liking India Cardiology 2.0 Facebook page the latest news and articles in Cardiology shall be visible to readers on their Facebook wall stream. Readers can also use common social media platforms including LinkedIn and Google plus to recommend the article to his/her own friend circle with pertinent comments.

Similarly, following @incardiology on Twitter will let a reader receive all new updates in his/her twitter stream/wall. Such platforms make finding and sharing relevant items so much simpler for medical professionals.

Social media and emails are well ingrained into our daily lives. Its time doctors make professional uses of such tools too.

Portable UV Disinfector To Control Hospital Acquired Infections

Technology provides hospitals with tools which can greatly improve their quality of care. This small portable disinfector is one such tool.

Hospital acquired infection is an age old problem which refuses to go away. Infections acquired during hospital stay still constitute one of the top 5 causes of mortality in patients. Antimicrobial solutions and fogging help in reducing the microbial burden but they have their limitations. Enter Xenex.

The futuristic looking Xenex room disinfection system uses pulses of high-intensity ultraviolet light to kill bacteria without contact or chemicals. The device can be moved from room to room, and can disinfect surfaces and the air in a matter of minutes. The system uses reflectors and movement to focus UV light toward “high-touch” surfaces. Motion detection system and door guard ensure the safety of patients, visitors, and staff. On-board database logs system activity for utilization tracking and analysis.

In hospital trials, Xenex was found to be 20 times more effective than standard cleaning methods, and a recent study proved it is more effective than bleach in reducing C-difficile.

What doctors don't know about the drugs they prescribe : Video

Medical Journalism and communication has become sensationalistic. Potentially beneficial results are overhyped and harmful possibilities simply brushed under the rug. Positive findings are around twice as likely to be published as negative findings.

When a new drug gets tested, the results of the trials should be published for the rest of the medical world -- except much of the time, negative or inconclusive findings go unreported, leaving doctors and researchers in the dark. In this impassioned talk, Ben Goldacre explains why these unreported instances of negative data are especially misleading and dangerous.

Freeing Medical Data: Video

Technology has enabled us to collect vast amounts of medical data from myriad sources. But most of this data is locked in silos and unavailable for use by researchers. Performing a medical or genomic experiment on a human requires informed consent and careful boundaries around privacy. But what if the data that results, once scrubbed of identifying marks, was released into the wild?

At WeConsent.us, John Wilbanks thinks through the ethical and procedural steps to create an open, massive, mine-able database of data about health and genomics from many sources.

Benefits and Risks of Healthcare Social Media

Social media includes all online tools and technologies which let people communicate and publish content easily. The most popular among them are Blogs, Facebook, Twitter and YouTube. Widely used for communications and marketing, these channels are considered as important (if not more important) as mainstream media channels like newspapers and television.

The use of social media in healthcare represents an increasingly effective tool in healthcare. It can be used to communicate with consumers, inform about new wellness schemes, market healthcare products, provide basic healthcare advice, inform about latest medical devices, get instant public feedback and much more. At the same time, Healthcare social media also presents challenges, including risks to information accuracy, organizational reputation, and individual privacy.

The primary focus for most organizations' social media programs is marketing and communications. Hospitals are using social media to target health consumers. As consumers are shifting to online searches before making important healthcare decisions, hospitals are looking at creating solid social media presence and fostering long term relationships with their consumers. Internationally, Mayo Clinic has taken the lead in healthcare social media. Mayo Clinic’s Center for Social Media has a stated mission to "lead the social media revolution in healthcare, contributing to health and well being for people everywhere." Indian hospitals are not far behind. The Apollo Hospitals twitter account has more than 2000 followers. Their Facebook page makes wonderful use of the timeline feature, has 91,000 likes and is fast growing. Their YouTube channel has been active for the past 4 years.

Many organizations have also formed online support groups for patients. Patients are encouraged to share their personal experiences and this consumer generated content is an invaluable source of information for other patients. Many doctors, too, have joined such support forums and provide information on various disorders. In a country like India where 70% of healthcare services are paid for ‘out-of-pocket’, Social Media becomes all the more important for healthcare marketing. Companies selling healthcare devices have found social media influences purchasing decisions. Internationally, many pharma companies too have realized the enormous potential of social media. Almost all major drug companies now have social media presence. Companies like Pfizer, Novartis, J & J and Sanofi-Aventis have launched many innovative social media campaigns. The HR departments in many healthcare organizations are using social media sites to spot and recruit talent.

These new tools of communications come with their own risks and dangers. Like a double edged sword, all points in favor of social media usage also contribute to the dangers associated with their use. The dangers social media exposes healthcare to are internal as well as external. Flippant remarks made by nurses or doctors online can be misconstrued by general public. Cases abound where protected health information was shared online inadvertently. The danger of violations of patient privacy cannot be overstated.

Conversations cannot be controlled and negative remarks made on social media by disgruntled employees or consumers cannot be erased. Such risks can be minimized by fostering positive comments by consumers and show casing achievements and consumer centeredness via these communication channels.

Organizations need to gear up to grab the opportunity and face the challenge that is social media. They need to monitor their ‘social presence’ and keep track of consumer sentiments. Use of social media for innovative marketing and communication campaigns should be encouraged. Organizations should educate both their employees and the public on their privacy practices to encourage responsible use of their social media sites. Guidelines and specific social media policies need to be in place to promote risk free use of social media by employees. Once policy is established, employees, volunteers, contracted employees, and medical staff members should receive training and education to ensure they are aware of the policies and procedures. With proper policy and training for employees, healthcare is slowly but surely taming the social media beast that technology has helped unleash on the markets.

Also See:

· Pharma and Healthcare Social Media Wiki: http://bit.ly/hcsmwiki

· Online Database of Healthcare Social Media Policies: http://bit.ly/hcsmpolicy

· Privacy Policies for Social Media: http://journal.ahima.org/2010/01/06/social-media-policies/

Top 10 Health Technology Hazards For 2013

The evolution of healthcare information technology systems such as electronic health records (EHRs) has definitely helped improve quality and efficiency in healthcare. At the same time, there’s a growing level of complexity and opportunity for error. With increasing use of technology in healthcare, healthcare providers need to be wary of the associated risks with its use.

Now in its sixth year, ECRI Institute publishes an annual list of top hazards of technology in healthcare. The Top 10 Health Technology Hazards list is updated each year based upon the prevalence and severity of incidents reported to ECRI Institute by healthcare facilities nationwide; information found in the Institute’s medical device problem reporting databases; and the judgment, analysis, and expertise of the organization’s multidisciplinary staff. Here are the group’s estimation of the most probable hazards which might crop up in 2013 because of use of technology in healthcare.

1.  Alarm hazards

2.  Medication administration errors using infusion pump

3.  Unnecessary radiation exposures and radiation burns during diagnostic radiology procedures

4.  Patient/data mismatches in EHRs and other health IT (HIT) systems

5.  Interoperability failures with medical devices and health IT systems

6. Air embolism hazards

7. Inattention to the needs of pediatric patients when using “adult” technologies

8. Inadequate reprocessing of endoscopic devices and surgical instruments

9. Caregiver distractions from smartphones and other mobile devices

10. Surgical fires

You can download the original report by registering here.

Here are the lists of Top hazards for 2010. for 2011 and for 2012

Photo credit: @Jacobsons on Flickr (CC BY-NC-SA 2.0)

Ten Most Innovative Companies In Healthcare 2012

Fast Company routinely publishes their list of 'Most Innovative Companies'. You can find their earlier list here. Here's  their list of most innovative companies in healthcare for 2012.

1) National Marrow Donor Program

Their use of technology shortens the 'Bone marrow transplant' time by using an online hub that helps keep donors and recipients on track during the steps before transplantation. They have also added new matching algorithms to improve search accuracy. NMDP makes extensive use of social media to search for new donors.

2)  Narayana Hrudayalaya Hospitals

India's pride, this is one institution which has beautifully married public and private healthcare enterprise, among it's many other innovations in healthcare services delivery.

3) Walgreens

They are a $70 billion company and the largest drug store chain in the U.S. They offer some amazing online deals in healthcare products.

4)  Castlight Health

Like a price compare in Healthcare services allowing you to bargain, Castlight Health provides transparency into cost and quality, so individuals can make informed decisions about health care.

5) Assistivewear
Found in 2000, they are a truly innovative firm working on assistive technology software for Mac OS X and iOS. Their inclusion is for developing a Virtual on-screen keyboard for users who cannot use a physical one.

6) IBM

They are a fixture in any such list of 'most innovative companies'. This time, they feature on the list for their hugely popular 'Watson supercomputer'. Watson is expected to soon bring its massive artificial intelligence algorithms to help improve healthcare and clinical medicine.

7) Össur

A niche player in orthopedic devices, they are in the list for building the "smart" knee, the first motorized, personalized prosthesis.

8) Heritage Provider Network 

A preventive healthcare services company, they are in the list for funding a data-mining competition to reduce unnecessary hospital visits. 

9) Esri

 A mapping software (G.I.S) company, they have brought in the concept of commercial use of 'Geo-medicine', where they use mapping software to help in diagnosis, management and prevention of diseases (many of which have an environmental trigger).

10) 3M
A large product manufacturing company, they have about 55,000 products in the market, many of them in the healthcare and electronics. Their inclusion is because of their cardiology grade Littmann® Electronic Stethoscope.  

Doctors in Australia Will Please Maintain Silence on Social Media.

The Americans never got it right in healthcare anyways. The Canadians have a beautified version of the same. The Europeans have their hearts in the right place and are still working on theirs. Now its Australia's turn.

Healthcare social media is definitely the elephant in the room and the Australian Health Practitioner Regulation Agency (AHPRA) has geared up to fulfill its mandate of “maintaining public safety at its heart”. They recently released their preliminary consultation paper on social media policy for healthcare practitioners:

A draft of the social media policy has been released as a preliminary consultation paper to targeted stakeholders for initial feedback, ahead of a wider public release....The policy reflects the National Boards’ role as regulatory bodies with respect to social media and does not provide more general professional advice.

The preliminary consultation process aims to ‘road test’ the initial draft to weigh operational impact, issues or initial concerns. As expected, Australian doctors have been forced into fighting for their rights! True to its name ‘practitioner regulation agency’, AHPRA has come out with its set of recommended ‘must-nots’ and penalties. This particular draft  is so ‘advertising’ centric, AHPRA misses out on their wider role to “develop or approve standards, codes and guidelines for the health profession”. Advertising in Social Media is only the tip of the iceberg.

As @edwinkruys hints in the comments here, some of the policy statements are plain dumb. While questioning the very need for the document's existence in the present format, some very relevant positions have been outlined on this Crikey health blog. The scope and expectations of the community this document hopes to regulate will hopefully be taken into serious consideration, even it means reversing some old policies.

In its zeal to regulate what they call advertising, the current draft borders on violating right to speech and the freedom of expression. The wordpress blogger Carolyndv says it eloquently “What use are we as healthcare workers if we cannot engage with our community about their health and wellbeing?”. If "Disclosing personal information on social media to current or former patients may breach professional boundaries", they are effectively trying to silence doctors on social media. As a regulating body for developing/approving standards and guidelines, what APHRA also needs to do is define protected health information and state the patient parameters/details which should not be revealed in Social media. It is these sort of definitive guidelines the document lacks while gleefully throttling health information rights of the consumer.

The AHPRA is taking in suggestions till 14th September after which they will hopefully come out with a more rounded and practical draft of social media regulatory guidelines for physicians. Later, the National Boards in the National Registration and Accreditation Scheme (National Scheme) will release a consultation paper on social media policy in October/November 2012.

Indians Expect To Lead The mHealth Revolution : PwC Survey

 

With large penetration of mobile phones in the country (close to 1000 million cellphone users, teledensity >79%), India has realized that mHealth adoption will play a very important part in improving access and quality of healthcare in the country. Countries like China, Brazil and the US have all turned to mHealth in varying degrees. There are significant differences in mhealth adoption among emerging and developed nations. A recent survey from PricewaterhouseCoopers tries to assess the climate for utilization of mHealth in 10 developing and developed countries.

The extensive study included patient survey with over 1,000 respondents, physicians’ survey with 433 physicians and a payer survey with 345 respondents. The study shows that expectations are high for mHealth from patients, providers and payers. Consumers are ready to adopt mobile health faster than the health industry is ready to adapt. Here are a few key findings from the study relevant to India:

•  India and China scored the highest in openness and awareness of mHealth. China shows higher use of mHealth at present compared to India, though the environment in India was felt to be most encouraging of all countries. From the ten countries in the study, Indians expect mHealth to have the largest impact on healthcare. 60% of Indians surveyed felt that widespread adoption of mHealth services is inevitable in the near future.
• 92% of physicians in India expected a noticeable effect of mHealth in 3 years. Also, 52% of physicians in India believe the widespread adoption of mHealth is inevitable.
• Patients in emerging markets like India and China are more willing to pay for mHealth than their counterparts in the developed countries.
• Despite the optimism and the desire, India scored the lowest on the technology front. Technology was found to be most mature in Denmark and US.
• Telephonic consultations, Administrative communication and Remote patient monitoring are the most popular uses of mHealth in India. Remote access to EMRs is fast gaining in importance.

The main drivers for patients using mHealth in India are

1. To reduce own healthcare cost,
2. Improve access to providers,
3. Ability to obtain information.

The main barriers in patient adoption of mHealth in India are cost, lack of relevant applications and unwillingness of doctors.

The main drivers for physician use of mHealth in India were

1. Lowered overall cost of care for patients,
2. Ability to reach previously unreachable patients and
3. Saving of time otherwise spent in administrative functions.

The main barriers in physician adoption of mHealth in India were lack of interest and unavailability of information about mHealth.

Of all stakeholders, Physicians are generally the most reluctant lot to adopt mHealth. In the whole study, 60% of active users of mHealth say that patients and technology companies are more interested in mHealth than physicians. Though Indian physicians seem more amenable to adoption of mHealth compared to physicians in most other countries, we still have a long way to go. Having doctors join the mHealth revolution will be the key to ensuring optimum benefits for the patients. And that, my friend, is going to be a tough task.

Related articles

• More than 60% doctors and consumers in India rely on mHealth (India)
• Latest Report: mHealth Adoption for Provider - Patient Engagement
• Patients adopting mobile health faster than doctors

Doctors on Google: Manhattan Research Survey 2012

It is important for the healthcare industry stakeholders in India to keep a close watch on physician practices in the United States as the same behaviour is soon replicated in Indian metros because of a large proportion of US returned doctors. Google partnered with Manhattan Research to conduct a very revealing physician survey recently which also has implications for the Indian markets.

A total of 506 practicing US physicians were surveyed online between February and March 2012 to assess their use of digital tools and new media. Here are some of their key findings.

• 87 per cent of physicians use mobile devices like smartphones or tablets.
• Physicians perform an average of 6 professional searches a day
• 68 per cent of physicians are prompted to use a search engine because a patient seeks more information during a consultation
• When search is used, 77 per cent  of the physicians use it between patient consults while 41 per cent physicians agree to having used it during patient consults.
• 84 per cent of physicians search on condition related keyword terms. Only 17 per cent search on pharmaceutical manufacturer terms
• 93 per cent physicians have taken action after consulting a search engine for clinical information.
• One in three physicians click on sponsored listings
• Medscape is the most popular platform used for watching professional videos.

Now Indians Can Compare Prices of Branded Drugs on Mobile Phones

Consumer mHealth is here. There has been a spurt of entrepreneurship in this field and some Indian phone/ mobile based start-ups have been launched over the past couple of years. Mainly, they have been services meant to connect healthcare consumers with doctors via phone (like Ask a Doctor from Vodafone, Mediphone by Religare technologies,  Dial UR Doctor  and Mera Doctor). Most of these tools are voice based and sometimes don't even fit the rigid definitions of mHealth. Further, they are all healthcare professional specific and have pointedly ignored patients in any decision making process.

Not that all mHealth projects in India are in the private sector. The government of India has also been active in harnessing the reach of mobile phones in the country with some projects in Public health like in ensuring treatment compliance in DOTS Program and in healthcare reporting at grass roots level. 

On the other hand, use of mhealth tools to connect Indian pharma industry and the consumer has not really taken off. One exception was the very useful  Drug authentiction tool ps-Connect which has been launched by PharmaSecure. based out of Gurgaon.

The latest mHealth project by the government of India looks to strike at the alleged root of costly medical care : the widely variable costs of branded drugs. The Indian government has taken the initiative to use simple messaging services (SMS) to educate the public on drug prices.

Here is how it works: Once the person sends a text message of the prescribed brand of drug to a particular number from his mobile, he will receive two to three options of the same medicine, along with the price differential. Say, a patient is prescribed a popular anti-infective like Augmentin (GlaxoSmithKline). He types in Augmentin and sends the SMS to the designated number. He would get a return SMS, possibly mentioning Moxikind CV (Mankind), which is substantially cheaper. But sources said that all responses would come with a caution: please consult the doctor before popping the alternative (pill).

The proposed mHealth project will definitely be trashed by medical associations who will look at this intrusion by patient in decisions regarding brands as an affront to their expertise. Nevertheless, this irreversible shifting of the power balance in favor of healthcare consumers has been long in the making. Instead of objecting to such tools, we must look at strengthening the quality of the tool. The only practical objection to such a project would be the possibility of lower quality brands being suggested by this tool. The quality of branded drug can be ensured by having stringent quality checks for the inclusion of any brand in the database which will be created. 

The savings potential of this tool is enormous and inability to ensure quality of database cannot be an excuse. We cannot afford to throw the baby out with the bathwater.

The service, expected to be launched by the government in August, will be available throughout the country.

PS: If you know of any innovative mHealth projects in India, kindly share the link below in comments.

Also see:

• The Dr SMS service from the Kerala government
• Mobile health to be Rs 3,000 crore market in India by 2017
• Delivery of healthcare service via mobile 'inevitable': Survey

Crowdsourcing Supervision Of Healthcare Delivery Services in India

Hello ? Where is the Doctor ?

The days of free lunches for doctors in government services will soon be over, if this attendance crowd-sourcing becomes the norm all over India.

Thousands of Indian primary health centers (PHC) work without doctors because there are none posted. Thousands more remain idle because the doctor and other medical staff simply remain unavailable. Absenteeism is a very big curse in the delivery of public health services in India. People dependent on the primary health care centers expect that the doctor is absent. Since all attendances of medical staff is verified at the PHC itself and generally by the absentee doctor himself, there has never been an official check on this culture of 'furlough'. A trial of giving supervisory powers to local 'Sarpanch' (village headman) to ensure attendances of medical staff didn't work out as well as hoped for.

Now Technology and crowd sourcing promises to do what no government administration has managed to do yet. Ensure the presence of medical staff on duty. How Mobile Phones Are Repairing India's Broken Healthcare System 

The Indo-Deutch Project Management Society (IDPMS) tracks SMS messages reporting staff absences sent by local patients, and maps the regions and facilities where absenteeism is prevalent. These maps are then made available to locals and policymakers. 

Presently this experiment is limited to Karnataka. But as and when results emerge, this simple system to involve the citizens to ensure the attendances of medical staff at rural PHCs is bound to have a number of effects on the Indian public healthcare setup. No doubt, the idea will be vilified and rubbished by the entrenched bureaucracy and status-quoist medical staff of government services. But this SMS enabled collaborative supervision of public health services can be a very good tool for improving healthcare delivery by making people more involved in ensuring they get the healthcare services they deserve and pay taxes for.

image: www.canada.com

How Doctors Use Smartphone Apps

There is an increasing use of smartphones by all sections of society in India. Villagers and city dwellers alike are hooked onto many multimedia apps, the most popular being Facebook and Youtube. Doctors, too, are avid users of smartphones and medical apps like Epocrates and Medscape.

   See:5 Useful and Free Android Medical Apps

It is always informative to look at trends among doctors in the United States since quite often the same trend is soon repeated among the Urban Doctors practicing in metros like Delhi and Mumbai. With a reverse brain drain of medical experts to India now being the norm, many of the doctors practicing in major Indian corporate hospitals have been trained in the US. And they bring back the current trends to India sooner than was previously expected. Here's a survey on how 266 doctors use smartphone apps (September 2011).

With smartphones and apps quickly gaining popularity in healthcare, there are now thousands of medical apps available in the app store. To illustrate this app overload challenge faced by doctors today, Epocrates conducted some research and created an infographic looking at the numbers – how many apps doctors download, how many they actually end up using regularly and which apps get used most. 

Interesting that 75% of the doctors with smartphones had downloaded more than 26 apps , though the number of apps they use daily was much much less (about 7). And recommendation of a friend/ colleague is the number one reason for trying out new apps.

Mobile App overload for doctors

Browse more Technology infographics.

Source