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.