Rural India Archives - InnoHEALTH magazine

Pilot initiatives of using digital health technologies to promote evidence based tele-medicine practice during COVID 19 period in rural India

InnoHEALTH magazine digital team — Tue, 23 Feb 2021 10:33:35 +0000

Partha Chakraborty

Partha Chakraborty is the Chief Scientific Officer at Arogyam Medisoft Solution Pvt. Ltd. Arogyam Medisoft (www.arogyammedisoft.com) is an IOT based digital solutions company focused in the healthcare & agriculture industry.

Not only patients, the doctors and health workers also get benefited from this digital health platform by providing necessary advice without visiting the actual infected area.

Importance of digital health solution in the current world during covid-19 pandemic situation

Providing efficient health solutions to this growing population is posing a major threat to this current world. Digital health platform is providing overall health coverage and has become a vital tool to serve the vulnerable. According to Bernardo Mariano, WHO’s Chief Information Officer, “Digital Health is the future of healthcare. As we take the big leap into digital health, we must ensure that it is people centric, delivers positive health outcomes, does no harm to people and it actually improves the healthcare system as a whole.” The limitations of physical healthcare system infrastructure and supplies have worsened the whole health system scenario during Covid-19. People living in rural areas are not getting proper treatment due to lack and cost of transportation. Not only patients, the doctors and health workers also get benefited from this digital health platform by providing necessary advice without visiting the actual infected area. In addition to this, the social distancing norm has effectively shut down the traditional face-to-face care. Digital health platforms can become the solution here during this COVID-19 pandemic situation.

Arogyam Health. HaemurEx can test 25 clinical chemistry parameters blood & urine related to diabetes management, liver, cardiovascular, and kidney function

Arogyam telehealth solution with connected devices

Arogyam Medisoft Solutions Pvt. Ltd, a Kolkata based startup, incubated at BioNest, SIIC, IIT Kanpur, has invented a tele-enabled, battery-operated, point of care photo analyzer, designed for potential clinical purpose(s) and a cloud-based lightweight tele-health management system, known as Arogyam Health. HaemurEx can test 25 clinical chemistry parameters blood & urine related to diabetes management, liver, cardiovascular, and kidney function. Use of HaemurEx has been cleared by CDSCO, Govt of India with regulatory approved reagents and received CE compliance certification. It comes with the Arogyam Health is easy to use e-Health platform, accessible through various computing devices, such as a tablet, laptop, or desktop. It is also integrated with digital prescription and electronic medical records. Apart from the standard features available in a telemedicine platform, Arogyam Health is connected with a lightweight 12 lead digital ECG, BP Monitor, SPO2, thermometer, stethoscope. All the equipment can transmit information remotely to a health-cloud, hosted on EU GDPR (European Union General Data Protection Regulation) and HIPPA compliant platform. All the health information remains protected and confidential on HaemurEx cloud server. It gives real-time advice even in the Indian languages.

The ability to measure oxygen saturation, blood pressure, temperature and cardiac outputs, to hear chest & lungs sound have made this device unique in this pandemic situation as determining the co-morbidities has become one of the most important aspects of the whole treatment.

Techniques having only video conferencing will not be sufficient to practice evidence-based medicine in future. The ability to measure oxygen saturation, blood pressure, temperature and cardiac outputs, to hear chest & lungs sound have made this device unique in this pandemic situation as determining the co-morbidities has become one of the most important aspects of the whole treatment. Ability of testing of these biomarkers at point of care, specifically in rural healthcare can be beneficial for the successful management of various disease conditions. Ease of use, not depending on 220 V power supply and ability to carry the system in a small bag are other unique features of this platform.

This platform can advance universal access to healthcare in countries like India. It can bring all primary health centers and sub centers and outreach clinics together where the patients get doctor’s consultation and follow-ups as well as medicine. This collaborative plan between the community leaders and health care providers is bringing the unconnected individuals especially the villagers into formal healthcare systems.

Arogyam Medisoft is supported by Dept. Of Science & Technology, Govt of India. It has been showcased at WHO global forum of medical devices, promoting accessible and affordable healthcare. It got awarded in various forums including Bengalathon organized by Govt of West Bengal, HealthHack organized by BCCI & Medica Hospital, NASSCOM Emerge 50. It has been recently selected German Development Corporation (Deutsche Gesellschaft für Internationale Zusammenarbeit – GIZ) for piloting the platform further.

Pilot application of arogyam health solution

Arogyam Health platform & devices are developed in consultation with physicians and rural hospitals, practicing community medicine, and piloted so far to treat more than 16000 patients.

In a remote clinic of serving the god foundation at purulia, west bengal

This platform is being used in interiors of Purulia District of West Bengal, 300km from Kolkata, for the past two years in a pilot initiative of evidence-based community medicine practice to provide healthcare services to population outside the mainstream healthcare system in collaboration with Serving the God Foundation, Kolkata, led by Dr. Santanu Bannerjee, treating more than 3500 patients. The clinic at Manihara village is set up by the foundation and all the components of eHealth are progressively being installed at the clinic. The doctors visit the remote health center once in a month. The physicians provide their consultations remotely through Arogyam Health platform. The patients are provided essential medicine charged Rs 10/- at no profit basis. Arogyam Medisoft has been able to provide a scalable infrastructure that comes with physician’s consultation, essential diagnostics & essential medicines for 100000 people. Serving the God Foundation, Kolkata treated more than 700 patients, added an ambulance, an infrastructure to remotely treat diabetic retinopathy and remote consultation by leading gynecologist, Dr Mitali Mukhopadhyay and Dr. Lipika Das Mukhopadhyay. Dr. Bannerjee is extending outreach through medical camps at nearby villages to provide support to the patients suffering from chronic diseases like diabetes and hypertension.

In remote clinics & camps of shramajibi swasthya udyog at cooch behar & purba medinipur, west bengal

One similar project is being run by Shramajibi Swasthya, led by Dr. Punyabrata Gun where they are using Arogyam Health platform successfully to deliver health outcomes to more than 200 rural patients during Covid 19 period since June 2020.

In remote primary health sub centres of govt. Of Arunachal pradesh

Being chosen as winner of the Arunachal Pradesh Social Entrepreneurship Meet, Arogyam Medisoft has deployed HaemurEx & Arogyam Health Platform in Changlang District of Arunachal Pradesh, under the supervision of DMO, since November 2020, connecting District Hospitals with community heath-centers (CHC), primary health centers & sub centers, providing e-Healthcare, essential diagnostic and essential medicines. Arogyam provides all types of the technology infrastructure, training by teaming up with a local partner, in collaboration with Govt. of Arunachal Pradesh. physicians from leading centers across India and USA are providing treatment using Arogyam Health Terminal in Arunachal. Effectiveness of the program will be evaluated in next 6 months to decide on speed of further scale up.

Training is going on with Arogyam’s help in Arunachal

Health clinics going on using HaemurEx and Arogyam Tele-Health Platform in Arunachal Pradesh

In employee health centers of a plantation in African country

Arogyam Medisoft has deployed HaemurEx & Arogyam Health Platform for a plantation in African country, where the company wants to extend facility of modern medicine for safety and welfare of its employee in affordable and accessible way.

Conclusion

The HaemurEx device and the Arogyam Health platform has huge potential in rural health during this pandemic situation due to its ease of use, portability, no dependence on external power supply and calibration-independent nature. This system can be used in all primary health centers and sub-centers and outreach clinics in combination with provisioning of physician consultation and essential medicine. In future, a micro entrepreneur-based model using local partner is envisioned, ensuring local livelihood generation in the rural areas. If the plan can be deployed over 600 health centers through one particular state, it can generate employment of 1000-1200 rural youth. It can also be linked with National Rural Health Mission, Pradhan Mantri Jan Oshudhi Program and Ayushman Bharat Wellness clinic programs. It can improve preventive health and wellness and as well can reduce pressure on hospitals. This, in turn, can advance universal access to healthcare in countries like India.

The post Pilot initiatives of using digital health technologies to promote evidence based tele-medicine practice during COVID 19 period in rural India appeared first on InnoHEALTH magazine.

Artificial Intelligence Coming Big Way in Healthcare Sector

InnoHEALTH Magazine — Mon, 19 Nov 2018 10:13:51 +0000

Brig Arvind Lal, CMD of Dr Lal Path Labs, is a pioneer in bringing laboratory services in India at par with the western world. In 1977, he took charge of the medical diagnostics laboratory founded in 1949 by his late father. Under his expert guidance and leadership, the initiative has become one of the most reputed laboratories in Asia, having to its credit quality accreditations from various national and international bodies.

The critical care environment has undergone significant alterations in the past several years. This has happened because our lifestyles in the fast-paced lives of modern India are ensuring that most people, in the age group of 30-50 years are falling prey to life-threatening cardiac diseases and strokes, in addition to diabetes, hypertension, cancers, liver, kidney and lung diseases – these diseases being called Non-Communicable Diseases or NCDs. They are now responsible for killing more than 65% of our population says Dr Arvind Lal, known for his diagnostic labs across the country.

Flagging concerns on such trends, these patients need high-cost intensive care, be it for complications of heart attacks, strokes, diabetes, hypertension, cancer or lung diseases. This is where the importance of Point-of-care testing (POCT) comes in. It helps in almost diagnosing the patient instantly and improves the physician’s ability to take immediate corrective action and decreases hospital stay. One such test is Troponin – that has revolutionized cardiac care by diagnosing heart attacks or myocardial infarction.

This article is based on the keynote address on the occasion of 2nd Annual International InnoHEALTH Conference 2017 – ‘Transforming Healthcare Through Innovation’ in New Delhi, said there are numerous promising diagnostic technologies. The key message is that in a country where 70% of the population lives in rural surroundings, ‘it is our duty to rapidly adopt disruptive innovative affordable technologies including telemedicine. Thus, our underserved population would be able to avail of the best treatment possible and bring in massive visible change’. He said the importance of bringing quality healthcare needs no reminder and the time has come for India to change the direction of healthcare for the masses.

Healthcare is a right – and access to good healthcare should not depend on where one lives and how much he or she earns. But sadly, that is exactly what plagues India’s healthcare today, he lamented. India faces a severe shortage of both hard infrastructure and talent. With about one doctor and one functional bed per 1000 population, healthcare is truly underserved in India. Add to this the regional imbalances and variations in healthcare delivery. The healthcare infrastructure is skewed towards urban over rural India.

Although rural India accounts for about 70% of the population, it has less than one-third of the nation’s hospitals, doctors and beds, resulting in large disparities in health outcomes across urban and rural India. British Medical Journal (BMJ) has observed that there is a remarkable saving of lives in India if good healthcare facilities consisting of operation theatres, surgeons, anaesthetists, blood banks are available within 50 kilometres of the patient providing quality medical services within the ‘golden hour’.

Though there has been a sea change in the last five decades, India now needs to reinvent the field of diagnostics as laboratory tests are responsible for 70% of all clinical or medical decisions.

In today’s life where internet rules the roost, the patients have become very knowledgeable, thanks to the globalisation of healthcare, and are demanding very high-quality healthcare for themselves. They are insisting on a very wholesome and satisfying experience rather than being told that the ‘treatment is over’.

Soon, a time will come when the tests shall be ordered by the patients based on clinical history and clinical findings that shall be answered by an Artificial Intelligence (AI) application. Artificial intelligence has already found several areas in healthcare from the design of treatment plans to assist in repetitive jobs to medication management and drug designing. The most obvious application of artificial intelligence in healthcare is data management. Collecting it, storing it, normalizing it, tracing its lineage – it may well be the first step in revolutionizing the existing healthcare systems.

Recently, the AI research branch of the search giant, Google, launched its Google Deepmind Health project, which is used to mine the data of medical records in order to provide better and faster health services. The project is in its initial phase, and at present, they are working with Moorfields Eye Hospital of NHS Foundation Trust, UK to improve eye treatment.

Just a few years ago the patient after giving the sample used to come back in the evening to the lab to collect a physical copy of the test report. This was replaced by making the report available on the internet that could be downloaded by the patient in the comfort of his home. These days this has been further replaced by making available an App on his mobile phone wherein he can book an appointment for the sample to be collected at home and the report being later available on the same mobile App.

‘IBM Watson, whose headquarters I had the privilege of visiting a few months back in the Silicon Valley, is an AI-based engine that has launched its special program for oncologists to provide clinicians evidence-based treatment options. The program has an advanced ability to analyze the meaning and context of structured and unstructured data in clinical notes and reports in its encyclopedic memory that may be critical to selecting a treatment pathway’. IBM launched another algorithm called Medical Sieve. It is an ambitious long-term exploratory project to build a next-generation ‘cognitive health assistant’ that is able to analyze radiology images to spot and detect abnormalities faster and more reliably. This shall help radiologists in the future to look at the most complicated cases where human supervision is essential.

[/vc_column_text][/vc_column]

‘Wearable Tech is another area which I am personally very excited about. It has the potential to change the world as it helps people understand their own bodies by using mass data collected on a daily basis. From fitness bands to smartwatches to eye based wearables, they are being adopted widely. Take the case of Zephyr’s Anywhere Bio Patch which is an FDA-approved, small device that is attached to a patient’s chest and monitors their vitals minute-by-minute and collects medical-grade data for doctors’ use. These devices will connect our organs digitally, enabling disease detection at very early stages. It has the potential to bring down cardiac and other deaths drastically. This offers immense potential to do remote testing, monitoring and thus assisting the doctor in timely treatment’.

[/vc_row]

Point of Care Testing: Technological advancements in laboratory automation, including POCT, and initiatives to increase patient satisfaction are transforming the clinical laboratory market. POCT has come a long way from a handful of simple tests to a multibillion-dollar global market that holds great promise for the future. Not so long ago, laboratory data would often arrive at the bedside too late to be of significant use in the active, continuing care of critically ill patients. Now, most clinicians acknowledge that POCT is a prerequisite for early recognition of life-threatening conditions as they require that laboratory results are made available in real-time and, if possible, at the critically ill patient’s point of care. The College of American Pathologists defines POCT as tests designed to be used at or near the site where the patient is located, that do not require permanent dedicated space, and that are performed outside the physical facilities of the clinical laboratories.

Examples include kits and instruments that are hand-carried or transported to the vicinity of the patient for immediate testing at that site (e.g. capillary blood glucose) or analytical instruments that are temporarily brought to a patient care location (like operating room, intensive care unit). In many cases, the simplicity was not achievable until technologies developed that was simple and affordable. For example, various kinds of urine test strips have been available for decades, but portable ultrasonography did not reach the stage of being advanced, affordable and widespread until recently. Similarly, pulse oximetry can test arterial oxygen saturation in a quick, simple, non-invasive, affordable way today, but in earlier eras, this required an intra-arterial needle puncture and a laboratory test. Thus, over decades, testing continues to move toward the point of care.

The lab-on-a-chip (LOC) is another device that integrates one or several laboratory functions on a single integrated circuit (commonly called a “chip”) of only a few square centimetres to achieve automation and high throughput screening. Imagine that a patient comes to one of our 2,100 collection centres in the remote tier three or tier four towns in India with the high fever. We take a drop of blood from his finger and inform the clinician almost immediately that the patient is suffering from Chikungunya and not from Malaria or Typhoid, or Dengue fever or Japanese Encephalitis – all in a matter of minutes! The driving notion behind POCT is to bring the test conveniently and immediately to the patient. Needless to add, the patient’s data by POCT shall be made available to update the patient’s electronic health records (EHR).

Talking about POCT Instruments: Currently, two broad type of POCT instruments are available: Small benchtop analyzers (for example, blood gas and electrolyte systems) and handheld, single-use devices (such as urine albumin, blood glucose, and coagulation tests). Now let us talk about if POCT is Boon or Bane? The strong point of POCT is speed and the rapidity with which it shall save lives in emergencies. As India marches towards quality healthcare delivery, in course of time regulatory compliances shall have to be adhered to in the interest of the patient’s health.

The post Artificial Intelligence Coming Big Way in Healthcare Sector appeared first on InnoHEALTH magazine.

Tele-Medicine System to Strengthen Healthcare Services in India

InnoHEALTH Magazine — Thu, 10 May 2018 09:43:02 +0000

Till date, the Indian Government has taken various steps to strengthen the telemedicine network. Healthcare services take in the country, especially in rural India. Some of the efforts in this direction which need a mention are:

National Medical College Network (NMCN): With the purpose of e-Education and e-Healthcare delivery, 50 Government Medical Colleges has selected to interconnect, riding over NKN (National Knowledge Network). For this, one National Resource Centre (NRC) requires to centralise infrastructure and 7 Regional Resource Centres (RRCs) has established.

State Telemedicine Network (STN): The States/UTs have been supported under National Health Mission (NHM) under Program Implementation Plan (PIP) for strengthening State Telemedicine initiatives under STN & to create reliable, ubiquitous and high-speed network backbone, all available and future networks. So far,10 states have financially supported.

Ministry of Health & Family Welfare (MoHFW) in collaboration with Department of Space has setup Telemedicine nodes at some pilgrim places for health awareness, screening of non-communicable disease (NCD) and for providing specialty consultation to the devotees visiting holy places like Maa Vindhyavasini Mandir, Vindhyachal Dham, Mirzapur (UP), Sheshnag, Amarnath Pilgrimage (J&K), Pampa Hospital, Ayyappa Temple at Sabrimala (Kerala) and Kashi Vishwanath Temple, Varanasi, Uttar Pradesh.

Tele-Evidence: The tele-evidence facility streamlines the process of doctors appearing in courts in response to the summons. And saving their time not only for patient care but also for medical education and research. The project is operational in Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh since March 2014.

Also Read: An Interaction with J.P. Nadda on Health Plan

Want to write for InnoHEALTH? send us your article at magazine@innovatiocuris.com

The post Tele-Medicine System to Strengthen Healthcare Services in India appeared first on InnoHEALTH magazine.

Rural healthcare: Solutions lie in innovations

InnoHEALTH Magazine — Mon, 23 Apr 2018 11:10:53 +0000

It has become imperative to make rural and remote areas healthy and free of diseases and infections to make ‘National Health Mission’ a success. There are still many parts of the country where medical services are still not accessible. With the iKure’shealthcare delivery system, the dream of providing minimum health service to the rural parts of the country has become true. Armed with Wireless Health Incident Monitoring Systems, Community Health Workers have been at forefront to provide doorstep solutions at minimal cost. iKure’shealthcare has become a new frontier to drive innovations in rural healthcare delivery

There are over 330 CHWs who are trained and strategically deployed across six states in rural India and have been rendering services under iKure’shealthcare delivery system.

Jayashree is one the CHW who works relentlessly in her village Hubli(Karnataka). One day, she visited a woman named Pushpa who was in her first trimester and looked quite unwell.On enquiring, Pushpa was found to suffer from Epilepsy. Her family also revealed that she has been prescribed with medicines by a local doctor, but she didn’t take them regularly.

Epilepsy is a disorder of the nervous system and such patients during pregnancy have major concerns. Jayashree felt the need and promptly captured her vitals on her smartphone loaded with Wireless Health Incident Monitoring Systems, (WHIMS), and pushed the patient’s vitals on to the cloud for a quick doctor reference.

For the next few days, Jayashree monitored and screened her closely and counselled her and family about different preventive measures pertaining to her health conditions. Soon after, Pushpa recovered and gave birth to a healthy child.

In the context of rural settings, it is never possible to create doctors or health clinics as required. To bridge the gap, the grassroots community members are empowered to provide clinical careenabled through WHIMS.The technology application is designed with an intuitive graphics user interface that can be efficiently used by a health worker even with a basic education.

For instance, WHIMS screen has a complete photograph of a human body.When a health worker clicks on the head, WHIMS gives options of potential symptoms of the head, such as ache, dizziness, seeing dark spots, and so on.

[vc_single_image image=”3737″ img_size=”large” alignment=”center” style=”vc_box_outline”]

Usually with the standard diagnostic tool, low accessibility and portability remain a huge constrain. WHIMS is accompanied with low-cost portable instruments to measure basic statistics and loaded on a tablet is carried by the CHWs in the remotest villages to diagnose patients. The patients pay an affordable rate for basic diagnostics and consultations, through which they earn additional income.

Unlike the Accredited Social Health Activists (ASHA workers) who work as community mobilizer and not authorized to deliver clinical services, these CHWs meet both the ends.

Equipped with a medical kit that consists of devices including BP machine, stethoscope, pulse oximeter, thermometer, first aid kit, weight machine, Height measuring scale and gloves,they carry medicines for basic common ailments, non-invasive hemoglobin meter, haemoglobin kit, mobile phone based sphygmomanometer, urine analyzer, calorimeter, ECG, flipcharts/ Hoardings & registers.

Through these CHWs, every patient is also provisioned with Digital Health Card (DTH) encrypted with a QR (Quick Response) code and during home visits. DTH gets updated with latest clinical indicators. The health data obtained from the health cards is synced to a cloud for effective utilization in the upward heath chain at both secondary and tertiary levels.

CHW’s contact and familiarity within the community drive effective community mobilization measures. As they become an integral part of the healthcare delivery model, CHWs act as a catalyst to drive behavioral change. While they interacts and communicates the necessity on the ground and identifies appropriate health needs, it is through street plays, hoardings and message dissemination on mobile phones, theymobilize patients at different levels. They are also attuned to provide nutritional counselling, and spectacle services based on the community needs.

Further, WHIMS is upgraded with robust supply chain management framework, innovative algorithm, and Data Warehousing solutions. Driven by its CHWs, iKure aims to bring efficiency in public system & programe and improve lives.

The CHW model of empowering the women community and gender mainstreaming represents transformational change in rural healthcare delivery. As they champion tech-savvy cultural values in otherwise austere facilities, and limited supply of doctors, such effort has established inspirational leaders driving catalyst change in sustainable rural development.

“For a basic diagnostic long distance travel time, high cost of services and prolonged waiting hours at the local PHCs was a huge burden for these rural residents. Use of P-O-C devices is extremely portable, affordable with high accuracy rate and can be used by any health worker with a short training. This has been a critical step in rural healthcare delivery with a positive outcome on prevention, curative care and treatment procedures”.

Dr. Ajay Agrawal, Medical
Director-iKure

“Initially when I used to visit pregnant women, they were apprehensive and reserved. But repeated visits have given them confidence to open up. They ask many questions, show doctor’s report and ask for medicines. I have a joint family and few among them are pregnant, even they are educated, but they would consult me and ask for my opinion. I feel valued and found a voice through iKure”.

Gayathri Acharya
iKure CHW, Hubli, Karnataka

(Author: Dr. Tirumala Santra Mandal is a research and communication analyst at iKure. With a doctorate degree in corporate communication from IIT Kharagpur, she has worked in diverse fields of communications such as lie detection, multimedia communication, communicative English. Prior to working with iKure, she has worked as an editor and authored several publications in referred and business journals both at national and international levels.)

The post Rural healthcare: Solutions lie in innovations appeared first on InnoHEALTH magazine.