The first session was about the ‘Challenges in the implementation of DISHA’. The panelists were happy that InnovatioCuris has taken an initiative to critically discuss the challenges a hospital will face once the act becomes the law. All the panelists agreed that the act lacks various aspects. Few concerns that bother the clinicians are, that who will give the consent if the patient is unconscious.

The ambulances have the capability that it sends the health records from the ambulance to hospital before the patient reaches the hospital for doctors to study the emergency cases. In this scenario, what should be done if a patient denies the consent for sharing the data at a later stage? Should the clinical establishments discard the already shared health record or should they handover the same to the owner (in this case, patient) or what should be done. There are no set protocols defined in the act for such cases.

A question was put forward, does the patient has the authority to edit their health record, or can they view, who have seen their health record. A healthy discussion took place where we got to know that citizens of Estonia have chip cards, where one can see their health record and can also see the logs of who has accessed their health record. This made us realize, that India as a nation state can use Aadhar card as a mechanism, where we can log in into a portal and get to see health records.

The third challenge that came forward was interoperability of health records. As the record lies with the custodian, not the patient, editing and viewing of it can be done by the clinical establishments. The health record can be shared by the clinical establishments to another, but there is no standard on how to transfer it. Data integrity is a point of concern, which is not mentioned in the act.

One of the challenges that came into light was according to ‘Clinical Establishment Act Standards for Hospital[2]’ the hospital has to keep health information and statistics in respect of national programmes, notifiable diseases, and emergencies/disasters/epidemics and furnish the same to the district authorities in the prescribed formats and frequency. The question is what if the patient does not give consent. The proposed act should have a provision where the clinical establishments are liable to take the health data.

As we have unstructured healthcare facilities in India, the act should also empower the clinical establishments by various means to keep the data safe. As of now the DISHA is a proposed act, not a law and has lots of loopholes. It also lacks in many aspects discussed earlier. This is just a start and the government should take necessary steps to improve it.

The second panel discussed on ‘Opportunities for making health sector DISHA and data protection ready’. The panelist consisted of CIO of path labs, owners of healthcare IT firms, who shared relevant thoughts and comments. The panel started the discussion on why do we need the act and what are the benefits of the act. Panelist were grateful to the government to bring the act. They told that the clinical establishments will take steps to increase the safety of the health record.

The gaps in the technology for generation, storage and transmission will be lowered down. Sectors such as banking, financing and insurance have structured their data, but this lacks in healthcare. Detailed scope of security features are missing from the act, this would help the companies to design the software from the ground up by using security as an important consideration.

The imminent threat is in the software which are already in place and have not been patched or the system has not been upgraded. The good news is that many have an audit trail in built in their system, which track any CRUD(creation, read, update, delete) of the records. The discussion contributed a fruitful thought: Data at rest is not encrypted. The question that arises is what is preventing the healthcare IT companies to encrypt the data at rest.

One of the challenge in the DISHA is that, the owner of the data must be informed of any breach of the privacy or confidentiality of their digital health record within three days. But according to IBM report it takes on an average of 197 days to detect a breach[1]. How can the Healthcare IT companies safeguard the health record and let the owner know about the breach. The solution is to encrypt the tables in the database, but that might hamper the performance.

It is a huge opportunity for the stakeholder to bring standards in the act. DISHA might have only completed its first round of comments from the public and stakeholders, it can be expected that the revisions made based on the feedback will churn out a more refined version of the act. In any case, it is evident from the draft that the government has really pushed to provide additional security, privacy and confidentiality for individuals, with respect to their digital health record.

The chair introduced the discussions explaining how the session was planned to further motivate the delegations as it was a hugely important session on non communicable diseases. Utmost importance to be given in spreading awareness. Ongoing efforts to medicate the impacts as NCD constituents to both economic and human well being throughout the world.

NCD accounts for 40% and 60% deaths by NCD, according to the statistics Jesper found and he compared with statistics of his country where 90% of deaths occur due to NCD. Danish organizations are raising awareness about NCD and Jesper to engage in the project around the world that aid to build necessary health infrastructure to combat these NCD.

Dr. Gupta shared his views on 3D healthcare as he felt the practical model of health is the 3D approach to healthcare which can address all problems. He suggested changing the perspective of looking a human being as a whole instead of a particular disease.

3D in healthcare was termed by Dr. APJ Abdul Kalam at an event. Dr. Gupta then compared the important factors in two frames which were before and after lifestyle interventions in which he found drastic changes. He showcased how they trained people by various enthusiastic activities promoting 3D healthcare.

The 3 Dimensions of 3D healthcare are Spiritual care, mental care, physical care and recommended a holistic approach to healthcare.

Sixty percent of all mothers today work, either part-time or full time outside their home. Moreover, statistics show that the No. 1 emotion working mothers struggle with is guilt – guilt because they are not home when the kids get home from school, guilt because their son does not like his sitter and guilt because they cannot be a room mother. “Working mothers suffer from two major ailments: guilt and role strain,” says Devika Singh, psychologist at International based in Dubai Herbal Treatment Center.

A universal mom problem

Guilt and parenting go hand in hand. Every mother experiences it, as she somehow believes if something is wrong with the children it must be her fault. In addition, because a working mother is not physically present with her kids 24 hours a day, she naturally blames herself even more when there is even the slightest of problems.

Working mothers face challenges all the time. Mixed with the responsibilities they have as concerning their children are the commitments of their careers. Devika adds, “Women who must work, may feel guilty that they do not spend sufficient time with their children and worry that their child-care arrangements are inadequate, but they find some comfort in the fact that their working will provide the best for their children.”

“Women who choose to work in order to develop their own potential and to prevent boredom or even depression, which may result if they feel forced to stay home, feel guilty that they are ‘abandoning’ their children. Professional women also feel guilty that they are not devoting themselves as thoroughly to their careers as they ought to in order to move forward. These women struggle with their anger at children who present extra, time-consuming demands.

Whatever the reasons why they work, few working mothers do not feel a constant undercurrent of guilt about the effects of their working on their children. The guilt is usually most intense for mothers of infants and preschool children,” she says.

Affects On Moms Guilt On Mental And Physical Health

“Role Strain’ is the somewhat euphemistic term for the chronic fatigue, anxiety, sense of always being behind, and near panic that working mothers so commonly feel from trying to manage their separate and often conflicting roles. Working mothers of small children who need them in the night may suffer as well from sleep deprivation, which leaves them less alert, less productive, and somewhat irritable on the job. Even those rare few who seem to manage both work and mothering without suffering stress may face periodic exhaustion, lack of private time, and neglect of exercise and appearance.”

“A crucial conflict in professional women today is between achievement and the fear of loss of love. They worry that men will be put off by their competence or their interest in their careers may present conflicts in their marriages. Most women do not realize that these conflicts may underlie their anxieties, disappointments, loss of meaning, lack of ambition, frustrations, or boredom in their working lives.”

“It is important for working women to recognize the internal obstacles that they bring to the situation. Then they will be freer to recognize and deal with external limitations that society continues to impose on women in the workplace. Most working mothers keep their guilt and role strain within tolerable limits, although some may need professional help to deal with the stress and self-criticism. Most try hard to focus on the quality of the time they spend with their children rather than its amount. Many try to compensate with special activities and material benefits they are able to shower their child with. They cope with role strain; most often by lowering their career ambitions or slowing down, at least until the children no longer need them as much, and by teaching their children earlier to be self-reliant and independent.”

Tip For Moms To Ease Their Mommy Guilt

A mother should recognize that her feelings are trying to tell her to change something and the change always requires at least a two-step process. First, you have to learn to let go of the things that are causing you problems. Sometimes it is just a matter of looking at a situation in a new light. Other times it is a matter of getting the training of handling your parenting job differently (like learning yell-free discipline techniques or meal-planning tricks). Second, you have to replace the old ways with new ones, which is not hard. Once you begin prioritizing the enjoyment of your parenting experience, you will want to create even more ways to do so. You will be modelling for your kids what it means to be a happy, balanced, well-adjusted parent, so your whole family will be better off.

Moms, View Your Career In A Positive Light

You do not have to be there every second; most children will obey and act accordingly. Even if you are not around all the time, they instinctively know when they are loved.

Set your priorities and evaluate them often. Focus only on what is truly important, not what that stereotype in your head is saying.

Do not be slack on the rules for discipline and routine give them a sense of security no matter how much they rebel and complain about it. Your children want to know that you are there if they need you.

Remember when you leave your child at day-care that nonworking parents may also use childcare help even though they are at home. If your child is having a particularly rough time with separation, it is most likely a phase that he/she is going through rather than something that she would really want to change.

Working Moms Can Benefit Their Children, Too

They encourage independence and cultivates a sense of responsibility in children. Kids of working moms are with adults who are not their parents for at least part of the day. This separation, which makes moms feel guilty, can actually breed a kind of self-reliance that improves self-esteem. Children with working moms get used to starting homework on their own; watch their siblings and help with dinner preparation.

For children, having two working parents can go a long way in shaping their understanding of men, women and families. This means boys may be more likely to have supportive attitudes toward the woman being equal in his future household. For little girls, the idea of achievement in a career outside of mothering can be stimulating, and encourage them to do the same.

Seeing a mom as a working person often confirms for children the sense that people, especially women, are multidimensional. Best of all, their feelings of pride in you doing your job well can carry over into feelings about their own self-worth and give them encouragement about their own capabilities in the future.

Many working parents see the benefit of having caregivers, who offer more opportunities for socialization and a wider range of activities for children than they could at home.

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

Read all the issues of InnoHEALTH magazine:
InnoHEALTH Volume 2 Issue 3 (July to September 2017) – https://goo.gl/MCVjd6
InnoHEALTH Volume 2 Issue 2 (April to June 2017) – https://goo.gl/Nv3eev
InnoHEALTH Volume 1 Issue 2 (October to December 2016) – https://goo.gl/4GGMJz
InnoHEALTH Volume 1 Issue 1 (July to September 2016) – https://goo.gl/iWAwN2

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This article throws light on current data related challenges in healthcare sector along with how organisations can benefit from various digital initiatives like getting a unified and 360 degree view of various entities for an efficient and effective data exchange and management. Building a predictive intelligence and data analytics platform aggregating data from all stakeholders with real time reporting capabilities can bring a transformative change in digital healthcare.

Traditional Healthcare is experiencing a tectonic shift and is clearly one of the hottest frontiers for digital disruption. The sector is ripe for digital transformation as it could give an opportunity to unlock data related intelligence and analytics to a largely underserved industry, touching millions of lives. Many countries are devising their national eHealth programs investing heavily on digital healthcare. With organizations increasingly investing in robust IT infrastructure for an effective and efficient data exchange and management, initiatives such as digitizing medical records have made the need for good and clean data at the center of this digital transformation.Incorrect and inconsistent information across organizations due to reasons like information duplication or IT systems not talking to each other often leads to higher operational costs, compliance penalties, sub-optimal resource utilization with consequent impact on key stakeholders.

Organizations need a powerful and unified platform for an end to end data management of various stakeholders with a 360° view of entities like practitioners, patients, suppliers, insurers and other players in the ecosystem. Let us face it – data is the new oil,and goes without saying, we need good data refineries to really make sense of all the available data to get the right insights. Mining the massive amount of data, which most of the healthcare providers have access to can help in building predictive healthcare intelligence.For a largely traditional industry like healthcare, where practitioners depend on independent evaluation and derive own clinical diagnosis and decision making, an ecosystem level collaboration and exchange will be beneficial for the entire industry.

Key Challenges in Data Management

• Data duplication : Refining and making sense of the deluge of data from different sources.

• A 360° view of relations and interdependencies between various entities like providers, patients, suppliers for decision makers to take a holistic view.

• Risk categorization of patients for an integrated and holistic medicare.

• Data security and privacy.

• Data capturing is not taken seriously especially in the context of eHealth monitoring for digital health services.

• Right clinical data to get the right insights for effective decision making.

• High administrative and operational costs.

• Fraud in payments and other customer touch points.

• Data transparency in patient care.

• Lack of a good feedback mechanism for healthcare input companies (Pharma, Insurance, Medical instruments, Technology vendors, digital health systems etc) for innovating new and cost effective R&D in medical treatments.

• Building an effective outcome and evidence based service approach.

Why is 360° view important?

Healthcare providers across the world are sitting on huge amounts of data, often in silos, which when used in the right way, can really help drive better outcomes. The multiple sources of disparate data captured from diverse stakeholders can add to the complexity. Under these circumstances, Data integration and aggregation with robust infrastructure and technology platforms with inherent deduplication capability (which can remove noise from the sound, so to speak) becomes crucial. A unified and 360° view can help in getting a single source of truth with all possible contributing parameters available. Deduplication is an important step as it gives a streamlined, unified, duplicates-free and 360° view of the available data – which can mean connecting the right dots where decisions are taken in totality and not in isolation. After all, the analytics you get is only as good as the contributing data which drives it. For example, if a practitioner has a full overview of a patients’ health (current and historical data) in real-time, the diagnosis and prescription could be holistic and data driven which can be very effective.

The Big “Datalytics” moment is here

Data analytics can play a catalytic role in overall healthcare management for better services and outcomes. Analytics has become a proven phenomenon which has transformed many industries from government to banking, retail to travel verticals and has the potential to transform medicare industry too. While cost savings and overall improvement in medical services are immediate benefits, taking a lead in the data centric initiatives can give competitive advantages to organizations in many ways apart from giving the industry a new thrust and direction which could have a lasting impact on lives of millions of people around the world. An outcome based approach leveraging operational, clinical, claims and other available data can help improve overall patient care, something which access to right data can enable.

Access to the right data can help providers deliver superior quality service with differentiated and personalized value added services. Every aspect of patient care could become a digital data point for a comprehensive outcome based diagnosis in the overall clinical process. Some of the other tangible benefits include creating actionable insights, improving clinical effectiveness and decision making, reduce data related medical errors, and improve patient wellness and overall satisfaction. On the administrative front, it can reduce costs and improve overall operational efficiency, drive revenue growth. While healthcare has been a fertile ground for payment related frauds, a good data engine can help reduce fraud and incorrect payments. Regulatory compliance is another major area where good data analytics can help mitigate the risk and help build robust pro-active and stringent compliance initiatives.

Big Data Mining for Predictive Intelligence & Real time reporting

A pertinent question is: How can all the stakeholders in the healthcare sector together with government collaborate to build a risk mitigating and predictive intelligence platform? Essentially, a platform that can give a combined and aggregated view of different sources of data to get insights streamlined into a single view simplifying complex data. Can the organizations re-use and mine the massive data points to connect the dots (in terms of conditions for a particular health trigger to happen, discovering relationship and patterns within these disparate sources of data) and predict if a given place is going to have a health epidemic (like Zika virus)? Can we get reliable intelligence in making sure that does not happen as well as contain its spread further? The individual contributing data pools from each stakeholder when combined and rinsed for data related insights can be a great information clinical repository. Such data mining can throw light on various patterns and help analyze the cause-effect relationships with real-time reporting capabilities.

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

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Stay update about the conference by visiting: www.innohealth.in