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Hospitals are the core of health and medical care and adaptation of new technology and innovations will make the biggest difference to our medical needs while improving the health conditions of all.

Highlighting the concern of data security and reluctance to depend on technology because of that concern, the keynote speaker for the first session Dr. Vijay Agarwal shared his views on the subject emphasizing on the fact that technology is rolling out at a very fast pace. Stating an example of landline telephones that took more than 100 years to reach the one billion mark of users, was reduced to less than 20 years for mobile technology to do the same. This way he highlighted the fact that newer technology will be very rapid in implementation requiring hospitals and clinics to adapt and be prepared to utilize it rather than be apprehensive about it.

Professor AK Gupta of the esteemed PGI Hospital in Chandigarh, also, supported this view and shared his personal experiences and experimentation with management and administration of the hospital. He emphasized that it’s not just in the medical and clinical field that we have to embrace innovations and technology, but in fact it will fetch very positively encouraging results if adopted in the management and administration of hospitals. He shared his views on reducing the time stay of patients in hospitals by means of using an innovative approach provided by tailored software and mobile apps. These efforts were recognized by the hospital; national level authorities and even internationally and was rightly awarded for this approach. He concluded his speech by asserting that you don’t have to discover new technology, but innovative utilization of existing technology can also provide very good results.

Touching the humane element in the hospitals, Prof Arti Maria of RML Hospital shared her experiences of involving mothers and non-hospital staff in caring for the young ones in ICU units. “A soft touch by the mothers, who are otherwise distanced outside the ICU units, has resulted on faster recovery of infants in the ICU.”

“In fact, this experimentation has also resulted in enhanced confidence of mothers and improved their social status with respect to their husbands, families and the social fabric as such.” Prof Maria, who specializes in Neonatology as Head of that Department is keenly working with other authorities beyond the hospital to promote this concept and is getting very encouraging results from hospitals, and relevant bodies.

Partha Dey, with years of experience at IBM shed some light on the subject of innovations with the simplicity that the IBM is known for. The three products and services of IBM, Watson, Block Chain and Cloud data are the way forward, according to Mr. Dey, Healthcare Leader and SME and IBM, India.

Watson, according to Mr Dey, is the most innovative friend for health care workers and doctors alike, as it understands many languages, including regional and Oncology. This helps medical staff to interpret and diagnose ailments with a high grade of accuracy and ease. Watson can, not only, analyze and conclude at a faster pace, but can also eliminate human error contributed in the form of emotional stress and personal bias.

Block Chain, on the other hand is the best mode of data utilization and can contribute to tracking of product and their status. Block Chain can also help eliminate counterfeit medicines by clever tracking of products and their batches.

IBM is constantly pushing the boundaries of innovations with introduction of new products and services. Watson and Block Chain are latest in the field of health and medical welfare.

In totality, the high profile panel of speakers from different fields of health and medical facilities explored the option of inducing innovations and new technology in the operations of hospitals and clinics beyond clinical procedures, leading to heightened efficiency and operational advantages resulting in a healthier society and population at large.

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

Read all the issues of InnoHEALTH magazine:
InnoHEALTH Volume 1 Issue 1 (July to September 2016) – https://goo.gl/iWAwN2 
InnoHEALTH Volume 1 Issue 2 (October to December 2016) – https://goo.gl/4GGMJz 
InnoHEALTH Volume 2 Issue 1 (January to March 2017) – https://goo.gl/DEyKnw 
InnoHEALTH Volume 2 Issue 2 (April to June 2017) – https://goo.gl/Nv3eev
InnoHEALTH Volume 2 Issue 3 (July to September 2017) – https://goo.gl/MCVjd6
InnoHEALTH Volume 2 Issue 4 (October to December 2017) – http://amzn.to/2B2UMLw
InnoHEALTH Volume 3 Issue 1 (January to March 2018) – https://goo.gl/fksdQx

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India has made substantial progress in health. This is also reflected in some of the millennium development goal MDG targets that have been achieved and for others substantial progress has been made. Under-five mortality rate has declined from 126 (1990) to 48 (2015) and maternal mortality ratio from 560 to 174 during the same period. Though India missed MDG target of 42 and 140 respectively for these two indicators but the progress is remarkable. The estimated number of child deaths have come down from 3.2 million in 1990 to 1.1 million in 2015 which means 3,300 child lives saved every day!

However this progress does not commensurate with the economic and technology progress India has made. Our neighbouring countries with lesser development have made better progress. For example, the under-five mortality rate in the neighbouring counties of Sri Lanka, Nepal and Bangladesh is 9, 36 and 38 respectively, against 48 in India (Kumar S, Bothra V, Mairembam DS, 2016). Innovations in program and technology offers an opportunity to accelerate improvement in health in India. The ministry of health and family welfare has actively encouraged the state governments to innovate, identify innovations that address the burden of diseases, are cost effective and replicable. The government provides technical and financial support to scale them up. We look at how technology innovations in public health system in India can help accelerate its progress in improving health.

Opportunities

There are many opportunities available in India today for innovations. Indians have provided substantial inputs to digital revolution across the world. However within India we have only recently started efforts to harvest the benefits for the Indian population. The recently launched ‘Digital India’ strategy in 2014, has made many government services available online cutting down delays, red tapism and corruptions. A common man is making payment for day today necessities online or through mobile telephones saving time and money. A related initiatives to accelerate innovations in the ‘Start-up India’ campaign facilitates bank financing and creates a favourable business environment for start-up ventures including technology innovations. Similarly, the ‘Make in India’ launched in 2014, encourages Indian and multinational companies to manufacture technology and medical devices in India.

The global statistics shows that the 4.61 billion mobile users in 2015 from 4.01 billion in 2013. In 2017 the number of mobile phone users is forecast to reach 4.77 billion. Considering the challenge in grabbing this opportunity, there is a need to respond with service innovation. Overall, consumers and society will reap the fruits of this technological and socio-economic development. Data consumption is growing 65 percent annually for accessing services such as e commerce and e-learning.

Bharat Net’s aim is to connect India’s 250,000 Panchayats at an estimated cost of $18 billion. Health and education have been identified as priority areas to benefit from this connectivity. There are alternative approaches to connect India, including cable TV pipes and White spaces (refers to the unused TV channels between the active ones). These and many other opportunities are available in abundance today. The Digital India, National Skill Development Corporation,Swachh Bharat Abhiyan and Kayakalp Awards, creating ‘Smart Cities’ are some more opportunities to mention.

Ministry of Health & Family Welfare promotes innovation in public health

Considering the tremendous potential in technology to compliment, accelerate effective implementation of health care, all the states have been encouraged to include innovations in the state programme implementation plans under National Health Mission (NHM). Annual national summits are held to recognize share successful efforts by the states. To facilitate this entire process including identification and review of such innovations a platform of ‘www.nhinp.org’ portal has been created. This allows uploading of innovations.

There are two categories of innovations program innovation and product innovation. Program innovation includes service delivery including referral, governance, treatment compliance, reduce cost of care or out of pocket expenditure etc. the product innovations include medical devices, innovative technologies including healthcare IT, m-health, and Tele-health/ E-health.

There are norms set for inclusion and exclusion of innovations. The inclusion criteria are –relevance to health needs, address endemic health problems and or diseases, facilitates accessibility, affordability, reduce cost of care, ensure quality and safety of healthcare product and process, and bridge skill gap required in service delivery. Similarly, the exclusion criteria are – Specific drugs, surgical or medical procedures or practices that need evaluation through one or more of the processes such as- Randomized controlled trials, Systematic Reviews, Meta-analysis etc, and Incomplete Documentation. The screening processes well laid out. This involves a six member screening group at NHSRC and an in depth reviews held by product and program committee.

In health, states are encouraged to propose innovation in program implementation plans for approval. In addition, to encourage and recognize the successful efforts, National Summits on Good and Innovative practices were initiated. In continuation, National Health Innovation Portal was launched by Shri. J. P. Nadda, Hon’ble Health Minister of India, in the year 2015. To strengthen and sustain the efforts further, Health Technology Assessment Workshops were held. In all, six such workshops with 325 participants were trained. To strengthen the whole effort, there has been health technology assessment trainings being conducted for non-invasive Haemoglobinometer and Glucometer, urine strip analyzer, SMS enabled patient monitor etc.

Table 1: Technology can help India leapfrog to improve health by addressing challenges, some examples:

Whole of population approach for addressing population health:

The world is moving towards promoting health among those who are healthy. Technology can help us in achieving this as traditionally people approach healthcare providers only after falling sick. Technology can help us in providing health related inputs to the whole population. The conceptual framework (Kumar S, Preetha GS 2012) is useful while addressing and ensuring health in a population. This framework broadly categorises the whole population in four sections (Fig. 2):

a. H ealthy Population (with no risk factors and no disease)
b. P opulation with Risk Factors
c. P opulation with Disease but not aware
d. P opulation known to have Disease

With the above categorization, the health efforts can be strategized and concentrated, for example – provision of preventive and promotive health services to the population categorised as (a) Healthy population; screening and promotive health services, (b) building resilience for population categorised as Population with risk factors; early detection, treatment and care including limiting disability and rehabilitation along with healthy lifestyle for category (c); and compliance to treatment and care along with healthy lifestyle for category (d) which is known to have disease.

Is technology innovation addressing major killers?

At this stage, it is very essential that we look at what are the major causes of death in India and address these. The seven major causes of deaths in India were prominently evident from WHO’s India Country Profile of Burden of Disease, NCD 2014. Accordingly, in all 98, 16,000 lakhs estimated deaths took place in India. An estimated 27,48,480 (28%) deaths can be attributed to communicable, maternal, perinatal and nutritional conditions put together, 25, 52,160 (26%) to cardiovascular diseases, 12,76,080 (13%) to chronic respiratory diseases, injuries taking toll of 11,77,920 (12%), cancers causing 6,871,20 (7%), diabetes 1,96,320 (2%) and other NCDs being 11,77,920 (12%).

Above understanding regarding causes of deaths in India shall not only inform the overall planning towards actions required for addressal but could be complemented by technological.

Some Innovations that can revolutionise healthcare in India:
Family health folders:

This has been another initiative which looks at family as a unit and tries to maintain health record for each and every member which could be linked and segregated for individual service like immunization, antenatal care, postnatal care, spacing methods, next month’s medicines, BP records etc. this initiative has been piloted in AIIMS and INCLEN projects in some of the states like Rajasthan called Jan Swasthya, Madhya Pradesh and in Himachal Pradesh by the name of ANMOL. There is a provision of print work plan for next day/ week/ fortnight/ month. Also, it can be linked with the Electronic Medical Record (EMR).

Electronic Health Records (EHR):

Government is working on EHR to ensure continuity and quality of care. EHR will help in recording disease episodes and core plans and would allow data portability between different providers. Also, the metadata and data standards have been developed for it. Not only between clinical systems but also between support systems such as HR, Finance, Logistics, Lab, Emergency Transport FHR etc.There is also a possibility of establishing linkage to UID (Aadhar card).

Access: Free essential drugs:

To widen the accessibility of free drug services, there is a web based supply chain management system (e-Aushadhi) has been created. This system allows online tracking of drug inventory. It enables steamlining of inter-drug warehouse transfer and efficient control of inventory. Also, it enables multi users and multi-location for storage. This initiative has been implemented by various states like Rajasthan, Tamil Nadu, Andhra Pradesh, Odisha, Jammu& Kashmir and at various stage in other states.

Access: Healthcare Any Time Medicine (ATM):

Presently, there are about 25 percent PHCs without a doctor, in India. This calls for innovative approach to address the challenges and originated an innovation called AT M. AT M, piloted by National Health Systems Resource Centre, New Delhi, provides Tele-consultation supported with mobile phone and the generic drug vending machine. The pilots have been conducted in five states [HP, Odisha, MP (3-4 each), UP (100) and AP (100). Total cost of this initiative per facility has been only 3 lakhs.

Access: Telemedicine:

Yet another example for use of technology is ‘Telemedicine’ which is very successfully piloted in states like Tripura, Andhra Pradesh, Bihar, Maharashtra and Assam. With this technology, images and scans can be easily sent across the specialists for diagnosis and consultation for treatment; especially when specialized treatment is required and is not easily available nearby.

Automation of fund flow:

It has been the experience so far that programme activities suffer due to delay in fund transfer and in this context establishing public fund management system with the use of technology is a bliss. With this, automation of recording, verification and calculation of payments are done a smoother and faster way and electronic fund transfer (EFT) towards payments into recipient’s bank account becomes easy. This technology has been utilized in states like Rajasthan- with ASHA Soft, in Bihar- namely HOPE and Delhi.

To simply sum up, it is obvious that the technology can address access to and quality of health care in India. Many initiatives across the country exist and therefore there is a need to identify cost effective, scalable innovations which address bottlenecks and the burden of diseases. To enable this, there is a platform provisioned called National Health Innovation Portal, in India. This is an effort of Ministry of Health & Family Welfare commitment to support scale up of good and replicable practices in public health in India. There is a need to encourage innovations and the government must make resources available to scale up the promising innovations to reach the last beneficiary.

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

Read all the issues of InnoHEALTH magazine:
InnoHEALTH Volume 1 Issue 1 (July to September 2016) – https://goo.gl/iWAwN2 
InnoHEALTH Volume 1 Issue 2 (October to December 2016) – https://goo.gl/4GGMJz 
InnoHEALTH Volume 2 Issue 1 (January to March 2017) – https://goo.gl/DEyKnw 
InnoHEALTH Volume 2 Issue 2 (April to June 2017) – https://goo.gl/Nv3eev
InnoHEALTH Volume 2 Issue 3 (July to September 2017) – https://goo.gl/MCVjd6
InnoHEALTH Volume 2 Issue 4 (October to December 2017) – http://amzn.to/2B2UMLw

Connect with InnovatioCuris on:
Facebook: https://www.facebook.com/innovatiocuris
Twitter: https://twitter.com/innovatiocuris
LinkedIn: https://www.linkedin.com/groups/7043791
Stay updated about IC, visit: www.innovatiocuris.com