e-health care services: Grow at a very healthy rate

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The government is also in the process of starting an e-healthcare service that will intensify health awareness in the country. E-healthcare services include helping people contact and interact with good doctors, buying medicines and taking e-prescriptions.

Sharing similar views, another industry expert said that though the e-health care sector is at nascent stage, it will register phenomenal growth in the coming years.  Patients in countries such as Afghanistan, Iran and Iraq are visiting different web portals which are helping them in choosing doctors and hospitals from their home country. Through telecommunication revolution, e-healthcare service delivery has become convenient in smaller cities also.

E-healthcare has come as a boon to developing regions or crisis-stricken zones. For example, the cloud technology has enabled doctors and patients to access healthcare records from anywhere- a development which makes treatment possible anytime, anywhere. The accepted tenet for sharing information through e-healthcare systems is that explanatory diagnostic information may be exchanged insecurely, and private information (such as personal information) must be secured.

Cloud hence, is definitely among the most important technological developments in the field, and as it continues to evolve, so will it make access to healthcare even easier for millions of people. Another very successful initiative has been the e-diabetes system, which enables data exchange at both the front and the back end.

Cloud-based services are steadily becoming more widely adopted by healthcare organizations. The past year alone has seen a surge of interest regarding the potential of cloud computing with many players set to start moving healthcare-related applications across to cloud platforms in the coming months.

The accelerating migration to cloud computing represents a change for the way the healthcare industry sources its information technology (IT). But will this shift affect other areas of healthcare?
Healthcare is moving to a digital platform, becoming more patient-centered and data-driven. Large international players such as Microsoft, Qualcomm Life, Philips, Verizon and AT&T have launched cloud-based vertical solutions aimed at the healthcare sector, and the global trend is that cloud solutions are supporting greater sharing and accessibility of health data.

Another area which has seen and is continues to vibrate with innovations is in the case of mobile health. This means providing tele-assistance to patients and caregivers via mobile. This has proved to be a boon for developing countries which are seeing a mobile phone revolution, but are characterized by poor physical communication. For example, countries like India, which are geographically vast and parts of which are often remote, are now adapting to use of mhealth at an astonishing rate. Mhealth has also come as a blessing for crisis stricken areas, where often caregivers are required to attend to victims and patients without any physical assistance.

The one area which will probably emerge as the most important is of cybermedicine, which is the evolved state of telemedicine. While this technology is only at its infancy, cybermedicine entails the use of the Internet to deliver medical services, such as medical consultations and drug prescriptions. Cybermedicine is already being implemented in small projects across the world, especially in primary healthcare stations. Especially, armed forces around the world are rapidly adapting to cybermedicine.
Another area which is seeing some very interesting work done is that of e-mental healthcare. Mostly, it entails talk therapy, online and telecounselling and intervention through video conferencing. Recently attempts are also being made to provide pharmaceutical aids online, and a growing academic interest in various field related to this area is setting up the stage for better and more effective technology.

Roadblocks & Speed Breakers
According to the Rockefeller Foundation report from an e-Health conference (2008) organized by Health Level 7(HL7) and WHO, one of the key challenges to the use of health information is the lack of interoperable health systems and consensus on data standards. Interoperability means the ability of two systems to share data and use that share data; and is considered a fundamental requirement for delivering cross-organizational and borderless services. Most authorities and systems are confused as to how to achieve this across platforms, especially considering the difference between developed and developing regions. In most cases, there are guidelines available for implementation, however, some countries, like Kenya, has drafted their institutional guidelines.

The next big hurdle is that of data privacy and security. Health information is as sensitive; if not more, as financial information. People suffering from psychological disorders and sexually transmitted diseases are the ones who are most vulnerable to abuse, and insecure data handling can lead to disasters.

There are also concerns over finding common medicinal terms and diagnostic tools. Lack of a common thesaurus has now emerged as one of the most glaring shortcomings in the existing system.

A Better Tomorrow
In emerging economies, e-healthcare is being welcomed by the government. Most such initiatives are in form of public-private partnerships and support from social and charitable institutions. In most developing countries, e-healthcare is still limited to hospital management, telemedicine, medical transcription and dissemination of knowledge and awareness through various portals. Granted, the physical limitations will always be there to overcome, but with hard work and new technology, hopefully, things will get better faster

eHealth in India
eHealth in India is primarily targeted at those unreached by modern medicine, and it is a challenge to run for-profit programmes where most beneficiaries are poor. In terms of scale, charitable organizations, particularly those that do not generate their own revenue, are usually unable to impact millions of beneficiaries. One of their biggest challenges is finance. Since the fees are already very low, it may not be possible to try and increase the number of beneficiaries by further reduction. There is also a danger in raising the fees, since this may make the service beyond the reach of current beneficiaries. Thus, it may require other efforts to put the programmes on a stronger financial footing. Aside from steps already mentioned, such as improved infrastructure, compulsory telemedicine duty for doctors in government hospitals, and replacement of paper records with e-records for data collection and surveillance, the government could consider the following steps.

Capital support based on track record. Over time, an eHealth activity could receive incrementally increased support, based on annual performance. Half or more of the capital expenditure could be borne by the government. Provide matching funds per patient. The government could consider matching the doctors’ fees charged to patients (and perhaps the cost of medicines or diagnostic tests), for non-profit eHealth providers in particular. Support training programmes. Since training is a major expense, this could be supported just as other skill-building or educational activities in the country are supported by the government. Awareness programmes, including health-based games, could conceivably also be given matching grants, especially when offered by non-profit organizations.

Tax benefits to any hospital offering a certain number of free teleconsultations per year.The government should provide greater clarity on the specifications that novel mHealth devices must meet, to help entrepreneurs avoid the cost and delay of obtaining international certifications. Likewise, greater public sector procurement would help entrepreneurs in this sector.
Some of the policy recommendations above are based on tracking patient use. For e-health initiatives, by definition, record keeping should not prove a challenge.

In the absence of such interventions, eHealth will essentially be left to the government if it is to have a large impact. Studies indicate, however, that programmes left solely to the government are not very effective. A partnership between the government and either a for-profit or a non-profit is the most likely to succeed. Even so, the lack of suitable human resources in rural areas will be a challenge to any large scale effort. eHealth Care project aims to improve the efficiency and effectiveness of India’s health care system through adoption of information technology. The Mission of eHealth-Care is to help patients, physicians, and community hospitals to make appropriate use of information and communication technologies (ICTs) in order to improve access and quality of health care delivery and reduce the cost of its management.

Key program components
The system is a web based patient care system that tracks a patient’s health record from the time of their joining the network and for as long as the patients manage to provide authenticated health data. It offers them an opportunity to maintain their health record and authorize their physicians to access it as needed. Physicians accessing the patient’s data must have the capability to access the data. As of now they will have to use the patient given authority and input some basic data for authenticating them. This helps port their health care information to anywhere internet can be accessed.

To ensure that some of the key information of the patient’s is readily available in case of emergencies to serve multiple functions as required by the local health authorities a Health card is also issued Health Cards are issued to any villager who wants them for a nominal fee. It contains details like name, age, sex, user Id and Password, weight, blood group, allergies, diagnosis, treatment and medicine prescribed) and this data is uploaded and updated online which can be accessed from anywhere in the world by the participating physicians.

At Last
One of their biggest challenges of e-health is finance. Since the fees are already very low, it may not be possible to try and increase the number of beneficiaries by further reduction. There is also a danger in raising the fees, since this may make the service beyond the reach of current beneficiaries. Thus, it may require other efforts to put the programmes on a stronger financial footing.

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