Information Technology has successfully reshaped our lives in ways unimaginable even a decade or two ago. The era of the telegram is now officially over and access to information is not just at our doorsteps but at our finger tips, due to the availability of communication tools like cellular phones, computers and the internet. It is no wonder then that technology has played a key role in healthcare as well and has the potential to completely change the way we deal with a disease at various stages.
The current government rightly focuses on using technology to improve the dismal standards of basic healthcare, not just for the urban population but also for people living in rural settings in remotest corners of ‘Bharat’ which is home to almost 70 percent of our country’s population. Evidence from national and international data clearly shows that the effective use of ICT in healthcare can improve access to better quality services, reduce costs, and empower doctors as well as patients. India has been aggressively experimenting with IT in healthcare, with notable progress in ‘m-health’, ‘tele-medicine’ and ‘e-health’. Many of these services are ready to take the next step and be scaled up to achieve their true potential. The use of IT in healthcare can be the first big step in improving the primary healthcare network in the country.
Simultaneously, it is also important to tap the energy of the private providers of healthcare services in India. Some estimates suggest that by 2012, private sector comprised 80 percent of the healthcare providers in India as against 8 percent at the time of independence. Traditionally, the private and public healthcare sectors in India have viewed each other with mistrust, and to get them to work in tandem is not an easy task. Efforts need to be made towards building confidence and fostering cooperation. This is where the true advantage of IT lies. Technology is available to doctors in both the sectors and can be used for notifying, reporting and following up on medical cases.
Take the issue of Tuberculosis in India, which accounts for more than 25 percent of the new TB cases worldwide. This contagious airborne disease kills almost 2.4 lakh Indians every year and is among the top four causes of death in adults. The Revised National TB Control Program (RNTCP) provides mechanisms to ensure treatment adherence monitoring and support, but these currently reach patients treated by the public sector. Inappropriate, inadequate and unmonitored care could lead to treatment failure, recurrent TB, and most devastatingly the development of drug resistant TB. Hence, proper mechanisms for awareness and monitoring for all TB patients, whether publicly or privately-treated, become all the more important.
In 2012, RNTCP launched e-NIKSHAY, a case-based and web-based reporting and recording system that would act as a centralized avenue for data collection of TB cases; aiding state and local systems to track the progress of patients and keep all the stakeholders in the loop. Over the last 6 months, in the Mehsana, Mumbai and Patna pilot Urban-TB projects, such IT- based systems have helped issue over 10,000 drug vouchers for privately-treated TB patients, and linked those patients to improved treatment monitoring and support. Total TB case notification in these districts, including public and private, has improved significantly demonstrating its success and importance. Increased transparency and monitoring leads to better planning and accountability.
The main reason behind the success of any IT application is its user friendly attribute. It is time to reach out to private practitioners with easy-to-use applications that take minimum time, and yield maximum value to providers and their patients. The most basic yet powerful communication device, the mobile phone, which is used by over 70 percent of Indians, will help us penetrate in the remotest corners of the country. This device can help extensively in increasing the reporting of cases and keeping a close watch on patient who often skip medicine. The Union Government’s recent launch of an initiative to maintain an electronic treatment record of TB patients by encouraging them to send a missed call notification on a number printed behind the strip of the drug is a classic example of how reporting and follow up can be done without involving significant extra cost and effort. This will help the treatment provider to intervene at the right time in case the patient misses a dose.
Training and education in e-healthcare plays the most crucial role in the implementation of these projects. For this purpose the Indian Council of Medical Research has made an open access online bibliography and there are hospitals which have collaborated with universities to teach certificate courses in telemedicine.
India is a leader in innovation, research and IT. It is important that this innovation potential and its resources are harnessed to combat India’s healthcare challenges. If we truly want to improve access to healthcare and sustain it, we need to scale up such innovative new practices by providing adequate resources and encouraging the appropriate skill-development. It’s time for us to move beyond working for IT and start making IT work for us.