With the projected increase in absolute numbers (319 million elderly by 2050 from 103 million in 2011) as well as the percentage of aging adults in India, and with the increase in life expectancy, it is crucial that we, as a nation, pro- actively design and implement schemes to look after their health and expand the “healthy life” for this age group (While 75% of them suffer from one or the other chronic disease, 40% have one or the other disability). Healthcare can be viewed from three levels: individual, community, and nation. At the individual level, one needs to be aware of and enable a continuous health regime to ensure a healthy life and postpone the onset of some chronic diseases. Also required, is access to a general physician and a specialist, if required, along with access to the latest drugs and injections. At the community level, a first aid center with at least a nurse to take care of basic treatment plus access to emergency care 24×7. At the national level, policymakers need to understand the demographics and customize solutions for communities, districts, or states to make sure that the country has a healthy population that can contribute to nation-building.
Digital health should be an integral part of health priorities and benefits people in a way that is ethical, safe, secure, reliable, equitable and sustainable. It should be developed with principles of transparency, accessibility, scalability, replicability, interoperability, privacy, security, and confidentiality.
In a vast country like India, which is equivalent to multiple nations combined, both in terms of land and in terms of population, telemedicine and care/support systems are the two pillars that will provide strength to the mental and physical well-being of our aging population . Information and communication technologies help in mass dissemination of information, access to critical data, and last mile connectivity while learning from other countries’ experiences. Through technology a greater number of people can have access to services and data that may previously have been out of reach or unaffordable. With the recognition that information and communications technologies present new opportunities and challenges for the achievement of all 17 Sustainable Development Goals, there is a growing consensus in the global health community that the strategic and innovative use of digital and cutting-edge information and communications technologies will be an essential enabling factor. Digitization of Health requires huge resources and capabilities from Government and private players both.
The biggest gap in the healthcare system in India is inadequate organized / brick and mortar set-ups. Other problems include lack of trained healthcare workers, poor record maintenance and portability, low patient engagement and prescription compliance. With the pandemic, people did not want to leave their houses which was simply adding to the country’s overall disease burden. In today’s world, (especially during Covid) where we are working on various platforms and sharing information digitally, why can’t we have all health records stored online in one place too, regardless of which doctor or hospital one goes to. With multiple players in primary, secondary, and tertiary healthcare, physical data gets lost/is unavailable creating complications/adding to the cost of care (repeat tests).
With virtual care, remote monitoring, smart wearable devices, digital platforms to store health data and apps enabling remote data capture and exchange of data across the healthcare ecosystem, we can ensure a continuum of care, regardless of the geographical location or external circumstances like the pandemic. Moreover, with digitization of lab reports and digital extraction of radiology data, we can improve the quality of diagnosis, treatment decisions can be data-driven and more efficient ensuring person-centered care. With Telemedicine and at-home healthcare services, we can reduce the burden of patients visiting the clinics/hospitals, while ensuring continuous home-based monitoring, even providing complex services like ICU set-up at home for the terminally ill.
Telemedicine is not only video consultations but also includes
- Diagnosis, treatment, and monitoring of patients (including history taking and appropriate physical examination) by means of electronic technology
- Electronic exchange of health information including the collection, transmission, and interpretation of patient data
- Extraction of health data from wearable devices
- A quick exchange of digital information via patient portals, tablets, and cell phones (allowing for updates and reminders)
The action plan should be designed in such a way that takes into consideration different risk levels associated with different age groups, life cycle of respective health ailments and geographical location. For example, there could be different action plans for the metro dwellers, Tier 1,2,3 towns and rural India. For Tier 1,2,3 towns, access to specialists might be a challenge.
Telemedicine along with medical records online through mobile apps will ensure:
- Easy and fast access to diagnostics and specialized medical services
- Remote access to test results
- Constant access to personal health records
- Convenient for patients/doctors to seek an expert opinion
- No need to commute to medical centers, saving time and money
For rural India, one could start with access to doctors – general physicians and specialists – through internet-based applications and medicine delivery through supply chain networks and/or drones (remote areas). Once the basics are covered, other assistive healthcare services can be slowly integrated, with time. There is a need to leverage India’s platforms as public goods for healthcare, similar to the digital revolution we have seen in Fintech.
Disclaimer
Views expressed above are the author’s own.
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