Tag Archives: Indian HealthCare

How to build India’s HealthCare System?

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India is always compared to US, a nation which has established it’s 300 Years of Independence and quite a few times, the policies are compared and contrasted with the US. I personally feel we should not do this comparison and focus on how to build Innovative solutions to address the needs of a country like India.
India is 4 times more in population when compared to the US and we are an economy which has been struggling to establish itself in the 65 Years of Independence. I do not wish to go into history, but just a point of reference when in 1800’s, India was one of the richest land’s in the world and hence we have been invaded by quite a few people and finally ruled until 1947. There was a lot of damage done and we should take responsibility for it.
What is over is over and today, we are a nation of proud accomplishments. From the recent Mission to Mars to the complete eradication of Polio, it is not an easy task when a country has such a varied distribution of population and practices of many native medicine.
In India, the Union Government is responsible for allocating Budget for Health Services. This money is distributed to the State Government’s considering various parameters and the State Government’s are responsible for delivering Health Services to the common man.
If we go deeper into understanding how the HealthCare is structured in India, the Primary HealthCare Centre is the first point of contact for any of its 1.2 Billion Population. A PHC serves to a population of anywhere between 1,500 – 5000 people. For more information on the exact numbers and categorisation, please refer to my earlier blog post on HealthCare Infrastructure in India and my other posts under HealthCare in India category.
Today, the need of the hour is for us to push for some strong amendments to the HealthCare Law in India. Here are few of my thoughts on how we can work on building the foundations for a stronger HealthCare system in India.
1. On-line or Centralised Drug Database – This might look naive, however, this plays a very crucial role in building up a strong Health Delivery System. For technology to play a bigger role in building up India’s Health System, having a central Drug database is a must and the first step.
2. Fee Regulations for Private HealthCare – We hear the economic distribution of Private Vs. Public Health in almost all the case studies on HealthCare in India. 70% is still out of pocket. We need to have a law to regulate the cost of basic Health Services across the country. For example, for a first / basic consultation, the Doctor fee or the Hospital charge should be same across the country. This will help in more people approaching bigger/better facilities to ensure they receive the best consultation and there is no competition among Hospitals or for Doctors. My argument here is that the first point of contact for any consultation should be regulated.
3. Common Health Practices across the nation – We do not have a strong law in the country where the Hospital Workflow’s remain constant. Each hospital has it’s own rule and patients are bound to abide by them. If I need to fight out, i should take time out to go to the Court. We need to establish common rules of how Hospitals treat patients and the rights patients have to access their Health data.
4. Common Registration System – Each Hospital has their own rule of how they treat the Patient registration System. This has to be regulated to ensure the basic Patient demographic data is always constant and can be carried by the individual. Use of Adhaar like system to enforce this is very practical and brings ease of managing this aspect.
Last but not the least, we should encourage initiatives which bring in a stronger Health Law.

Does India Need an EMR?

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When we look at understanding how we can address the major gaps in providing Quality HealthCare, the one point which comes to mind is why we are not utilizing the power of Technology to bridge this gap.

Let me start with a story – Few years ago, I had to take my Dad to a Doctor for cough. We went to a Speciality Hospital near to a home (a Major Brand, do not want to use the name here though). This hospital had two facilities in the City. When we went there, the first thing which happened in the Registration. A Plastic Card (dimensions of a Credit Card) was printed with a picture and basic details – DOB, MRN and Place of Issue were printed.

After the initial check up, the Doctor wanted a test to be done which was not available in this facility and hence we were requested to go to the other one. After going there, I provided the card to bring out the details of the test ordered. The front office person informed me that they do not have connectivity with the other Branch and hence I had to pay the registration fees (Rs.100) and post that, looking at the Hard Copy of the Prescription, entered the details. Then I had to go to another Doctor (since the consolidated list of Doctors in the Hospital is not available and the prescription had to be cross checked) to re-confirm the test and then we proceeded for the test.

This hospital has made major investments in using Technology in their Hospitals. Staff are trained and the charges of this Hospital is also definitely not nominal.

What does this story illustrate? A simple aspect of integrating two facilities has not been taken seriously. Why? Is it because they lack the technological infrastructure? Or, is it because they can make more money (Double registration fees)? Or, is it unwillingness to invest further on the technology required to integrate? There are many questions which arise, however, for me, it is just the fact of lack of “Ownership” from the management side.

In a country like India where the demographics play an important role, there are many multi-national Hospital Chain’s and single facilities which have setup shop across the country over the last decade and continue to do so with huge investments coming up in the next decade.

The Government, with due respects has its own, things to do and hence am not even considering the fact that they should take ownership to force Hospitals to implement any automation to their care facilities.

With the vastness of the Country dynamics and considering the fact that the system works in a silo, is it easy to consider implementing basic EMR across all Hospitals and Clinics across the country? I do not think so.

Even though technology has become affordable, the socio-economic factors like affordability of Care facilities with-in a 10 KM radius across the country makes it difficult to even imagine implementing EMR across the country.

Continued – Part 2