The PATHOGENS are evolving, but not your HEALTHCARE SYSTEMS!

Image: 1918 flu pandemic in India

Throughout the history of Mankind, Humans have faced outbreaks of infectious diseases that have had lasting effects on societies. The worst epidemics and pandemics have ravaged nations and still are one of the biggest threats to humanity. 

However, In the medical world, outbreaks have not only defined the basic tenets of modern medicine but have also pushed the healthcare community to advance care management for better prevention, immunization, and treatments; year after year! 

This article will walk you through different developments in medical history, during and after the pandemic. 

1918 flu pandemic in India

The 20th century’s worst pandemic – the Spanish Flu – erupted in March 1918. This outbreak took nearly 30 million lives in a span of four months globally, half of those were in India.  During that period, the healthcare system in the country was unable to meet the sudden increase in demands for medical attention, hence, the pandemic lasted longer than it was anticipated. 

Later, In this case, the influenza virus mutated and evolved into an endemic disease with lower and more manageable levels. Therefore several scientists estimated 

that —

 “ Most pandemics end within 2 to 3 years as the virus mutates into a less virulent pathogen and the population builds up immunity.”

Bubonic Plague

It was a zoonotic bacterial infection and was also referred to as the ‘Black Death’ (due to the effects of gangrene) & it took the lives of 25 million people during the 14th century. This constituted two-thirds of the population in Europe at the time. Back in the day, the only method of diagnosing the infected person was to note their symptoms and categorize them according to the severity of the infection. After which, the healthcare facilities would treat the patients with limited drugs, while hoping for their natural immunity to kick in! 

But, this procedure was slow and has laid even more bodies. Moreso, poor sanitation and a large rodent population pushed the pandemic towards a worst-case scenario. 

However, During the 18th century, In Argentina, Sulfurozador was introduced to deliver sulphur dioxide to eradicate the pest. Also, In different parts of the world, researchers have started with targeted chemoprophylaxis, which has played a key role in controlling the 2003 Oran outbreak. 

Today, the Bubonic plague still exists in Africa, Asia and America, which is controlled by pest control, modern sanitation techniques and modified drugs with much better results. 

AIDS (acquired immunodeficiency syndrome)

Did you know, A study in 1985 showed an 89% increase in new AIDS cases compared with 1984, and out of the total AIDS cases to date, 59% of children and 51% of adults have died?

Over the years, treatment of HIV has evolved from high pill burden, inconvenient dosing, treatment-limiting toxicities, incomplete viral suppression & emergence of drug resistance to manageable one or two pill once-daily regimens. Also, after HIV is diagnosed, the treatment can be initiated at the early stages and continued till the control of viral replication over much of an individual’s lifespan. 

Today, HIV is still a major concern in the medical world, however, an adaptation of new research and better disease management protocols has enhanced the quality of life of the infected while making it easier for medical practitioners to take care of patients.

SARS-CoV-2

COVID Pandemic has held back the best of humankind and their businesses while infecting 301,118,69 people globally. Especially, the healthcare facilities across the world, who were seen struggling to contain the devastation brought on by the sharp increase in the infected cases. During this time, telemedicine has facilitated patients from remote corners to connect with doctors. Bringing virtual healthcare systems to rural communities in India. 

Did you know – India has seen around 300% enhancement in online consultation during 2020. Yet, a large population is still struggling for proper counselling,  diagnosis and treatment. And today the country needs a care delivery system not only to enhance the doctor-patient network but also to focus on niche areas while advancing various elements of care delivery. 

HArbor Says:  In the medical world, the requirements of its stakeholders are ever-evolving. With every pandemic, we are even reminded of the need to bring in effective development with respect to medicine and care providing. However, the battle against pandemic won’t be won until healthcare developments and development acceptance go hand in hand. 

Tech tip: Technology can only serve you if you give it a chance! 

ALERT: Is our current healthcare delivery system just a ‘fix it’ module? 

2021 has been a year of change for medical professionals. Be it Doctors or behind the scene IT professionals working for these medicos, 2021 had everyone on their toes. We saw old age consultation practices being challenged with urgent requirements to change to modern “video” based consultations, we also saw doctors performing complex surgeries remotely using robotics and what not! However, as we move ahead and delve into 2022, let’s look at these changes or transitions happening in the industry. Let’s ask ourselves, WILL THEY LAST in the current form or evolve to serve the greater good?

The current healthcare system in India is entangled into ignored issues and a few of the most significant points are – 

Fragmented care delivery:  

The Indian healthcare system is focused on niche areas while advancing various elements of care delivery in silos of growth. Although these silos of advancements are happening they are not adequately appreciating their relation to the whole ecosystem.

Hence, this unbalanced rather ‘broken structure’ at the grassroots level has built up a more obvious health crisis of unsustainable costs, poor quality and low patient engagement. 

In order to resolve these underlying issues, several healthtech companies have tried to take the medical practices online with hundreds of thousands of healthcare providers around the world. This worked fine, until care providers realized the harsh realities of listing businesses. The majority of these trends, like listing the practices online, an unnecessary competition has now popped up between the care providers where none is needed. Given the fact that we are a country where the care delivery system is already suffering due to a lack of doctors and skilled hospital staff, a race to win more patients proves detrimental to the status quo. 

Did you know? The doctor to population ratio in India is 1:1456 against WHO recommendations of 1:1000 only for Urban areas. This number skews up to more than 10000:1 if you add the rural population in the mix. 

To resolve the above-mentioned problem, yet another patchwork was introduced by the big corporations trying to leverage patient data. They insisted medicos & practitioners have their own listing which fragmented the patient flows. Further not to mention the increased cost of domains and web maintenance which the medicos had the bear, with little to no knowledge on the subject. 

For a healthcare professional, every new technology which pops up on the corner brings the promise of better practice, but when you look closely, you’ll find nothing but the temporary fixes to grassroot problems, creating more hindrances in the longer run than easing the operations for our beloved doctors.

Maintaining healthcare records: 

It’s not a hidden fact that every year a hefty sum of money is invested into maintaining MRD rooms and the introduction of Electronic Medical Records was nothing but a blessing for healthcare stakeholders. However, EMR software came with its own set of drawbacks. For instance, Imagine being a healthcare provider with years of practice in writing paper prescriptions and patient reports and being asked to invest money and time in EMR software. Difficult right? 

Let’s elaborate!

Today, Electronic Medical Record systems have become the core component in a hospital’s IT ecosystem, where patients book appointments, receptionists manage schedules, and physicians access patient charts. In addition to that, the care facility can even compile prescriptions and send them to pharmacies, receive lab results, prepare insurance claims, and so on.

But, in a  country like ours, where the average time for a doctor to see a patient is less than 2 minutes, the process of filling out EMR sheets is excruciatingly time-consuming & cumbersome, especially for the doctors.

Later, in order to tackle this challenge, smartpens were introduced. Although, this new ‘fix’ has solved the problems of the prior EMR system, but added an extra expense to the care practitioners pocket.

Every time while adding new patches to the care delivery system, software companies somehow forget or choose to ignore that the technology is just a means to deliver care & for a close to perfect adoption of technology, it is required to be simple, minimally time-consuming and cost-friendly. 

Half-cooked Video Consultation upgrades: 

In the last 2 years, we have seen advancements in virtual health gaining momentum, which has facilitated patient monitoring through computer and phone technology. This enables care practitioners to verify prescriptions or supervise drug oversight. However, in India where the maximum population resides in rural areas with a low digital literacy rate, just a basic telemedicine tool won’t work. 

The way these video consultations are happening currently, they seem to take away the human connection from the whole medical care delivery. For instance, a patient taking consultation from a general practitioner online for a frozen shoulder has no way of connecting back to the same doctor for continued care. 

Expanding further, the majority of the Indian population basically needs these video consultations with doctors in remote areas because they do not have accessibility to the medical services near their homes nor a digital payment option available for them which blocks their entry into the care ecosystem. 

Such technological advancements prove to be helping only the privileged thus further widening the gap between India & Bharat. 

Let’s look at the possible ways for solving these nerve-wracking problems deep-rooted into the ecosystem for generations with simple yet effective solutions. 

“The future of Indian healthcare will be defined by collaboration and not competition.”

For years, manual processes have been in place to create paper records for the patients which were personalized. So when EMRs were introduced, each practice needed its own customization. These customizations proved to be expensive for the technology providers and thus the EMRs were never adopted to the scale they were intended to!

A simple artificial intelligence, AI which can hear what their doctors are saying and convert the speech into machine-readable language can not only push the adoption of digital records but also replace the age-old medical transcriptionist which is still prevalent in 2021. Such AIs will prove to be an amazing assistant to medicos which will reduce work pressure on them.

While Telemedicine has taken a centre stage in healthcare delivery, it needs to be equipped with a personal assisted care provider while being integrated into diagnostics & pharmacies, thus completing the entire ecosystem. It is safe to say that these integrations will not only help the healthcare stakeholders to a great extent but improve clinical outcomes.

Technology is supposed to be maximizing value. While redefining healthcare delivery, it is a must that we step away from the fragmented healthcare systems that lack coordination, which is only possible with an integrated healthcare platform. 

HArbor Says, It’s time that we discard the fix-it modules from care practices and establish a strong foundation that will serve the real stakeholders of the care! 

Top 5 reasons to stop using Paper Health Records

Paper is gradually becoming an outdated source of record storage in this new age of technology. By now, you must have even concluded that there are more problems than benefits in continuing to use paper-based records a.k.a Medical Records.

It’s time to switch to electronic medical records! However, a major section of healthcare professionals in India is still continuing to invest in humongous real estate involved in keeping the so-called “medical record rooms” alive. 

So, here is a listicle to make this transition easier for you!

  1. Yearly Expenditure for Maintaining Paper Health Record

One of the major concerns of every Indian healthcare facility is protecting medical documents from rodents. Which obligates medical practitioners to spend lakhs of rupees on maintaining the MRD (Medical Records Department) rooms. In fact, the expensive paper-record maintenance should be enough for medicos to consider switching to healthTech platforms. Also, the real estate cost is not worth spending, when you can optimize the area for revenue generation.

With an electronic medical records system, you can ensure the safety of medical records from rodent attacks. These digital systems not only provide safety against damage but also clear up the occupied MRD rooms to expand your services and revenue sources. 

2. Paper Records are Subject to Tampering

The medical documents in MRD(Medical Records Department) are in imminent danger of being misplaced, copied or even altered to substitute the real information. Sometimes, it is even difficult to figure out the person responsible for tampering and further, it may take days to recollect the documents. 

But, electronic health records are encrypted and generally password-protected to prevent unauthorized distribution or adjustments to the medical documents & patient charts. Upgrading to an electronic record system clearly helps you maintain pristine records with the highest levels of safety. 

3. Paper doesn’t give Real-time Data backup in Disaster

It’s not just about keeping your medical data confidential, but also its availability in adverse conditions. Consider if the MRD or the server room is on fire. Then, how will you retrieve the care facility’s data? It can be a simple mishap or natural disaster; a medical record system must ensure 100% data backup. Paper records certainly do not provide any backup which is also their biggest disadvantage over digital records. 

An electronic medical record system in-built with automatic disaster recovery via real-time data backup will enable zero per cent data loss and 100% business continuity during such disasters.

4. Protection against Data Breaching

Patient data privacy & security breaches have raised some serious concerns regarding the adaptations of healthTech platforms. Do you know, according to a study in 2020, In the past five years, we’ve seen healthcare data breaches grow in both size and frequency, affecting nearly 80 million people worldwide?

There are also some quality healthTech platforms in the market that provide three-layer data security. These security measures include but are not limited to:

  • App-level protocols 
  • Network-level security 
  • Database-level encryptions

This implies that you don’t need just a system! you need the one that follows regulatory requirements under HIPAA and ensures maximum data security. Several healthTech platforms in the market use military-grade SHA512 encryption, encapsulating all medical data which can only be accessed with a secure user ID. 

5. Internal Audit Trails & System Integrity checks

With paper records, how would you know who has exploited the patient’s chart or if they altered it? 

EHR systems not only facilitate enhanced security but also benefit your facility during the audits. An electronic medical record system can assist you to verify people who have accessed patients records/documents along with time of access and their authorization ID. At the time of the audit, an electronic medical record system will be able to shed light and will allow damage control. 

HArbor Says: It’s true that electronic healthcare records may have some addressable limitations but they hold a mile-long advantage over paper records. 

PS: It’s time to reuse your MRD Room for a better purpose.

Vaccine hesitancy is not new – history tells us why?

Vaccine hesitancy is a story as old as vaccines themselves. Time after time, vaccines have proved their worth and toil invested in their development. Yet, getting vaccinated is a continuum between its absolute acceptance and outright refusal!

Did you know – In the 20th century, vaccines have aided the global population from ten historically fatal diseases that have helped in the eradication of infection by 92-100% (Emory University Report). Yet, convincing beneficiaries to take a jab is still challenging in 2021. 

To understand vaccine hesitancy, one must start with how they were perceived in its introductory phase. So let’s begin at the beginning! 

Concept of Vaccine hesitancy

World Health Organisation(WHO) refers to vaccine hesitancy as the delay in acceptance or refusal of vaccination processes despite the availability of vaccine services. 

It is a complex concept that varies across geographies and vaccine types. The general reported reasons responsible for the conditions are confidence, convenience and complacency. All these factors hold significant weight since the first introduction of vaccination. 

The Lessons of History

Today the global vaccines market is estimated at around USD 46.88 billion. However, when Edward Jenner inoculated a 13 year-old-boy with cowpox virus and demonstrated immunity to smallpox, he was opposed massively. Marking the 1790’s as the beginning of the resistance to vaccines! 

For example: In India, a similar inoculation practice had also been documented from different parts of the country, especially in Bengal & Bombay presidencies. However, the lack of reliable records of patients inoculated with dead or attenuated microbes has caused more suspicion during the early days of vaccination. Lack of confidence in the vaccine’s safety & efficacy was responsible for decreased vaccine coverage and an increased risk of vaccine-preventable disease outbreaks in the past. 

To elevate confidence in vaccines, we need to integrate apt care delivery systems that are reliable & competent with experienced work professionals. Also, the intentions of the policymakers are required to be conveyed efficiently. 

Back in the day, when governments imposed compulsory policies on their countrymen, very little was invested in designing vaccine delivery models (including availability, affordability, geographical accessibility, ability to understand information). This lack of convenience has caused limited vaccine uptake.

To resolve this issue, we need transparency into policy decision-making before immunization programs. This includes facilitating up-to-date information to the public and healthcare providers about the meticulous procedures undertaken before the introduction of new vaccines.

Another factor that had a huge impact while vaccinating the masses at the beginning was vaccine complacency. Several communities considered the risk of vaccine-preventable diseases as low. Moreso, in some rural areas vaccination is not even considered necessary. 

At this point, self-efficacy influences the degree to which a person weighs the risk of vaccination against the risk of getting infected. In order to walk such individuals out of vaccine hesitancy, an elaborative awareness strategy is required. Changing the pre-existing mindset is indeed difficult, but to resolve this challenge, a channelled system to educate as well as deliver the vaccines might do wonders! 

The Past is not Behind us!

In any community, beliefs are passed from generation to generation. Therefore, myths regarding vaccines are still deep-rooted, explicitly in the collective memory. The evidence that more than 50% of the world population “neither agree nor disagree” on the effectiveness of COVID-19 vaccines, is a concerning vaccine hesitancy rate, that requires immediate attention!

To counter vaccine hesitancy, program managers must initially adequately identify the target population and understand the true nature of their particular vaccine and/or vaccination concerns.

Today

Vaccination is one of the most cost-effective interventions for survival against dreaded pathogens worldwide. Today, India has universal immunization programmes (UIP) & national immunization programmes that are responsible to immunize the Indian population. However, future vaccination programs need to reflect and address the dynamic issues of the vaccine delivery systems. 

HArbor Says: Vaccines have always been a subject that is labelled with myths and conspiracies. However, establishing a strong healthcare delivery system can assist in the eradication of both the disease and the myths. What do you think? 

Understanding the first sign of civilization

Often people debate about what will be a first significant sign of a civilization. Some thinkers believe Agriculture was an important steps while others believe invention of wheel started the process of settling down. Today, we bring you a different approach to settle this long standing debate.

The first sign of a successful civilization that put Humans a notch above the other animals is the practice of Medicine, our ability to fix tissues, bones and take overall care of our kind.

The way the entire animal kingdom works is simple – If you can run to hunt or run to avoid being eaten – you will survive. Going by that principle, if primitive human would break their leg, they would not be able to hunt. They would slow the pace of their tribe, eventually leading to their destruction.

However, if a fellow tribe member could do surgery to fix their broken leg, feed them food when they are recovering, give them #medication for pain relief and faster recovery, the entire tribe would benefit.

The people in the entire civilization would prosper more because they would not lose members just because of broken bones and other “fixable” issues. That’s the impact of medicine, it gave us our ability to live life against the brutal forces of Nature.

Our Medicos not only keep our loved ones safe, but they also contribute in the most efficient way to keep our kind, our civilization going. And for that, we are indebted to our Doctors.

HarborSays, we should be thankful to our doctors for keeping our humankind going.