History of Healthcare

Doctor Patient Relationship – An Ever Evolving Mystery!

The doctor-patient relationship is dated back to 5000 years. Back then, in ancient Egypt, it resembled a priest-supplicant type engagement – a relationship involving healers to stage themselves as MAGICIANS who have mastered sickness and death through magic, mysticism and spiritual healing. For the most part, this relationship can be categorised under ‘beneficent paternalism’. Wherein, not only the healers were seen taking responsibility for their patients’ health but procured the right to make health decisions for them. Somehow managing a unique but functional relationship; Functional but not ideal!

On the other hand, In India reputation of doctors were beholden next to GOD and labelled under social and humanitarian line of work – a profession yet to be introduced in the business realms of the service world.

It was a different scenario back in the ancient times, when majority of medicine practitioners would be around much of the rural areas and only a handful were to be found in the high citadels of the towns. This helped these ancient medicine practitioners know personal details and the personas of their subjects, which led to greater trust and round-the-clock availability. With time, when the civilizations evolved and professional structures emerged, these care professionals leveraged their interpersonal relationships with patients and their families for probable diagnosis and explaining treatment protocols. Thereby, ensuring the best care outcomes.

Since the beginning of the 20th century, the dynamics of this relationship have evolved to the way we see it today. Where people seemed to be doing better, but the trust and compassion elements have hustled to stay afloat. This relationship strained further with new-generation doctors choosing cities over rural areas for their practice setups. As a result, the two-third of India’s rural population suffered tremendously by being dependent on mere 27% doctors available for medical care in these areas.

Fast forward to the present —

TECH-ADVANCED AGE, BETTER RELATIONSHIPS SCOPE

Although the public & private healthcare systems tried to compensate for low doctor-availability issues in Gramin areas of the country, the limited medical care was not enough to enhance patient satisfaction!

Rapid commercialization and globalisation has influenced every part of this globe, and healthcare is no exception. With the enormous impact of technology in the healthcare industry on it’s whole, the patient behaviour & their expectations, care professional roles, and doctor-patient relationships have all evolved and changed. Meanwhile, the non quantifiable like these have changed enormously in recent times, the technological advancements are still made on the SOPs made in the past, leaving us with a healthcare systems haunted by the ghosts of the pasts & jammed with the growing expectations of its stakeholders.

If played on its merits, care practitioners can leverage technology in their favour by enhancing patient care satisfaction and elevating doctor-patient trust.

For example, Dr Prakash Sharma, a renowned Cardiologist diligently points out the small yet significant changes in doctor visits in the last two decades —

Patients hate waiting in lines for appointments or bill payments, which is why most of his appointment scheduling has shifted to digital payments and telephone calls before the patient actually arrives.

Patients living at far away localities in cities prefer primary consultations via video calls and would happily visit the clinic for their second consultation if required.

Patients are now getting conscious about preventive care and like to evaluate the possibilities of developing a disease via genetic or lifestyle related issues.

Not all patients prefer an in-person primary doctor often, they are satisfied with Telemedicine consultations or any other health related instruction.

Overwhelming medical expenses can demotivate patient will to seek medical help; a healthcare practitioner is expected to find ways to decrease the overall medical costs to eliminate the burden of medical bills on doctor-patient relationship.

Dr Prakash Sharma further speaks of the impact of empathic and clear communications. As a doctor, he feels — “It is an indicator of competence and skills. It enables my patients to express their illness and establishes a friendly connection with me which encourages their treatment and medication adherence”

When asked, if it is okay to be friendly with patients?

He nodded ‘YES’. It’s easier to converse with patients when they perceive doctors as friendly. This relationship isn’t just easier to break down a patient’s anxiety levels but allow the care practitioner to make deductions of the factors influencing the overall treatment’s outcome. However, he warns to be wary of the risks of becoming friends with a patient. It could distort a doctor’s judgement. Nevertheless, having a friendly interaction is not against the law and has reported positive outcomes, mostly!

THE FOREVER CHANGED DOCTOR VISITS

Technology is re-structuring the doctor-patient relationship and re-defining their roles in the healthcare system. Bringing in a sustainable method in healthcare, Telemedicine eased-up the consumers and providers responsibilities on a single platform while enabling the healthcare system to reduce the overall care cost. With the increase in virtual healthcare visits, medicos are now being able to facilitate primary care at any time, anywhere with just a few clicks on their mobile phone. Today, digital technology has transformed healthcare enough to provide excellent primary care with the assistance of easy-to-set up, remote satellite clinics. And, assist medicos to insure continued care via homecare healthtech devices.

Currently, digital technologies are revolutionising care delivery by assisting it to be more precise and personalised to an individual’s need. Enhancing value-based care in the years to come.

HArbor Says:

The common misconception of doctor consultations being merely about treating the disease is outdated and with changing healthcare stakeholders’ behavior, the healthcare world is shifting its gears towards a stress free, sustainable and secured healthcare. And, if that involves simplifying the conventional and tiresome doctor visits, then so be it!

ARE THE GHOSTS OF THE PAST, HAUNTING THE FUTURE OF HEALTHCARE IN INDIA?

Healthcare has always been an integral part of our lives. India, the country of ‘AYURVEDIC’ practices has seen its glorious tradition of public health service from 5500–1300 BCE when the likes of Sushruta and Saints performed care-giving as practice. Ever since then, the objective of delivering healthcare to ‘everyone’ has indeed presented a spectrum of contrasting landscapes. Fast forward to the present, the healthcare sector has made prolific advancements, but its leaders and care providers are still appalled by the same challenge every now and then. The situation of the present healthcare delivery system is an eye opener and, make no mistake, it will be a ticking time bomb, unless it is systemically fixed.

Truth be told, several attempts have been made to enhance healthcare delivery in India since 1983, when the first National Health Policy of India (NHP) was formulated. With central and state governments trying their best to put forward the most ‘suitable’ policies to provide healthcare for all, very little has been done to make space for the integration of advancements of the future.

In fact, when the seismic effects of technology in healthcare commenced the change to strengthen the existing care delivery system in India, the outdated infrastructure and policies limited this partnership between healthcare & technology, in the first few phases while leaving us in doubt about its excellence.

Although, there are several challenges in the path of the advancement of digital healthcare in India, let us add a little more light on basic infrastructure and healthcare policies.

India has a three-tier structure that comprises primary, secondary and tertiary care. This structure further segregates the primary care via sub-centres, primary health centre (PHC), and community health centre (CHC) and sometimes, even Anganwadis. The secondary care is largely delivered through district and sub-district hospitals while on the other hand, tertiary care is extended at state and central level institutions, super/multi specialty hospitals. While this system looks ‘perfect’ to facilitate healthcare coverage even at the extreme corners of the country, the ground realities are different than we anticipate!

Even after creating huge buildings and infrastructures across the country, the existing public healthcare system is still relatively inaccessible, inefficient and primitive for its stakeholders. This makes the public healthcare system, undesirable for a large part of the communities, even though many still avail it for its “free-of-cost” approach.

According to a study —

“Despite private healthcare being four times more expensive, 72% of rural and 79% of urban residents would not trust a public healthcare facility.”

On one hand, the statistics present patient experience and care outcome concerns, and on the other, it questions us if this has always been the case. The answer is No. In its initial days, Public healthcare in India was preferred by everyone and has assisted care professionals to deliver care to the patients. However, the times have changed, and so have the patient’s expectations; delivery methods and even treatments, but public healthcare infrastructure, policies and care-givers in India remain stuck in the old times, enjoying past glory without preparing for the future.

The blame for the underdevelopment of the healthcare delivery system in India also lies on the shoulders of ‘ancient’ healthcare policies & norms that we still follow. Moreover, these “dinosaur-era” policies remain to be one of the most significant factors why establishing digital healthcare delivery is so hard in India.

The Role Healthcare Policies in Healthcare Delivery

Since its establishment in 1983, the National Healthcare Policy was hardly revised till 2002. As for the latest National Health Policy (NHP) 2017 highlights, it presented the ‘Health for All’ approach to provide assured healthcare for all at an affordable cost. With schemes like Ayushman Bharat Digital Mission (ABDM) and Pradhan Mantri Jan Arogya Yojana (PM-JAY) we are possibly even pacing up towards the vision of better healthcare practices, but as stakeholders are we ready for it?

Earlier in 2021, when the Ministry of Health announced the National Digital Health Mission, to digitise the existing healthcare structure, the policymakers certainly overestimated its results. The adoption of such remarkable policies has been much slow because we overlooked the ground-level reality check. The current state of the system lacks skilled professionals, it has low technology literacy and even the basic infrastructure to sustain these changes have corroded with time.

The truth is Digital health and the existing healthcare design is still at a crossroad. These are the times, when we as a civilization are facing a mounting healthcare crisis extensively exposed by COVID combined with Natural Disasters, Heavy Rains combined with an ever-increasing burden of disease with ever increasing population, resulting in low care quality.

These aged policies are hampering the adoption of digital health solutions in India. Interestingly, on the other hand, the time tested way of delivering “non-digital care” has also been affected by these policies. For example :

The norms of establishing healthcare facilities required a certain minimum land acquisition which increased the project cost by multiple times.
The process of hiring medical staff is tedious, requires “caste certificates” and numerous rounds of approvals.

This has had a knock-out effect on the development of any sort of health solutions, as many of the modern day solutions require a fresh look at things from beyond the purview of the ancient policies.

As a result, the potential benefits of digital health are not being realised in India, and the country’s healthcare system is still struggling to keep up with the demands of a rapidly growing population. It is essential that the government revises its policies in order to allow modern health solutions to flourish in India. Only then will the country be able to address its healthcare challenges sustainably and effectively.

From the Stakeholders Perspectives —

Ideally, digitization and modernization of the healthcare system must optimise the practice of doctors, enhance patient-doctor communication to improve patient outcomes. But, since the introduction of ABDM in 2021, the statistics showed a mixed response from the major stakeholders of healthcare. Wherein, the urban regions of the country showed significant adoption rates concerning Virtual Care Modules, but in the rural areas, nothing has changed. Infact, the ‘burden of digitization’ on the ‘Gramin’ healthcare system’ has created nothing but chaos!

Often the challenges that care professionals go through are due to age-old infrastructure or outdated policies. And, it is evident that until we redesign the healthcare delivery systems according to care professionals and the beneficiaries, we ain’t moving anywhere. Below is a small example of a public health doctor, exposing lack of infrastructure and trained medical professionals which would help him execute his duty.

Read the full answer here.

On the other hand, when we have unnecessary policies on the infrastructure side, we totally lack policies, guidelines and regulations on the data security side. This has led to data theft, misuse of digital prescriptions, electronic health records, fraudulent practices and solicitation in the form of listing websites in the noble field of care delivery.

HArborSays:

Change is often not so easy but, when the existing policies and regulations lead to insufficient care experiences for the beneficiaries as well as the service providers, it is time we change them. We must modernise them. And, it must start with changing the age-old perspective toward healthcare delivery. An approach that remains more India-centric in healthcare tech while keeping all the major stakeholders on a single platform.

Here at HArbor, we have already started our journey by simplifying care practices for medicos to assist them to deliver the best care outcomes possible.

Connect with us to know how HArbor platform can help your care facility!

Can HealthTech take the temperature-off of the Healthcare Worker Shortages?

When a system flourishes on default and not by design, its foundation experiences chaos. It fails to manage & utilize resources, resolve the existing problems and disrupts revenue cycles which is crucial to keep it fueled. Unfortunately, due to its disorganized growth, it faces difficulty while adapting new-age modules; we call these advanced modules ‘the helping hands’!

India’s healthcare system is no different. Carrying the weight of the entire system, care professionals are not just working their fingers to the bone but burning their potential capacity to zero! Now, the only question remains;

DOES INDIA REALLY LACK AN OPTIMUM HEALTHCARE WORKFORCE?

According to WHO’s 2020 midterm report, the Indian healthcare system needs at least 1.8 million doctors, nurses and midwives to achieve the minimum threshold of 44.5 professional health workers per 10,000 people.

*Number of health professionals/workers per 10,000 persons, 2018*

So yes, our healthcare system needs an additional workforce, but this inference shall not excuse the adverse effects of disrupted healthcare structure on healthcare professionals. And first, it is of great importance to understand the impact of relatively old and disorganized healthcare practices in private and public health spheres that are not ideal anymore!

Outdated Management

In all the loud and necessary debates about resolving the staff shortages in India, the conventional care management has been constantly overlooked. Although the Ministry of Health and Family Welfare is striving to improve the healthcare sector with several initiatives, policywise; the workflow foundation of the majority of primary healthcare centres (the heart of the system) is too old to sustain the load. Outdated management exhibits tragically slower workflows, reduced care efficiencies and pressurizes the care professionals to share the responsibility. A load which can be perfectly handled by practice management software.

Simply put, healthtech solutions for practice management can efficiently assist every healthcare stakeholder, especially doctors, nurses and administrative personnel. Such solutions not only eliminate the redundant and manual processes but also build standard protocols for care procedures for anyone and everyone to follow. Thereby reducing re-work or any last-minute extra shifts.

Fragmented Care Delivery and Manual Processes

While talking about tiring manual care modules, this discussion must take the responsibility to address the strain of fragmented care delivery on healthcare professionals. Our healthcare system is an unbalanced rather ‘broken structure’ at the grassroots level that lacks an integral value chain. It restricts care professionals to coordinate smoothly during patient care while burdening care facilities during referrals, record maintenance and designing treatment protocols.

HealthTech platforms in such scenarios will not just streamline patient care delivery, but will eliminate the cumbersome and unnecessary processes. As a result, facility staff will always have more than enough time for patient care without worrying about tedious and redundant administrative work.

Lack of Data Interoperability and Lack of Data Protection

A doctor spends around 35% of their time documenting patient data. What if managing patient data becomes as easy as tapping a few times on your phone while sharing it with a swipe?

You probably do not believe this but the funds, time and workforce required to maintain paper-based healthcare records are noticeably high. In fact, the expensive paper-record maintenance should be enough for medicos to consider switching to healthTech platforms. Yet, the vicious cycle of filling up MRD rooms and dedicating valuable staff working hours every month has become more of a healthcare ‘habit’ than a practice.

Paper based medical records slow down the data exchange process between its stakeholders, which means treatment delays and disruptions in care professionals’ schedules. Moreover, paper medical records are prone to tampering, stealing and are even hard to retrieve.

A modern EMR can come with cloud-based storage that guarantees maximum data security and the convenience of retrieving the medical records at their fingertips. Not only are these records encrypted and password-protected with correct authorization, care practitioners can exchange data and compile it all under a single patient ID within a few minutes. The Governement of India, has even started working on something on similar lines, with the visionary Ayushman Bharat Digital Mission, ABDM, where they have envisioned a central EMR storage for citizens of India.

Automated and faster processes may not be a long term solution for staff shortages in healthcare but it will have a significant impact on care practices and workplace conditions. Hence, it is justified to say that since the healthcare system is ‘stuck in time’, integrating healthtech platforms from ground zero (primary care facilities) should be our first call. And there by, improving physician response times, increasing efficiency and transforming team communications.

The Impact of Skilled and unskilled care professionals in Healthcare

To resolve the shortage of healthcare workers in India, it is also important to analyze the number of skilled and non-skilled professionals in the domain. According to a report published in the journal BMJ Open, India does not meet the minimum threshold of 22.8 skilled workers per 10,000 people as recommended by the WHO (World Health Organization). However, the study revealed an alarmingly large number of low qualified health professionals and low performing workers. These care professionals usually come under the first point of contact in low economic and rural parts of the country.

When distribution and qualification of health professionals is serious problem, healthTech platforms will not only keep standard care processes in place, but will enhance overall productivity in care facilities. The SOPs designed by these platforms will eventually reduce any illegal practice, medical data breach and errors while delivering care.

HArbor Says

One of the biggest challenges faced by the Healthcare industry is the constant shortage of skilled workers. The increasing demand for qualified medical professionals has led to the creation of thousands of new jobs, but the industry can’t seem to find enough qualified workers to fill them. This has prompted many to ask if technology could solve this problem. Only technology can be used to “create efficiencies, automate tasks, and address staffing gaps through technology.”

Undoubtedly, India needs to invest in Human Resource for Health, HRH for increasing the number of active health workers but also needs to integrate healthTech platforms to improve the skill-mix and overall care practices.

By Vishakha Katekhaye

HArbor Says

Facing Systemic Exclusion, can the LGBTQ+ community receive better care Accessibility via HealthTech?

Healthcare is a fundamental necessity of life, but its accessibility and quality differ for different communities in India, especially for the LGBTQIA. For them, it is a privilege to get basic healthcare needs satisfied due to the deep-rooted stigma in the society. This often leads to creating gaps in essentials and basic healthcare needs. Plunged in ‘the swirl of social biases’, it is critical to address the medical needs of this community by leveraging modern healthtech platforms.

From waiting outside a clinic to booking consultations for yearly health checkups at diagnostic centers, the healthcare journey differs for each one of us. We all have our share of concerns while reaching out to a medical professional, but what if a social stigma around a human’s “partner choice” becomes the first barrier while seeking medical help?

It is generally the first thought for nearly 8% of LGBTQ+ people living in India while going for a medical visit.

For the LGBTQIA community, discrimination and fear of non acceptance leads to care disparities. As a result, they are more prone to chronic diseases and mental health issues that may often be left unattended, degrading their quality of life.

As a thumb rule for any thriving society, access to quality and continued care should be a basic and fundamental right and healthcare systems and the approach should be equal for all its beneficiaries irrespective of their biological gender or choice of partner.

Since, the patient experience for this special case, varies to a dipping point in India, we need to look at ways of restructuring care delivery right from its foundation. Primary care should and must evolve to be inclusive of all humans from all communities.

The Current state of Primary care for LGBTQIA community in India

Indian LGBTQ+ comprises 104 million people, and their exclusion is relatively tied to socioeconomic status, identity and community. Moreover, poverty and distance to care centers have exacerbated the lives of LGBTQ+ communities. In a recent study by NCBI, LGBTQ+ youth are more prone to substance use, sexually transmitted diseases (STDs), cancers, cardiovascular diseases, obesity, bullying, isolation, rejection, anxiety, depression, and suicide as compared to the general population.

“When medical help comes with societal barriers, they choose to suffer in silence.”

On the flip side, the situations are different while yielding an inclusive care system with better health outcomes for anyone & everyone via TECHNOLOGY. On this side, Healthtech platforms facilitate medicos to build comfort and trust for the LGBTQIA community, to help patients get the best care possible at their fingertips.

Let us explain!

Telehealth can change the preconceived notions or experiences of the community members by connecting them with healthcare practitioners who can take care of their unique physical needs in a more confined and confidential way. While, going to a clinic might be inconvenient for most of the patients, humans from LGBTQIA community face those extra and not required “societal looks” while in the waiting area. Though this problem should not exist in the 21st century, it can be easily overcome with telemedicine.

In the future perspective, the wave of online consultations, homecare regimes via Virtual Care modules, DIY Kits and many other care delivery mechanisms this lines will assist LGBTQIA community to connect to Mental health groups, specialists, certified hormone replacement therapy (HRT) experts, and HIV specialists while giving the patients a chance at periodic monitoring and stigma-free treatment. Assisted telemedicine kiosks will successfully help in delivery care in trans member localities and government organizations for LGBTQ+, where these standalone kiosk modules will deliver public awareness and permanent health camps.

Empowered with Rapid Test Kits and battery operated pathological machines, these freestanding care delivery modules can even provide diagnostic capabilities with privacy to LGBTQIA community members and help in eradicating several communicable and noncommunicable diseases, right from the deepest levels.

Wouldn’t that be a befitting and cost-effective initiative for the Health authorities and society in General?

The surge in telemedicine in the LGBTQIA community is necessary to concurrently streamline and tailor the services for these under-served individuals.

Building Inclusive Clinical Trials

Clinical trials help the world population towards a healthier and better quality of life. However, generally speaking, members of the LGBTQIA+ community are often left out of these clinical trials. The lack of such diversity in clinical trials has significantly affected the LGBTQIA population while restricting them to only generic medications.

Such a diversity lacking study data fails to collect the drug effects on genetic levels of these marginalized sections of the society, especially the transgender communities. And, being uncertain of the risk factors of the medications, a medical practitioner will be indecisive to write the prescription.

Had it been for an inclusive clinical trial which was being run on a technology platform which does not discriminate, a patient’s clinical trial participation would have been strategically recorded in EMRs to assist care professionals in the longer schema of things.

HArbor Says

Social stigma in India has been forcing the healthcare system to be viewed under the lens of heteronormativity, sidelining the LGBTQIA community’s needs. As a result, this has led to the negligence of their health, driving the situation to a point of concern for the entire community.

Assisted Telemedicine can significantly assist private and public care practitioners to address the community-specific health issues while spreading awareness among LGBTQIA.

Let’s Rethink, Redesign & Rebuild a healthcare system which is inclusive and caters to the medical needs of every community!

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!

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.