Rural Healthcare – HarborSays

Practice of Medicine: Story of Two doctors, Two Realities & One Profession.

Two dynamic young doctors – Dr Jay & Dr Keshav, got admission in a renowned medical institute in the old city of Vellore for their post-graduation studies. Growing up in different parts of the country, Dr Jay & Dr Keshav had different approaches to their patient care methodology. While Jay grew up in the suburbs of South Bombay, Keshav saw his family struggle with electricity supply in their agricultural field in the remote areas of Gadchiroli.

These academically brilliant minds found solace in each other’s company while in medical college. Fast forward to 2022, both have completed their Masters in General Medicine and are ready to take on their lifelong mission of helping people in dire need of their skills.

Dr Jay & Dr Keshav had an immense influence on each other’s lives, so much so that when Dr Jay wanted to open his first clinic, he chose a remote area in Gadchiroli, not far from Dr Keshav’s childhood home. His motto was simple: nobody should suffer to get healthcare as much as his dear friend Dr Keshav did in his early days. Meanwhile, Dr Keshav, inspired by Dr Jay’s lifestyle, moved to Bombay to bid goodbye to his financial worries; once and for all.

Practicing in his new clinic in the well-educated suburbs of Bombay, Dr Keshav was astonished to see how well-read and aware people of the city were, yet they would abuse their health intentionally or unintentionally with their city-based lifestyle. Most of the time, his patients in the city would have a pre-consultation with Dr Google before meeting him. For the first time in his professional life, Dr Keshav recognized the importance of online brand creation and digital awareness about his clinic amongst patients.

On the other hand, Dr Jay struggled to give necessities like continuous electricity in his clinic. He was in pain to see patients around his clinic, taking their health so lightly. His proposition of creating awareness amongst the people for “wellness living” has failed miserably.

Against popular belief and trying various platforms to keep his clinic lights on, Dr Keshav understood that all such platforms gave a temporary boost to his patient flow and eventually, the inflow decreased to a marginal level unless he paid to “Advertisements” in these marketplaces. Moreover, most of his patients who came via these platforms were prompted with too many details about the disease to sell devices or other services, which made his patients self-aware and forced them to internet search their issues before coming to him for consultations. Dr Keshav almost faced legal action once when he signed up for a cheap and free clinic management platform to manage his patients, and the software-cum-advertisement company sold the private data of his patients to the highest bidder for their own profit greed.

All this while, Dr Jay recognised the major health issues in the region were very different to what he saw his friend Dr Keshav deal with. Dr Jay had his own set of issues. While he had a very active Instagram page with more than 45K subscribers, found no impact of that on his clinic business. In the rural location, his patients struggle to find the correct pills from the medication envelope he was used to giving them, himself. He saw most of his patients going to the old Ved Ji near the old Bazar road in his village for all health ailments instead of coming to his clinic. Yet, all these problems did not even bother Dr Jay. His main concern remains the fact that patients near his clinic found his consultation fees to be very high, and for every step, his rates & fees structures were being compared to the wrong side of the governmental institutes, many of which did not even come close to the quality of services he provided.

Later that year, while both struggled to keep their work-life balance intact, their alma mater invited them to the annual alumni meet. Unaware of their individual struggles, they both confided their care giving problems to each other. That evening was the awakening moment for each of them. They found their old long lost passion for care giving. It was like walking back to their college days, where they used to talk about fixing healthcare issues in India. Even though their challenges were different because of their practice locations, their collective goals were the same – Better Healthcare for All. The eureka moment was when they discerned that their most problems could be solved with technology. They both skipped the alumni dinner party, rushed to the old dormitory stairs, sat with pen & paper and decided to conceive a solution to their every problem.

They both were stunned to see the solutions were ever so simple. To build patient trust, Dr Keshav suggested Dr Jay write prescriptions in local languages so that the people around his clinic would understand better, while Dr Jay advised Dr Keshav to give timely medicine and appointment reminders to his patients. Furthermore, Dr Keshav was happy to find that the only way to beat Dr Google at his clinic was to keep in touch with his patients even outside his clinic, as suggested by Dr Jay. On the other hand, Dr Keshav strongly advocated Dr Ram use much more affordable rapid test kits for quicker and cheaper diagnosis instead of much more expensive and hard-to-run pathological tests.

Collectively, while Dr Jay needed satellite clinics in remote locations to create awareness about his care giving methods and reduce travel costs of the patients in that area, Dr Keshav needed these satellite clinics in various locations to increase his patient reach in the competitive urban setup. However, they both agreed that these satellite clinics would only work if they were manned by paramedics and connected to their central locations, facilitating assisted telemedicine to everybody. It was a fun night for these two medicos who were divided by their needs and environment of practice but connected by the end goal.

From studying the existing fragmented healthcare system to modern-day data breach issues, these young professionals concluded that only an integrated healthcare system would lead them to a better healthcare future. A single-platform system to equally benefit every stakeholder in care and thereby take responsibility for their roles. An integrated platform that will not only enhance the personalization of care with better care coordination but will also curtail the manual processes to keep their staff busy in patient care and not in documenting and managing paper records.

The next morning, both left that passionate ‘TED Talk’ between themselves, hoping to find a one-stop solution to each of their problems. Probably, one day they will be able to achieve their dream of providing equitable health for all.

Readers, this could be you waiting for your perfect solution, but if you have read this story and related practice issues of these young doctors, it is your time to start using HArbor.

Healthcare Accessibility & Affordability is Tampering your Care Delivery. Do you know why?

Idealistically, healthcare must be same for all, however, when it comes to healthcare accessibility and affordability, this world is distinctively categorized into the privileged and not privileged people.

Interestingly, there are several factors contributing to this segregation but the main factor which contributed the most to this is the outdated and overburdened public care delivery system which places the primary care practitioners to foot the bill for age-old conditioning within the healthcare system.

Majority people who are the beneficiaries of these public health systems are so tired and exhausted with the sheer lethargy of the process they go through when they needed instant care that they get worked up on the smallest of the factors in private care. When these people make that transition from public to private, they expect their medicos and care-givers to be prompt and create a holistic environment for them. However, This does not mean that they can suddenly afford to pay higher than what they were paying in the public system.

So the next time when your patients in the private clinic are unable to keep up with their follow-ups or they are concerned if they should continue with the treatment or they are showing temper tantrums while waiting in the reception area, believe that a single step towards resolving these issues will enhance better patient engagement and overall care outcomes.

Being a doctor, do you think that healthcare system’s limitations are significant enough to hinder your healthcare delivery and if yes, then how to ensure better healthcare outcomes while addressing these hurdles?

Trust us, TECHNOLOGY is your ring bearer.

There are many reasons why it is imperative to enhance healthcare affordability as soon as possible. First and foremost, rising healthcare costs are putting a strain on families and care practices alike. According to a report by BMC,

The average cost per episode of outpatient care is around INR 400 for public providers, INR 586 for informal private providers and INR 2643 for formal for-profit providers. This cost is marginally above almost 55% of households in India. In addition to this, the current healthcare system is simply not sustainable in the long run.

One way to do this is to improve the efficiency of the healthcare system. This can be done by streamlining processes, increasing transparency, and using technology to improve communication and coordination between care providers. Moreover, we need to find ways to reduce the cost of care on the whole. This includes the cost of medicines, diagnostic test, long travels. Another aspect of reducing the over-all cost of care would be to move the society towards preventive care and using point of care test kits (POCTs)

It is clear that there is no “one silver bullet” that will solve the healthcare affordability problem. We need to take a comprehensive approach that looks at all aspects of the healthcare system and only then can we hope to make meaningful progress in improving healthcare affordable for all.

Do you know: Out of 55-60 Mn Indians are pushed into poverty every year, a staggering 39% do not have ‘access’ to requisite healthcare services i.e. around 22-24 Mn Indians do not receive any medical attention before death.

One of the most important factors in healthcare affordability is accessibility to care.

When people have easy access to quality healthcare, they are more likely to get the care they need, when they need it. This can prevent serious health problems from becoming worse, and can also help to identify health problems early, when they are more easily treated.

People who have difficulty accessing healthcare are more likely to delay seeking care, or can forego care altogether. This can lead to serious health problems, and can also make existing health problems worse. In addition, people who have difficulty accessing healthcare are more likely to end up in the emergency room, which is often the most expensive place to receive care. These burden of a series of small payments sum up to ‘care dissatisfaction’ while en route to a healthcare facility.

Making healthcare accessible to everyone is an important step in making it affordable for everyone. Meaning when people can easily get the care they need, they are more likely to stay healthy, and less likely to need expensive emergency care.

How does bad healthcare experience affect healthcare accessibility?

Bad healthcare experiences can have a significant impact on healthcare accessibility. If patients have negative experiences with the healthcare system, they may be less likely to seek out care when they need it. This can lead to a number of serious health problems, as patients may avoid seeking care for fear of encountering more negative experiences. In addition, bad healthcare experiences can also lead to patients feeling more disconnected to the system, which can make them less likely to cooperate with their care providers. This can make it more difficult for providers to deliver effective care, and can ultimately make it more problematic for patients to access the care they need.

How Technology can assist your practice?

Technology can go a long way in improving the affordability and accessibility of healthcare for the millions of people around the world that live in rural areas and do not have access to healthcare. While Healthtech platforms enable you to connect with your patients, you can ensure timely healthcare delivery and continued monitoring via assisted care.

From the use of pen & paper, to the use of computers and laptops, to the use of mobile phones for remote monitoring, to POCT diagnostic modules, technology has allowed the healthcare industry to deliver more efficient and effective care to their patients. Furthermore, technology has allowed patients to more easily monitor their own health, which has been a boon to patients who are on medications or chronic conditions. All of this is made possible through the use of technology, which has made healthcare more effective and affordable.

HArbor Says:

Affordability & Accessibility are crucial parameters of healthcare delivery that determine the quality of a healthcare practice. And, when the healthcare dynamics is changed along with your patients’ behavior, only a healthtech platform like HArbor can enable you to reduce the overall healthcare costs for your patients while keeping your revenues unaffected while strengthening your relationship with patients.

By Vishakha Katekhaye

HArbor Says

Why is Point-of-care Testing crucial for Primary Care?

For promoting evidence-based medical decisions & better outcomes.

While waiting for a cost-effective, consistent and faster mode of healthcare delivery, millions of patients go unnoticed every year. In India, this substantive reality hits even worse with the reports explaining the spike in mortality rate even for the diseases that can be cured. This suggests a significant issue in the healthcare system, affecting a large population cohort. A system that has advanced over the years is yet to reach the ultimate milestone and still has major limitations while facilitating care.

For instance, people living in rural or remote parts of the country are expected to travel long distances to avail healthcare. This increases the cost of care and causes inconvenience to the patients during their treatment. One of the most severely affected groups are the low-income communities as this population is struggling due to high “out-of-pocket” care expenses and travelling on an average of 94 Km for every test and follow-up report can get frustrating! Moreover, even if the sample is collected at the patient’s location to send to a far-away diagnostic centre, the sample’s integrity cannot be trusted, which in turn, can result in false positives or no result at all.

Often cited as one of the major healthcare barriers, long distance travelling is quite a cause of concern for doctors as well as lead to missing appointments, rescheduled consultations, delayed care, and missed or delayed medication use. Furthermore, this restricts the medicos to deliver care with poorer chronic illness management; eventually resulting in an unsatisfactory patient experience.

Although transportation barriers can be challenging to deal with, a change in perspective while searching for a solution can benefit the stakeholders involved. This means – when disease prognosis comes at the expense of PATIENT EXPERIENCE and TIME, healthcare delivery processes need to be re-structured for those who cannot show up now and then for a diagnosis or regular follow-ups. This calls for introducing point-of-care testing(POCT) kits in healthcare delivery.

Establishing point-of-care testing kits(POCT) in remote locations is a cost-effective alternative and can be easily operated by trained paramedics. These remote care units are equipped with Rapid Test Kits(RTKs) along with some basic medical instruments like handheld and battery Electrocardiograms (ECGs), Haematology / Blood Analyzers, Biochemistry Analysers, Thyroid and Urine Testers, Blood Pressure & Sugar Machines and several other such devices that can deliver instant disease diagnosis along with facilitating them with continued treatment via assisted telemedicine.

says,

“The faster the prognosis, the better the treatment”
Dr. Prabhakar Hiwarkar, Retd. Asst. Dean, Community Health Department, GMC, Yavatmal.

The idea of point-of-care has been existing for ages. Since its inception around 6,000 years ago with the introduction of “urinalysis,” POCT has been advanced and adapted by many secondary and tertiary hospitals in India. Today, they have evolved to include blood gas testing, electrolytes analysis, rapid coagulation testing, rapid cardiac markers diagnostics and more, to save precious treatment time and enhance patient experience (while moving around the diagnostic department for tests). At times, these rapid tests have also proved their excellence in the emergency situation by assisting care practitioners to reach a confirmed diagnosis and treatment plan.

“When every minute counts and specimen integrity is at risk, point-of-testing may prove to be a miracle that will save a patient’s life!“
Dr. Shilpa Chaudhary, a leading trauma surgeon.

However, primary healthcare in India is yet to get its hands on POCT. There are several reasons why point-of-care is not seen in primary care in India.

First, primary care providers in India often do not have the training or experience necessary to effectively use point-of-care technologies.

Second, setting up these point of care testing camps temporarily, can be expensive, and many primary care providers in India do not have the financial resources to do so.

What if we tell you that there are several point-of-care integrated practice management platforms in India that are not only cost effective but are lightweight. These free-standing care delivery modules not only assist you to reach your patients at any corner of the country at ease, but ensures an overall reduced setup cost.

Want more, we’ll suggest you check out kiosk-based remote satellite centres by HArbor!

HarborSays:

Talking about better healthcare outcomes, it is crucial to note that diagnosing a disease is not enough, we need healthcare systems that deliver care “on-the-spot” as well. With the emergence of healthtech, leveraging the point-of-care modules along with assisted-telemedicine will assist care facilities in easy patient data capturing and analysis, review reports and suggest treatment in a few clicks. Moreover, using the same technology across multiple settings will maximise efficiency for the clinician, and can therefore expedite treatment courses while establishing evidence-based medical decisions & better outcomes.

By Vishakha Katekhaye

HArbor Says

Changing healthcare dynamics – Here’s what you should expect!

While continuing to adjust with evolving dynamics, the traditional stakeholders of the healthcare industry are beginning to integrate with new and diverse players in the system, focused on expediting the use of technology in healthcare.

Traditionally, the stakeholders in the care value chain used a more static approach towards operations and expansion which has become more dynamic with the entry of new age operators. This disparity also affects the patients and has divided them into largely two groups, where one group of care seekers are the one’s who prefer the less fancy, age-old ways of treatment – driven by experienced yet old-schooled doctors and the new-age millennials who prefer tech savvy caregivers.

This blog is your window-view to how the healthcare stakeholders behavior is changing with the evolving healthcare market!

Evolution of personalised healthcare in the healthTech age.

As healthcare becomes more personalised, the stakes are higher than ever to provide high-quality care in a cost-effective manner. The healthTech age has seen the evolution of personalised healthcare, with patients now able to access their own health data and receive tailored care based on their individual needs. This shift has been made possible by advances in technology, which have allowed for the development of new tools and applications that make it easier for patients to track their health data and receive the care they need.

Healthcare providers are also recognising the potential of personalised healthcare, and are beginning to offer more services that are tailored to individual patients. This is a positive trend, as it means that patients will have access to the care they need, and that healthcare providers can offer more targeted and effective care.

“For instance, you would be surprised to know that a team lead under Issam Zineh, Director of CDER’s Office of Clinical Pharmacology, has been working on using genetic or other biomarker information to make treatment decisions about patients for over a decade. This means, even the drug that is going to be prescribed, will be customised for each patient.“

Mobile is now part of the fabric — every day in everybody’s life.

If you’re not looking at mobile solutions, then you’re not really looking at all to solve your care delivery problems. Mobile-based solutions are one of the most significantly increased access to point-of-care tools for every stakeholder in the healthcare industry.

“According to survey reports by NCBI, 85% of the healthcare stakeholders were found to be using their mobile device at least once daily for clinical purposes.”

Other than supporting fast clinical decision-making and improved patient outcomes, mobile-based healthcare solutions have a higher penetration rate amongst every age group of the users. Moreso, It is extremely important to implement different solutions that can be easily interpreted and understood by stakeholders. Hence, from simplifying the day-to-day management of the healthcare organisation to being an active care participant mobile-based healthcare apps will be the next big thing in healthcare.

The use of mobile devices also increases tech adoption between the staff of the medical facilities and thus brings better accountability and reduces the changes of human errors since technology can easily send alerts and validations on each step that the procedure team takes. This improves the efficiency of care-giving but also assures patients of better care thus improving trust.

Healthcare is ageing and so is the global population, so you need a system!

The pace of population ageing is much faster than in the past and as reported by WHO in a shocking report, WHO stats, “Around 80% of older people will be living in low- and middle-income countries”

The age demographic shift will have a profound impact on healthcare systems around the world. The challenges posed by an ageing population are numerous and far-reaching, and they will require innovative solutions from all sectors of the healthcare industry.

The first challenge is simply meeting the increased demand for healthcare services. This will put strain on already overburdened healthcare systems.

The second challenge is the cost of care. As people live longer, the cost of their care will increase. This will put pressure on healthcare budgets and it will force tough choices about which services to provide and which to cut.

The third challenge is the workforce. Limited healthcare workers in rural/remote areas.

Utilising technology to resolve these issues is the need of the hour and being a healthcare provider/leader your first course of action must head towards delivering person-centred integrated primary care and facilitating them with access to assisted-long-term care.

Patients are ‘not just receivers’ anymore!

From managing their own health to the level of awareness a patient has about their needs while in nursing, the spectrum of patient engagement has been conceptualised variedly. Some patients are viewed as passive recipients of care and some are categorised to be active stakeholders. With a significant shift in the numbers of active stakeholders in healthcare, healthcare systems can no longer practise the age-old passive-recipient focused protocols and expect patient satisfaction!

In such a case, we need systems that support patients in engaging with their care. Starting with the modules that elevate the active recipients in healthcare, enhancing patient engagement and eventually better health outcomes and experiences of health care.

Where shall we start from?

By addressing the basic ‘issues’ in healthcare, relief amongst the healthcare stakeholders can be expected. In the last few years, the healthcare industry has expanded its roots with the new discoveries and technology and now that the healthcare market is ripe with possibilities, let’s reap the fruits of better healthcare for all!

HArborSays:

Healthcare dynamics are constantly changing and so is the behavior of its stakeholders. Thus, the hunt for ideal healthcare solutions has concurred healthcare leaders with disappointment. However, in the middle of aggravated dynamic complexities in healthcare, if we can expect the best possible solutions that can bring an overhaul of the existing system; we can redesign it brick by brick as well!

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!

Health Camps – A too good to be true ‘Picture-Perfect’ strategy!

Public healthcare in India is free & AVAILABLE for every resident which encompasses 18% of total outpatient care and 44% of total inpatient care. Unfortunately, this care is not as ACCESSIBLE as its reputation precedes on paper. However, the emergence of healthcare camps has provided a dynamic opportunity to fulfil the underserved healthcare needs and today, this widely adopted strategy has become an integral part of the Indian healthcare system. Irrespective of its promises, one must ask,

Is it an effective strategy or just a ‘picture perfect’ scam?

Every year, swasthya shivirs/health camps are organised by private and government healthcare organisations. These are even highly welcomed by the lower economic sections of the societies, in a hope of subsidised or free medical care. Sadly, it is estimated that the conventional health camp modules hit ground zero soon after the first phase of initiation; because of the following limitations:

Lack of continued care for patients.
Increased care costs – after attending the camp patients are expected to take follow-ups or further treatment at a hospital which maybe far off.
Travel fatigue

With the rapid adoption of Health camps, medical practitioners have successfully addressed the medical needs in remote communities. Still, the drawbacks of this conventional care delivery module have outgrown its benefits. Furthermore, with this ‘one-time care affair’, the patients are forced to choose between out-of-pocket expenses or discontinuing their treatment.

According to an NCBI report, India contributes to 2/3rd of the total deaths in the South-East Asia Region due to non-communicable diseases. Although the government pays handsomely to establish optimum care modules, major benefactors include the middle and upper-class rather than the lower economic population.

In such a scenario, healthcare camps can efficiently ensure primary care to the rural population; but, expecting the optimum results from a ‘one-time treatment’ module is too good to be true!

Is it navigating patient engagement and trust?

A health camp strives to bring awareness and screen underprivileged population to enhance patient access to healthcare services. Sometimes, organisers even get estimated results after distributing basic medication but, thinking from a patient’s perspective – this doesn’t seem enough!

For example – For a patient diagnosed with chronic conditions, one-time screening without follow-ups imbalances the act of care delivery. Moreover, it leaves a negative outlook toward the practitioner in the minds of the patients after being diagnosed with the condition. This will result in a decline in overall health camp participations and thereby, decrease patient engagement and trust.

Hence, medical camps must facilitate end-to-end care on an easily accessible platform to enhance patient care and maintain patient stickiness in the long run. And, this comprehensive care demand can only be fulfilled with an assisted virtual care delivery system.

A system that is driven by care professionals and backed with technology!

The Solution – Health camps with assisted virtual care support!

Imagine being able to deliver care in remote locations around the year without a need to be physically present at the location.

Yes, it’s possible!

2019-2021 has given quite a boost to the Virtual Based Care (VBC) modules. Utilizing a similar approach to treat the patient in health camps will enable doctors to deliver comprehensive care and may ensure long-term patient engagement. However, while providing care for a technologically-illiterate population, a kiosk-based assisted telemedicine module is an ideal solution.

Advantages of a kiosk-based assisted telemedicine module:

Consult patients at any time and from anywhere
Easily render homecare services along with a regular vital check-up for comprehensive patient monitoring.
Organise a medical camp and continue the treatment, as per the patient’s medical needs.
Maximum patient engagement and minimum travelling costs.
Provide rapid diagnostic kits via the assisted telemedicine route.

HArborSays

Medical health checkup camp is an effective way of delivering primary health care; typically in the unreached area to achieve optimum health coverage. However, the conventional health camps come with their own demerits and it’s about time to resolve those issues. Assisted virtual healthcare platform is one of the best possible ways to ensure healthcare access for all.

We believe – “If it cannot sustain the care requirements, it shall be replaced or at least advanced.” And, it’s time to deliver the best possible outcomes from health camps.

Why Referral System in India Needs Optimizing?

Can you guess the number of doctor consultation visits a patient would need during the treatment? Now, multiply it to the number of visits for report consultations and most importantly for referrals. Tiresome right?

A healthcare system is strengthened by healthcare professionals/facilities/diagnostic centres, along with an efficient referral system is at its heart. The Indian healthcare system is one such system. However, the referral system in India constitutes several challenges. As a result, it is hung precariously between the care providers and patients today.

These challenges need immediate attention so as attain a smoothly running healthcare system. For a better understanding, let’s move ahead with care referral system scenarios and their impact on the care practitioners, diagnostic technicians and patients.

Scenario 1: Typically, the healthcare system is pyramidal, wherein primary healthcare centres (PHC) constitute the base, which is large in numbers. Less number of secondary centres are in the middle, and a fewer number of tertiary care centres are at the top. This means whenever a primary care physician (PCP) refer patients to a secondary or tertiary care facility, this poses a burden on the existing healthcare setting in the cities. Such practices interfere with the already aligned patient appointments and surgery schedules.

More so, for a healthcare professional this scenario comes with a high patient influx while increasing the patient waiting time disrupting the care facility flow.

Scenario 2: Often due to the lack of resources at the primary healthcare level (PHC), PHC doctors are compelled to refer patients to another healthcare facility. Now, imagine all these patients with minor illnesses flock around the OPDs of secondary or tertiary care facilities! Ideally, these patients can be easily tacked at the lower level health facility.

Moreover, according to a study more than 50% of morbidity can easily be treated at the PHC level.

But unfortunately, due to the lack of advanced equipment and skilled healthcare staff patients suffer. Leading to long treatment duration and multiple hospital trips.

For example: If a rural patient visits his nearest secondary/tertiary healthcare facility in India, the person would’ve to travel at least 50-90KM for better healthcare facilities. Making a consultation to be time-consuming and considerably costly. Eventually leading to poor patient engagement.

Also, these patients consume resources of a higher-level health facility, which can be effectively utilized for emergency cases.

Scenario 3: The government of India provides health benefits to its armed force professionals along with several other government employees. However, to attain these facilities from a private hospital, the beneficiary needs to have a referral letter from the regional ECHS/CGHS polyclinic. Also, the patient needs to travel to regional polyclinics to demand a referral letter.

Furthermore, during treatment, the patient is required to apply for a new referral letter for every procedure. Which is basically every time the beneficiary moves from one stage of the treatment to the other.

This condition may seem easy to process, however, it extends the pace of the treatment. For patients, even if their treatment cost is reimbursed fully, the multiple visits to the polyclinic and then to the assigned hospital, impair the care experience. Meanwhile, the healthcare practitioners are forced to reschedule according to the issued dates of the referral letters.

In such a system, although the patient is treated under a specialist, somehow the convenience of caregiving and care receiving remains conventional and slow.

So, why not introduce referral module into the healthcare platforms to optimize and advance the referral system in India?

But before that, we need to know the characteristics of an ideal referral system.

Adequate coordination and meaningful communication between doctors, patients and referrers.

Reduce the multiple visits to the hospital for documents

Optimal utilization of primary health care services without burdening the secondary and tertiary care units.

Provide optimal care to the patients at the right level, right time and right cost.

Cost-efficient utilization of health care systems to provide easy and legit access to referrals.

In healthcare, the integration of Electronic Medical Records (EMR) and Telemedicine, modules have taken centre stage in healthcare delivery. It is safe to say that these integrations have assisted healthcare stakeholders to a great extent while improving clinical outcomes.

Due to healthTech platforms at the OP level, the user interface is so easy that the data can be entered by desktop computers, iPad, or even a phone with user access. Similarly, the integration of the referral module on the same platform will assist care providers with an innovative approach to check on patients’ diagnostics reports & follow-up consultations via video calls. Moreover, such platforms readily update patients’ medical records.

The introduction of such a platform may prove to be a road ahead for stress-free healthcare practices.

HArbor Says: It’s true that to strengthen primary care, adhering to strict regulations are necessary for existing referral systems in India. However, from the above discussion, it is quite evident that healthcare stakeholders need more than just that for an efficient referral module. Moreso, a referral module integrated healthcare platform is a way forward towards building an ideal referral system in India.

What do you think?

Urban Healthcare: Responsibility to Reach Beyond the Cities for Care Delivery

The healthcare stakeholders seem to be enjoying the healthTech wave in India. A recent report also proved that the HealthTech industry in India is expected to flourish with a total economic value of US $50 billion by 2033 (Source – RBSA).

Yet still, why have these healthtech innovations not been able to penetrate the remote areas, especially villages to facilitate optimum medical care. The article explores the following points to elaborate further on the topic:

Issues with penetration of healthTech in villages.
The solution for the existing healthTech issues.
Impact of these solutions on Bharat economy.

Let’s get started!

Challenges faced by urban medicos while delivering care

Over the last few years, the Indian healthcare system has undergone dramatic changes with the introduction of technology. Yet, there is a huge gap in care delivery mainly resulting because of the urban to rural doctor density ratio of 3.8:1.

This is why every year – 86% of all the medical visits in India are made by Ruralites, still traveling more than 100 km to avail health care facilities. Out of which 48% of them are emergency overnight trips (source: NCBI).

Logically thinking, the easiest solution for these problems would be building healthcare facilities in the village itself. But would that be economically feasible?

NO!

Here are some of the factors, that a medical practitioner would consider before building a healthcare facility:

The total cost of building a healthcare facility in a village.
Availability of the paying population.
Availability of other healthcare stakeholders like pharmacies & diagnostic centers.
Trained medical staff to provide effective patient care.

Keeping these basic points in mind, the majority of doctors or healthcare facilities are generally reluctant to build such infrastructures.

This problem has somewhat been addressed in urban & suburban places with the introduction of Telemedicine. According to a recent study, during the COVID pandemic – India has seen a 500% rise in healthcare teleconsultation, out of which 80% were first-time users.

Yet, why hasn’t this incredible healthTech boom reached the villages?

A rural patient may be equipped with a smartphone but lacks the complicated nature of the healthcare ecosystem thus leaving them more frustrated with virtual care than providing relief. Other basic functions like bill payment and checking the patient queue considered essential from the doctor’s perspective are not possible, due to low literacy rate & unavailability of transactional modes.

Ordering medicines from a pharmacy application or booking a telemedicine appointment may seem like just a few taps on urban patient’s smartphones, although it is much more difficult for a rural patient.

This implies that the current form of Telemedicine can never be the means of interacting with village patients for a virtual consultation!

The solutions for creating healthtech inclusive of Indian villagers.

Even though the urban population has taken basic advantage of HealthTech, the rural healthcare systems are facing pre-existing healthcare issues along with the newly emerged tech troubles.

So shall we resolve them?

Yes!

Upgrade from the practices of creating brick and mortar care centers & create lightweight movable assets for quick setups and complete care. These healthcare Kiosks should provide assisted telemedicine care, enabling the village/rural/remote patients to access care efficiently.

Now, will assisted care prove to be better than just telemedicine application?

Firstly, the kiosk centers should be administered by doctor assistants to provide round-the-clock medical care. More so, when the patient will be interacting with the doctor in-charge on a video consultation, the assistant will help the patient to state all the symptoms, which will enhance patient care along with reducing any possibilities of error.

Furthermore, these doctor-trained assistants should be equipped with basic diagnostic kits, vaccines, and medicines to provide primary care, if necessary. More so, the assistants placed can be a local care practitioner or even a quack – interacting with the patients in their regional language.

This futuristic & effective digital care model for evaluating, diagnosing & treating patients without the patients needing to visit facilities, may help us achieve the best care possible for the rural population in India!

Also, wouldn’t this care delivery module have a small, yet significant impact on the Indian economy?

Yes, definitely!

These light-weighted movable assets can be easily established in multiple villages while providing essential medical care to the patients. These simple yet effective care units can also be used to provide emergency care to the patients while connecting with specialists living in any part of the world!

And now that patients no longer have to travel to the cities for primary care, the cost of care can be reduced without any additional expenditure.

HArbor Says: It’s time that we start thinking about taking healthTech beyond the cities when India’s maximum population lives in the villages! Let’s rethink healthcare from the eyes of a villager.

Fixing healthcare gaps step-by-step with Technology in India

COVID Pandemic has held back the best of humankind and their businesses. Especially, the healthcare facilities across the world, who were seen struggling to contain the devastation brought on by a sharp increase in the infected cases. Despite all the hard work of medical professionals, the healthcare systems currently in place couldn’t manage the sheer number of patients visiting the already cramped medical facilities resulting in uneven care and even further reduced healthcare accessibility for urban as well as rural populations. Though healthcare leaders & policymakers have tried incremental fixes to the current systems, the final goal of creating better healthcare technology for the ‘patients’ is still a far fetched dream for India.

All of these problems in addition to the lack of literacy to use technology products in India led to bad patient care experiences. Moreover, the existing healthcare technology systems aren’t serving in medicos interests for reducing their load and it’s high time that it should be fixed!

Reasons For Gaps In Healthcare System

Healthcare systems are created for maximizing value. When we are redefining healthcare, it is a must that we step away from the fragmented healthcare systems that lack coordination. These un-synced care facilities create unnecessary stress – followed by lengthy treatment procedures, health risks to the patients and unsatisfied care experience. More so, it adversely impacts quality, cost, and outcomes.

Wouldn’t an integrated care delivery system(IDS) resolve the problem of inefficient allocation of resources to improve care quality & optimize operations?

Yes, it most definitely can. When a patient visits an OPD, the majority of the treatment is performed at different care units, not necessarily to be under one hospital. These care units include diagnostic centers, pharmacies and the doctor’s chamber. Integrated care delivery platform collects all of the fragmented data in a single EMR report, irrespective of the care unit. Furthermore, an IDS will coordinate and collaborate with health care professionals to achieve clinical outcomes & improving patient care, while easing up care delivery for medicos. However, talking about creating a healthcare system providing a complete EMR, delivering care in rural areas when patients are dependent on quacks or spin doctors for allopathic care is difficult.

‘Did you know, according to a WHO report, nearly 57% of doctors in India are quacks.’

However, the rise of telemedicine in India facilitated patients from remote corners to connect with the ‘real doctors for actual consultations’. Bringing virtual healthcare systems to rural communities has shown a 300% increase in online consultations in 2020. Furthermore, it reduces patient dependencies on quacks and unburdens them of the unnecessary expenses via online treatment.

As for the already existing quacks in the healthcare system – the Indian population requires an assisted telemedicine modules which can be successfully managed under their supervision. This way assisted telemedicine will be able to enhance and assist in transforming rural healthcare while regularizing and creating job opportunities for an unregulated sector.

In a healthcare system, every stakeholder plays a crucial role in patient treatment. Even after virtually connecting a patient with a certified care provider, the unavailability of tools for assessing health is still a major gap that needs fixing. The establishment of health assessment facilities i.e diagnostic centers in rural areas has special challenges of its own like limited funding and lack of skill set in medical staff other than doctors.

Technological innovations such as POC (point of care) tools and Rapid test kits could help address part of the problem. As yet also hospital ground staff/nurses & even quacks with access to healthcare platforms that can easily interpret the diagnostic data while facilitating continued care in rural/remote locations. This is probably the best possible way for creating & delivering complete patient care, even in remote areas.

‘Data is the new oil for the world but in healthcare, it has always been the crucial element.’

A complete medical record serves the interest of the medicos and their patients equally, especially when a patient consults multiple doctors and switches one healthcare facility to the other.

Independent, un-connected care facilities create multiple files for the same treatment resulting in unmanageable, untraceable disease origins. More so, when the need for a second opinion arises, the patient’s losing the physical files can never be ruled out in Bharat. This gloomy context of Indian medical record management can easily be fixed with technology. By incorporating EMR integrated healthcare platforms, the healthcare providers can easily manage patient data while sharing it amongst them, obviously with the patient’s consent. With detailed health data, providers can deliver better care & avoid any medical error which was unavoidable in unstructured records.

“ In an ideal healthcare world, if a perfect interoperable EMR exists then the care will be structured and independent of the patients input to provide treatment data while switching between the care facility”

HArborSays: The traditional health system appears to be coming apart at the seams, and this will likely worsen with time. Hence, now is the time to act and restructure healthcare by fixing the gaps while creating ripples for a positive change in healthcare.