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.

Digital Receptions – A step forward in healthcare delivery

Over the years, while digital care platforms have largely come up with innovate solutions to ease out operations for doctors & patients, the most crowded corner of any hospital remains to be a reception desk, still operating under heaps of paperwork and manual processes.

Manual reception desks do not only consume valuable human time but also exposes medical staff to unnecessary exposure especially during these pandemic times. A study was done at Robert Wood Johnson University Hospital in New Jersey, USA revealed that hospital support staff is generally hit harder than doctors. This trend was later confirmed and observed during the second wave of pandemic in India too. The primary reason for such a trend was mainly associated with lesser awareness and an extremely large number of footfalls happening on the reception desk of any hospital.

The largest crowd gathering in any medical setting is always at the reception desk, where queues of patients can always be seen waiting to get themselves registered, make bill payments or even simply inquire repeatedly about their turn to see the doctors. In a country with population to doctor ratio of more than 6000:1, these problems will always be congruous with overcrowded reception desks.

How do we solve this issue in a country like India where 80% of doctors are concentrated in urban settings & 313 Million people are still illiterate?

The answer is simple – Automate the receptions, remove the humans in urban setups, remove redundancies & create infrastructure in rural India, namely Bharat. WOW! That seems quite a task but that’s the most relevant solution to the Indian healthcare industry’s underlying volcano waiting to burst out.

A digital front door with a capacity to do everything a medical staff can do while manning a reception desk is necessarily one-stop answer to all of India’s healthcare delivery problems, at least related to processes. The redundant activities of a reception desk can be easily automated to provide self-checkouts & appointment systems to the patients. Information should be displayed in a form legible to patients & all relevant stakeholders in Audio-Video formats only. Such a system would also be of particular interest to the majority of pharmaceuticals which can then use these front doors to create mass awareness amongst patients about the latest innovations in the drug world.

So these automated kiosks would result in loss of Jobs for receptionists?
Absolutely, NO!
The hospital trained medical staff can be relocated to smaller towns & villages where such kiosk would prove as single points of touch for telemedicine and registrations creating a bridge for a population with a lesser amount of literacy levels. Diagnostics, local language support, video camera and integrated network should be an essential part of such terminals, least in remote areas.

HArbor Says: In the era, where the healthcare domain is desperate for cost-effective ways to automate setups & extend care in remote locations, a digital reception will be our golden chance! A digital front door for a the clinic will provide continued care with improving patient experience to a level beyond imagination.

Assisted Telemedicine: A roadmap to improve medical care in Rural Areas

Healthcare in rural India relies mostly on public healthcare units, which has limited public funding & a diminished doctor to patient ratio, which gets strenuous with the limited resources while meeting the large population’s medical needs. On the other hand, due to low profitability, less skilled personnel & low availability of doctors who are ready to work under challenging circumstances, private healthcare units are not able to sustain care delivery in these areas.But, is it necessary to build a big healthcare infrastructure to meet care demands in fragmented rural areas, when 80% of Indian doctors are located elsewhere?

Absolutely not! 

Technology may have introduced retail opportunities for medicos practicing in urban set-up, yet the adaption of such new-age care practices in rural areas is low. Extensive adaption of assisted-medicine will facilitate medical practitioners to reach the rural population while solving unique challenges.

Retail healthcare platforms integrated with Telemedicine & diagnostic capacities will be a futuristic & effective digital care model for evaluating, diagnosing & treating patients without the patients needing to visit facilities that may be located far off from their villages.

Mapping each village to a “Village Health Officer” equipped with tools to carry basic healthcare packages along with diagnostic services would prove essential for chronic care management and access to emergency care providers in real-time for rural patients.

Powerful telemedicine integrated healthcare platform, not only benefits patients, but also assist medicos in:

  • Team-based care
  • Integrating diagnostic analysis in EMRs
  • In-home monitoring of patients for follow-up & continued care

HArborSays: Technology is changing the healthcare practices now, more than ever. Let’s dedicate ourselves to rebuild the rural healthcare foundation starting with Telemedicine and reduce the gap between the patients & medical care providers.