Mobile Healthcare India

Healthcare On Mobiles: Mhealth Model- Dr SMS in India- The Success Story

2012-01-08T10:19:00.000-08:00

Healthcare On Mobiles: Mhealth Model- Dr SMS in India- The Success Story

Healthcare On Mobiles: Mhealth Model- Dr SMS in India- The Success Story:

Mhealth Model- Dr SMS in India- The Success Story

The... patient should be made to understand that he or she must take charge of his own life. Don't take your body to the doctor as if he were a repair shop. -Quentin Regestein

The World of “Speed- Living”! as simple, easy and compact as a mobile phone. Reminds me of Aircel’s popular advertisement “Pocket main Rocket hai”… I think”pocket main Rocket hai” is the right definition of Mhealth today! Many mobile projects struggle with scale and impact. While a mobile health project may run well with a small number of patients in one hospital, expanding the scope of a project until it is large enough to have real impact takes money, time, and widespread support of key stakeholders in a given community. And that is one of the biggest reasons why Mhealth is not keeping too well now-a-days and is suffering from “Pilotitis”.

Therefore, KSITM took this initiative to launch DR SMS in Kerala, aimed at improving health of the citizens of Kerala by improving access to health care resources by making available authentic information, providing timely information on medical and diagnostic facilities and providing informational alerts about emerging diseases. Kerala was also prompted to launch this m-Health project as it ranks as one of the leading States in India on mobile penetration. According to Telecom Regulatory Authority of India, in March 2008, Kerala has a tele-density of over 72 per cent as against the national tele-density of 32 per cent.

Healthcare On Mobiles: Mhealth in India- Pharmaceuticals

2012-01-08T10:17:00.000-08:00

Healthcare On Mobiles: Mhealth in India- Pharmaceuticals

Disease Burden

non-communicable diseases – such as diabetes and cancer – have a slightly greater burden in India than non-communicable diseases – such as tuberculosis and HIV/AIDS.=Mhealth# Compliance and Adherence systems like Simpill to be deployed.
Hypertension is a serious issue on the sub-continent. Driven by changing lifestyles, studies indicate that prevalence of the disease has risen from under 5% in 1960s to 12-15% in the 1990s.=Mhealth# Remote monitoring of the Affected populace.
The WHO estimates that by 2020, a staggering 60% of the world’s cardiac patients will be found in India.In the past 50 years, rates of coronary disease among India’s city dwellers have increased from 4% to 11%.= Mhealth# Daily tips for self care, Drug reminders and Diet and exercise.
India is said to have over 2.5mn people living with HIV. The Joint UN Programme on HIV/AIDS
(UNAIDS) estimates that the number of AIDS cases topped 124,000 in 2006, with a third of patients
being under the age of 30. Overall, 0.36% of India’s population lives with HIV and accurate figures are
extremely difficult to gauge.= Mhealth# the number of cases has been falling in recent months, suggesting that the infection rate has effectively been decelerated by prevention campaigns and programs urging people to practice safe sex.
More than 2.5mn Indians are reported to be suffering from cancer.Oncologists are expecting a five-fold increase in cancer cases in the next 10 years.=Mhealth# Information, Awareness, Remote diagnosis using Telemedicine.

Healthcare On Mobiles: mHealth India- Proof Of concept

2012-01-08T10:10:00.000-08:00

Healthcare On Mobiles: mHealth India- Proof Of concept: Healthcare On Mobiles: mHealth India- Proof Of concept: ..If we look at the mHealth business cases back in 2008, we will realize that with more value chain participants and higher costs of execution, there was very less reward (whether in the form of revenue gains or operational efficiencies) to go around. It therefore became progressively more difficult to achieve the financial impact that provides momentum and leads to partnership with larger players.

Therefore today, with smartphones and other robust systems playing a volume game in mHealth, the latter will not be elusive anymore.

Efficient healthcare systems based on robust infrastructure like smartphones will drive revenue for all stakeholders in the next 5 years.

Which stakeholder will lead this Business?

It will be Mobile Operators/Carriers. Here is why:

Operators Define Connectivity: The progression of mHealth will largely be dependent on innovations in telecom and the speed of implementation of the same. 4G /LTE (Long-term evolution) will revolutionize the way data is sent over wireless networks. In the near future, I envision a scenario where a consumer can set up a telehealth appointment and get a physician consult leveraging the high speed wireless connection and high-def video conferencing capability right from his handset.

Hands on experience: Operators have a proven track record of implementing innovative technologies on a large scale (2G/3G/4G capability, smartphones connected to “app stores” with thousands of applications etc) and adapt them to different geographies in a highly competitive market.

Knowledge of Local customer needs: Deploying telecom solutions in various geographies and complying with local regulations, legal framework has enabled operators understand the local customer and their needs. Partnering with operators will enable organizations deliver specific solutions that meet local customer needs.

Already, Mobile operators have tremendous influence and strong relationships with handset manufacturers, and they should leverage this position to bring to market phones and other devices that can provide the mHealth and other mobile services consumers in developing countries need.

mHealth India | Press releases India

2012-01-07T07:33:00.000-08:00

mHealth India | Press releases India

HealthCursor, a niche mhealth consulting company based out of India aimed at delivering Insight Driven Healthcare solutions while realizing the promise of a connected health future was launched today. Through HealthCursor Consulting, clients in the India, Middle East and North Africa will have access to leading experts based in the region, while also benefitting from the company's strong links with practitioner communities and regulatory bodies in developing countries. HealthCursorConsulting is launched in direct response to growing demand from clients in the region for mHealth consulting services, and is a natural complement to the Founder's expertise in Healthcare IT business management and financial services.

"We are putting in a team together to innovate and deliver new value by improving health outcomes and look past standalone systems and find more ways to connect fragmented healthcare ecosystems in developing countries and support new forms of care delivery, "said Dr. Ruchi Dass, Founder of HealthCursor. "This enables unprecedented capabilities to provide the right care at the right time for a whole new breed of healthcare."

Healthcare On Mobiles: Mobile Healthcare scenerio in India

2012-01-04T05:18:00.000-08:00

Healthcare On Mobiles: Mobile Healthcare scenerio in India: India is the second most populous country of the world and has changing socio-political-demographic and morbidity patterns that have been d...

Healthcare On Mobiles: Mobile Healthcare scenerio in India

2011-09-09T12:04:00.000-07:00

Public Partnership- Mobile Healthcare India

2011-06-24T09:38:00.000-07:00

Public Partnership- Mobile Healthcare India: "Was busy the last weekend preparing for the GTF conference in Delhi.You can learn more about this by clicking on the emblem on the left . Go..."

Mhealth in India- Pharmaceuticals

2011-06-24T09:36:00.001-07:00

Mhealth in India- Pharmaceuticals: "The Technology Driven data channels offers a key opportunity for pharma companies to restructure their sales and marketing model, improving ..."

mHealth and Network security

2011-06-24T09:36:00.000-07:00

mHealth and Network security: "1. What are the major trends you’re noticing in healthcare mobility? In a country like India where Doctor to patient ratio is 1:900, Doc..."

mHealth India- Proof Of concept

2011-06-24T09:35:00.001-07:00

mHealth India- Proof Of concept: "Recent quote: “ In the years to come, mHealth applications will be distributed primarily through healthcare distribution channels like ..."

Mhealth - Counterfeit Drugs India

2011-06-24T09:35:00.000-07:00

Mhealth - Counterfeit Drugs India: "WHO tells a story “By April 1999, reports of 771 cases of substandard drugs had been entered into the WHO database on counterfeit drugs, 77%..."

Mobile based Healthcare model

2011-03-03T07:25:00.000-08:00

Healthcare On Mobiles: Mobile based Healthcare model: "Mobile based Model- The Process and the Differentiation Value Chain Healthcare Social Linkups ..."

Healthcare On Mobiles: 512 kbps of Mobile Healthcare

2011-03-03T07:24:00.000-08:00

Healthcare On Mobiles: 512 kbps of Mobile Healthcare: "The other day I was sitting with my Mentors and I realised that Doctors in India can do wonders if we provide them with 512 kbps bandwidth o..."

Healthcare On Mobiles: Mhealth - Counterfeit Drugs India

2011-03-03T07:19:00.000-08:00

Healthcare On Mobiles: Mhealth - Counterfeit Drugs India: "WHO tells a story “By April 1999, reports of 771 cases of substandard drugs had been entered into the WHO database on counterfeit drugs, 77%..."

Healthcare On Mobiles: Mhealth India- Counterfeit Drugs Check

2011-02-01T13:50:00.000-08:00

Healthcare On Mobiles: Mhealth India- Counterfeit Drugs Check: "WHO tells a story “By April 1999, reports of 771 cases of substandard drugs had been entered into the WHO database on counterfeit drugs, 77%..."

Healthcare On Mobiles: mHealth and Network security

2011-01-10T02:06:00.000-08:00

Healthcare On Mobiles: mHealth and Network security: "1. What are the major trends you’re noticing in healthcare mobility? In a country like India where Doctor to patient ratio is 1:900, Doct..."

Healthcare On Mobiles: Mhealth in India- Pharmaceuticals

2011-01-03T06:19:00.000-08:00

Healthcare On Mobiles: Mhealth in India- Pharmaceuticals: "The Technology Driven data channels offers a key opportunity for pharma companies to restructure their sales and marketing model, improving ..."

Healthcare On Mobiles: Mhealth in India- Pharmaceuticals

2010-11-01T04:57:00.000-07:00

DR SMS- A successful Mhealth model from India

2010-10-19T09:17:00.000-07:00

The... patient should be made to understand that he or she must take charge of his own life. Don't take your body to the doctor as if he were a repair shop. -Quentin Regestein

The project was piloted in Kozhikode (Calicut) in the district of Kozhikode in Kerala. The choice of Kozhikode was based on the fact that it is the third largest city in Kerala with a population of approximately 20 lakhs. Kozhikode was also chosen for the project piloting because it has the highest rates of mobile penetration in the State. Kozhikode also attracts huge migrant population/tourists, who are also one of the main targets of this project. The pilot project met with overwhelming success. The service was especially lapped by the large numbers of tourist population who did not know whom to contact in case of a medical emergency. During the pilot phase, an average of 200 daily transactions took place through the Dr. SMS facility.

The project has a credible and sound database on hospitals and emergency health centers drawn from a large data from the Health Infrastructure Survey, conducted by the National Commission on Macro economics and Health (NCMH), Ministry of Health and Family Welfare, Government of India. The system is supported by the National Informatics Centre and the State Information Technology Department. Encouraged by the success of the pilot project, the Government announced the launch of the project in all districts of Kerala.

What should be the Step 2 now?

I personally feel that Dr SMS can be very well linked with NRHM objectives for the State of Kerala. We actually have a lot to learn from a similar concept which Matt Berg described, during my visit to London. It’s called the ChildCount health monitoring system.

The project provides mobile phones to community health care workers who then use SMS to coordinate activities such as registering patients, transferring data to a central database, automatically alerting health workers to patients’ needs and facilitating communication among members of the health system. Roughly 100 community health workers at the Kenya site are equipped with mobile phones to monitor registered children for malnutrition and malaria.

The project’s five goals are to register every child under five in a given community into the ChildCount database, screen those children for signs of malnutrition every 90 days, monitor the children for the three major causes of death in children under five (malaria, diarrhea, and pneumonia), group all children into age groups in order to streamline immunizations, and record all local child births and deaths. The program has been meeting these goals with considerable success; for example, when the program incorporated a measles immunization awareness program, over 8000 children were vaccinated within seven days.

What will be the Business Model?

Though I am all set to pop a bill for this, I believe that NRHM should seek external funding as well. The ideology should be- “If the ultimate Goal is the same, Let us not work in silos, Let us work towards the common goal together”.Some of the Initiatives that could be of Interest to NRHM to collaborate with are:

Bill & Melinda Gates Foundation, Intel Digital Health Group,Robert Wood Johnson Foundation, McKesson Foundation, World Bank, UNICEF, UNFPA, European Commission, John Hopkins NCCC/GIAHC, U.S. Agency for International Development (USAID), Vodafone Americas Foundation, West Wireless Health Institute.

Reproductive & Child Health-II (RCH) program has already got funding from World Bank and the European Commission and We all know that the Rural Health Mission in Bihar recently got funding from Bill Gates Foundation.

According to the MoC, the Foundation will provide technical, management and program design support via NGOs in the areas of maternal, neonatal and child health; maternal and child nutrition; vaccine-preventable diseases, tuberculosis, pneumonia and Kala-azar, among others. While the MoC applies to all 38 districts in Bihar, the Foundation will initially start work in the nine districts of Patna, Banka, Khagaria, Begusarai, Gopalganj, Saharsa, Samastipur, and East and West Champaran. ..

To accelerate this momentum and fully unleash the potential of mHealth applications, dynamic multi-sector collaboration between groups as diverse as governments, multilateral organizations, and the private sector is needed.

We talk about 600 million subscribers in India- Are these subscribers or Connections?

2010-08-17T22:15:00.000-07:00

A recent report by India Mobile 2010, shuns TRAI for claiming a base of 621.28 million mobile subscribers at the end of March this year.India is without doubt the fastest growing telecom market in the world, but it had only 304 million subscribers at the end of May this year, according to a report by Juxt Consult. While Juxt survey measures and reports both the mobile users (subscribers) and mobile connections (subscriptions, ie who take new connections), TRAI data reports only the mobile connections, (which it mistakenly calls ‘subscribers’).

Apart from that, while TRAI data indicates a 75:25 split in urban and rural mobile connections, the split at both the subscriber level and the active connection level as found in the Juxt report is closer to 50:50. The report says that the mobile subscriber base in rural and urban India is 146 million and 158 million, respectively.

Also, according to the Planning Commission, 27.5 per cent of the population was living below the poverty line in 2004–2005, which means that only around 70 per cent of the Indian population can be the target subscribers.

There is little clarity on how the urban-rural split is recorded and reported by operators, and TRAI, and whether all SIMs in use in rural areas are recorded as rural, as many such connections may actually be getting bought in the urban areas.

Talk about a world of FREE SMS- (If you pay for an SMS, it got to be delivered. However there is no guarantee today, that is the reason why emergency or crisis management communication can't happen on SMS.- so why Operators are not giving SMS FREE- Is there something Handset providers can do- Yes yes Yes!.)

Wynncom has entered an exclusive agreement with a free SMS service application provider 160by2.com. The agreement will allow users to send free SMSs from their mobile phones through an embedded application.

Wynncom mobile phones will have a preinstalled application developed by 160by2.com, one of India’s largest free SMS service providers. This unique application enables mobile phone users to send free SMSs to any mobile in India and in the UAE, Kuwait, Saudi Arabia, Singapore, Malaysia and the Philippines.

This application will use a GPRS connection to send the SMS, and the charge for data use will be miniscule.

Sometimes, I wonder why Mobiles are the only effective source of communication Today? - Think of the engorging Deaf and Dumb population in India!

In Australia, more than 50 percent of the general population sends at least one text message a day.The result is a nearly universal, text-based communications medium that connects the deaf to the hearing world. By using text messaging, deaf mobile users can order a pizza or invite friends for a beer. It's great for younger people because their group of friends is extended to their peer group, and not just other deaf people.

I remember visiting a Deaf and Dumb village in Kashmir. People in Dadkai Gandoh village of Indian administered Kashmir's mountainous district Doda are becoming victims of an incurable genetic disease, which renders them deaf and dumb. At least 72 such cases have surfaced so far from the village and its adjoining areas. The figures are feared to rise in near future.

But here is a good news!Soon, deaf and dumb can talk on mobile using sign language.- Result: Better education facilities, Health related Information dissemination and much more...

Developed by engineers at the University of Washington (UW), MobileASL uses motion detection technology to identify American Sign Language (ASL) and transmit video images over cell networks in the US.

The tool, which can be integrated to any high-end mobile phone with a video camera, is undergoing field tests involving 11 participants and the researchers plan to launch a larger field study this winter.

Earlier, speaking in the valedictory function of E-India, Union Minister for Communications and Information Technology, Mr A Raja said M-health was the fastest growing part of e-health and its importance was increasing.

The rapidly increasing importance of mobile phones as a platform for healthcare delivery in recent years is mainly attributable to substantial price reductions and the resulting rapid expansion of mobile phones used around the world, he said.

As per TRAI predictions, mobile VAS revenue growth contributing to telecommunication industry is expected to grow to 30% in next 5-7 years, which is way beyond the current contribution of 10-12%. Many experts are predicting mobile VAS in India to be 1 billion USD market by 2011. Let us wait to watch, what is there for Mobile VAS service providers in 2011.

Useful Links:
http://telecomyatra.afaqs.com/news/index.html?sid=1584_India+has+just+304+mn+mobile+subscribers

http://telecomyatra.afaqs.com/news/index.html?sid=1586_Wynn+Telecom+to+enable+free+SMS+on+its+upcoming+handsets

http://telecomyatra.afaqs.com/news/index.html?sid=1592_Soon+deaf+and+dumb+can+talk+on+mobile+using+sign+language

Mobile health India -Learning from the west

2010-06-21T09:19:00.001-07:00

Was busy the last weekend preparing for the GTF conference in Delhi.You can learn more about this by clicking on the emblem on the right . Government Transformation Forum is first of its kind forum aimed at enhancing collaboration and exchange of learning practices among the industry, academia, civil society organizations and the public sector in India. Through this forum, the organizers intend to keep the stakeholders abreast of the latest trends and cutting edge technologies so that the e‐Government programs are designed keeping in view the needs of the next generation. You can expect a lot of action here...

I was thinking while discussing the mobile health care concept with my peers, that if in case my Medical Insurance can't give me freedom from long waiting periods; my prescription delivered at home; Nurse and physiotherapy facility and continuous monitoring for my old parents and Real time Emergency Response in seconds, probably I will not opt for one.

But in India, is it too much to ask for??
Well, to cite a feasible example, Jon Pearce and his partners have created a technology called Zipnosis, which allows patients to get diagnosed and treated for minor health issues using a computer or mobile device. They call it “Health Care in Your Pocket.”

The process they’ve created is quite simple. The patient arrives at the site-->A series of questions are asked—>>>similar to what a patient might be asked in a normal office visit—>>that should take about five minutes to answer. This first step is referred to as “bullet-proof medical.” He means that the questions are designed to give a medical clinician the information they need to diagnose the problem—without the need for a physical examination.(Applicable for a few diseases only but can be lifestyle diseases like Diabetes, asthma, hypertension, arthritis to start of with.)

After the patient has submitted their answers, Zipnosis sends a text-based communication back to one of their on-call clinicians. The clinicians usually will have one of three general responses:

(1) suggesting an over-the-counter medication and get-well plan;

(2) prescription for an antibiotic; or

(3) a recommendation to see a physician for further examination.

Lastly, the patient receives a response from the clinician regarding their diagnosis and recommendation.

If a medication is prescribed, a map will be presented, indicating where the closest pharmacy is located, based on the GPS location of the patient.

This means that a patient could be almost anywhere when they receive their diagnosis. If I live at Karol bagh but when I am seeking help I might be driving close to Aurangzeb Road and thus would be looking at a pharmacy within 800 meters from there, once a prescription is received.

Now the Question is, who will enforce something like this in India...and through what?

Telecom Operators are "the king" in India. Telecom Regulatory Authority of India (Trai) is planning to introduce spectrum audit to ensure efficient use of spectrum by telecom operators. Now what is the meaning of Efficient? Government is the only entity that can enforce Health, Prevention, Reach and Outgrowth. 6.2 MHz spectrum is available in 2G in most of the cities while in metro cities 10 MHz is available. The word efficiency clearly indicates:

1. Smaller number of operators. (New operators are coming up and ready to give 3G Spectrum linked one time fee)(Bharti Airtel, Vodafone Essar and Bharat Sanchar Nigam (BSNL), stand to lose tens of thousands of crore if the government accepts suggestions Trai to charge 3G-linked one-time prices for spectrum already allocated to these firms many years ago.)

2. If we talk about taking mobile health to Rural India the government should implement this with Telecom operators by giving subsidies to private operators rather than a centrally owned government authority being given the responsibility to do that.

3. The Rural India- On a per circle basis, it is clear that India’s growth largely depends on rural demand and how fast mobile operators can connect the unconnected. Nevertheless, even though we believe there is clear evidence that 3G can help to bridge the so-called 'digital divide' in India, it will take time for mobile operators to develop users’ appetite for data services. A number of factors will influence the rate of adoption, but pricing is the most important.

Mobile Healthcare Scenario in India

2010-06-16T07:26:00.000-07:00

India is the second most populous country of the world and has changing socio-political-demographic and morbidity patterns that have been drawing global attention in recent years. Despite several growth-orientated policies adopted by the government, the widening economic, regional and gender disparities are posing challenges for the health sector. About 75% of health infrastructure, medical manpower and other health resources are concentrated in urban areas where only 27% of the Indian population live.

The new buzz is Mobile Health; in simple words it means access to valuable information and consultation for preventive and post treatment advice targeted at doctors and end users. The idea is to use telecom as a backbone tool to leverage the current brick and mortar model of Healthcare delivery across the country.

The scope of Telecom as well as technology to disseminate valuable and personalised Health information is now evolving. Better practices are expected to rely heavily on telecommunications services. Most of the high costs inherent in the current system are related to the proximity of the patient and provider, as well as to the archaic administrative systems used to manage records and exchange information. Telecommunications can bridge these proximity gaps as well as provide a normalized set of baseline data that can remain secure and yet be shared among healthcare workers.

While a major step was taken by Dr. Brilliant to eradicate even the smallest remnants of Small Pox from India, digital technology was used to predict and prevent this infectious disease depending on information that fed in from the grassroots. Teledensity in India is increasing at a phenominal rate and Soon Mobile handsets will emerge as a Mass targeted Medium, and hence various Health awareness and Information programs can be penetrated amongst the end users using the same.

Today, 90% of operator’s revenues come from Voice and Rentals. Of the balance 10%, about half comes from Person-to-Person (P2P) SMS. So, VAS accounts for only about 5% of revenue. Operators have primarily focused on voice. I see a new breed of companies emerging who will create direct-to-consumer services and focus exclusively on VAS. They will have multiple revenue streams - not just from subscribers, but also from advertisers and businesses. 3G will be a big enabler for richer services, and can actually drive higher ARPUs (Average Revenue Per User). Consumer will sit at the locus, and Healthcare services will become more consumer oriented, consumer driven and on demand.

The major need gap which can be addressed to, using Mobile based Information is Preventive Healthcare i.e. measures taken to identify and minimize risk factors for disease, improve the course of an existing disease and screening for early detection of disease. It is been said that by the end of 2009 3/4th of the Indian Population shall be covered by a mobile network, many of these new subscribers are from Rural India and hence the next possible market for derived revenue and penetration for Healthcare is the rural and semi urban population along with the urban saturated market which will possibly grow with VAS.An SMS on your mobile Phone is more personal and targeted, it forces you to take a moment to think and may be act.

The Consumer advantage scenario will take into account the seven major considerations of Cost, Quality & Relevance, Reach, Real time, on demand and Convenience.

Nominal subscription fee of say Rs. 30/month for Healthcare information and Tips on mobiles will be perceived as far more relevant when compared to spending the same on ring tones, Jokes or entertainment. The Challenge here lies in creating awareness as to how an early detection of disease will control your Health Insurance premium and lower your hospitalization costs. Also, a continuous follow up of an already detected disease using subscribed health information will reduce frequent doctor visits and in turn incurred cost.
The Quality of information dispensed should be from a reliable source, should be relevant and of local disposal. Partnership sources should include private and government participation using a strong and well branched out data collection network and a team of doctors.
People in rural areas usually have basic handsets, where literacy concerns are not paramount text messaging offer significant advantages in terms of convenience and flexibility. Information dispensed in local language with the ability to store and send data on ways to stay away from the possible ailments is the key.

As is the distribution and prevalence of certain ailments, so are the demand options, for e.g. Ulcerative Colitis is common in Punjab in north India, Cardiovascular diseases are more common in South India. Therefore, either data taken from the consumers can be utilized to develop an On Demand service or MOHFW or WHO Information base can be used to target risk factors in a particular community. An interesting publication in WHO Global Infobase indicates high prevalence of Multiple Coronary risk factors in Punjabi Bhatia community.

Convenience is probably the signature mega trend of the next era since the consumer desire for time saving plus the insistence on simplifying complexity coincides with technology developments able to deliver precisely the desired information in real time. Early detection of a disease always pushes early response and management. The information provided should enable the End User take informed decisions as a part of Primary Healthcare Module. In this model, Consumer convenience and rights to access the information is the major gap, which needs to be bridged.
The whole process of Mobile Healthcare not only requires knowledge of applicable requirements but also a thoughtful combination of technology, laws, policies, Insurance, procedures, appropriate contract provisions and regulations.
Maximizing the mobile and technology benefits in the coming era will offer effective Healthcare Management at the commencement of such a venture and beyond.

Potential of Mobile telephony in Mobile Healthcare

2010-06-16T07:23:00.000-07:00

The potential of mobile telephony is to bring health care to the majority. Acute and emerging epidemiological challenges are encouraging public sector to welcome and support the development of increasingly innovative health care initiatives. Given that nearly 70 out of every 100 people carry a mobile phone in the region, if the easy-to-use mobile platform can be applied to health care to contribute to increased equity, mobile care could also contribute to improved clinical outcomes and productivity, as well as to better public health monitoring and education.

Oh yeah! we know about the potentials but then where does mhealth exactly fit in? Is it for Prevention?- Disease management or Real time monitoring?..

Actually Mobile Health is gonna be everything- Mobile health is a recently coined term, largely defined as health practice supported by mobile devices. For purposes of this note, mobile health practice includes public health, clinical medicine, and self-monitoring supported by mobile phones and personal digital assistants (PDAs).Currently active mobile health applications include the use of PDAs in collecting community health data; using the mobile phone to deliver health care information to practitioners, patients, and nonpatients; and real-time monitoring for citizens, both patients and nonpatients.Mobile health services tend toward preventive care and support for wellness, essentially helping individuals take care of their health before they become patients.

Ok! So if we talk about India what will support its growth, PPP?

Acute and emerging epidemiological and demographic challenges to health care systems are pressing the public sector to welcome and support the development of increasingly innovative approaches and initiatives. Emerging fields in health care include biotechnology (gene therapy, etc.), nanotechnology (instrumental in drug delivery), and information and communication technologies (mobile health). Together these offer a basket of new tools to address health care issues.

Need of the Hour?
The potential benefit of the mobile phone as a tool in widening access and improving health care is clear. Increasing penetration, combined with a wider range of possibilities for communication and an easy-to-use platform, allows access to less technology-literate groups.

So as the increasing subscriber base is in rural India, there is pressure to bring on best value benefits to the rural Consumer. No wonder Nokia Life tools Agri services forecasting weather to farmers and fishermen is such a hit. The mobile market in rural India has significant potential with number of subscribers anticipated to grow at a CAGR of around 32% during 2009 to 2012. When we talk about bad terrains , climate and remotely located areas. More than Mobile commerce, More than Location based services- The prime and the most important are Occupation related VAS (that's why lifetools is a hit) and Healthcare Value add services.
I think that's the way to go ahead...Need and supply....

Workshop- Mobile Based Healthcare Business Models for India

2010-06-16T07:18:00.000-07:00

The Mobile Healthcare Industry summit brought up all the stakeholders to discuss and share views on the best practices all across the world. The Post Conference Workshop led by me on “Mobile Healthcare Models for emerging markets” provided a participating opportunity for all players in the ecosystem to clearly define and strategize Challenges as well as opportunities in countries like India, South Africa, Kenya, Indonesia etc. I was pleased to see the overwhelming response and enthusiasm.
Some Key points that were discussed were why emerging markets? What is the role of mhealth in India, Africa etc.? Who will pay? Why will they adopt mhealth systems?
Pretti Lounamaa and Seppo Luede suggested some very initial points to approach these methodologies. First, Size the market, when we are talking about market we are not only talking about the addressable market but also the number of stakeholders and customers who are willing as well as able to purchase or are interested to deploy. This was the thought that led us to reach to the next point of minimum base infrastructure available and required.

Dr Ruchi Dass- mhealth is quite new and thus the competitive indicators to develop or define a market size from the bottom up are absent and information about health providers, task force and expenditures from the top down lacks detail for India and other such developing countries. We Live in India where most of the people still don’t have their Birth Certificates. So we moved to Market opportunity and I suggested to start from somewhere like Joining Hands with Big hospital chains like Apollo. So we positioned mhealth as end to end as in to start with Education/awareness--------à Monitoring---à Data Access------à Disease tracking/Emergency------à HIS---à Diagnosis/Consultation. With a Doctor to patient ratio of 1:900, this looked like a reasonable solution to start with.

Per Ljungberg et al, have developed some very advanced and useful solution related to prevention and remote monitoring of patients, some of them also address wellness. Here, Per mentioned that how mobility appropriateness is necessary and how it is dependent upon a balance of technical performance, cost and efficacy. Talking about Bandwidth problems and connectivity issues, Per suggested that there is no point waiting for the 3G and other such advanced technologies to get deployed in developing nations, Some simple solutions can bring success to the overall approach as well.

Dr Ruchi Dass- Mhealth, ehealth, Telehealth and everything similar are facing the Silo based problems today as was clearly mentioned by Neil Jordan of Microsoft in his speech. Something is compatible to PDA, something to Laptops and something to mobiles. I feel that the technology should be backwardly compatible as well. It is difficult and practically impossible to scrap Windows 99, 2000 and XP when Vista arrives. Mhealth is not only aimed at moving to new healthcare delivery models but also to strengthen and transform the existing weak health systems. Some very simple solutions of Mhealth are Healthmate by Airtel in India, DrSMS by Kerala IT mission in Kerala, India and SIMPILL in Africa.

Dr Mohammad Arif Ali- Dr Ali suggested some systems overviews in particular like Success and Failures of Electronic Medical Records, What were the factors affecting? What are the advantages and disadvantages of Open Source software in terms of a Developing country perspective? Understanding Social Behaviors in a new country is as important as understanding the Government Policies. Dr Ali cited some such examples.
Dr Ruchi Dass- Mobile based primary healthcare management system in which each family/individual will have an up-to-date data will prove to be a valuable tool for maintaining, analyzing and interpreting enormous data. It will also be used to provide personalized attention to the consumer.

Manfred Kube, stressed that the healthcare industry is realizing inefficiency in the system and is moving towards a system in which connected applications aggregate, visualize and manage medical data on web-based platforms. He narrated some good examples of Data access which would provide clear picture for patients, doctors and service providers to all aspects of a patient’s health. Manfred wanted to understand the self care and home care market in India.

Dr Ruchi Dass- With so much of disease burden in India, Inefficiency should have no room, as it further delays access and cover, but big hospitals or Insurance providers show hesitation in buying and deploying a solution such as electronic health records etc. for two main reasons:
1. There is no public support for insurance companies as well as hospitals to do this, not even any motivation. Also they feel that it is a futile practice as Apollo group will never share their records with Escorts group or Fortis group and vice versa, so there should be a third party managing the same.
2. In case the third party comes as a Government regulation or policy with a different structure, this investment of the hospitals in medical records will go futile.
So, I suggested the role of Telecom operators in this, in managing something like this and charging consumers for the value add. See one example from HealthNet Global .

John French -The presentation on Corporate Wellness was good and I would like to recommend theyoucompany.com.The Traffic light concept for Danger, Moderate and Healthy interests me the most.Wellness industry is growing at a very fast pace and basically most of the people who need mhealth technologies help are Old Age people who are not mobile, These people may need remote monitoring, emergency aid and other help at their convenience and this will be possible using technology and mhealth in near future.

Adesina Illuyemi explained that Health care delivery in the developing world often relies heavily on public sector services that reflect the political structures. Different provinces, districts and villages will have different health authority and facilities. Scaling up of the Healthcare systems is required, but these new models should be cost effective, made using appropriate technology and should be scalable. Cross sectoral public policies have constraints may include government bureaucracy and poor communication, connectivity and transport. He said that strengthening Healthcare systems in developing countries is a formidable task.

Dr Ruchi Dass – The obstacle that need to be overcome include appropriate model of healthcare financing, building physical infrastructure, assuring access to medications, qualified and dedicated workforce and efficient use of technology, including wireless and mobile technology. To ensure broad access to needed services adequate financing is required. The WHO recently suggested that $ 34 per person in spending on health could provide essential health services in low income countries to address major communicable and other diseases.

Mhealth may be able to support new systems of care that offer both generic and personalized health information in a more accessible, lower cost ways. Mhealth could decentralize effective care strategies into a community setting and develop larger networks for care.

Thanks for the participation!!!

Mobile Healthcare India

2010-06-15T13:17:00.000-07:00

The other day I was sitting with my Mentors and I realised that Doctors in India can do wonders if we provide them with 360 kbps bandwidth on mobiles. Apollo Telemedicine Network Foundation and Ericsson started a program sometime back in 2007 called "Gramjyoti" in rural India and that was considered to be a big foray of telemedicine in rural healthcare.Thousands of people within the Gramjyoti project area covering 18 villages and 15 towns were able to use broadband applications. Ericsson worked in partnership with Apollo Hospitals, Hand in Hand (a local NGO), Edurite, One97, CNN and Cartoon Network to deliver a range of services including telemedicine, e-education and e-governance.Point to be noticed is the prolem area. Sometimes the main factor itself is not the sole criterion on which the success of a project depends and that is what we learnt. Those were the days of GSM technology and the conditions of roads in India was bad especially in the rural areas. Consider a van where people are coming to Be treated/Operated.This van was well equipped but a small ditch or bump on the road, and the wireless transmitter used to turn 360 degrees and we could see nothing...Trust me if we can get 512 kbps on mobile, It will be like a boon for us Indian doctors to serve those patients who live in far-flung areas and need medical attention.

"In India, there are 1 million people that die each year purely because they can't get access to basic healthcare," said Dan Warren, director of technology for the GSM Association, the umbrella organisation that hosts the MWC.

For people in Rural areas, prevention still starts with Good roads, Better electrical and water supply, Proper Sanitation and then we can talk about Health and wellness with them.Through video conferencing, doctors based in Chennai, 70 km away, held surgery with patients in village citizen centres and the Gramjyoti broadband van. The patients were supported by paramedics who could administer ECG tests, blood pressure and injections. Overall 200 patients were treated like this during the trial.Ninety percentwere givenmedicines on site, and 35% have been referred to consultants.We used the UETR and GPEH to track for any problems that arise during drive test activity.

Lesson/Tip for a Rural Healthcare Project (If one is planning to start one):If you want to roll out 3G in a cost effective way, you need to attack capex and opex costs. Seventy percent of these are in the towers.Gramjyoti project with the help of network operators showed that site sharing works.The site sharing experiment showed that what we did in 20 villages, we could do in 250,000 villages without any problems.This is roughly the number of GSM cells in India and each one could share a tower with a 3G cell without interference. Operators came, the regulator came and people fromthe government came to see the trial and they left convinced that site sharing works. With site sharing and refurbished 3G handsets,we can bring the same economics to 3G that have made 2G such a success. It’s a myth than 3G HSPA is only for urban environments.

There's a business case for it now; you have to have the experience of the Healthcare Providers + Telecom Providers and on the ground talking to the big corporates out there and creating real business models, and that's the only way to success.