aśvinau health – health at your fingertips by Venu Malyala, @dubugu

EDIT – As of 28th Nov 2020, NDHM issued a clarification that HealthID will be made an OpenIDC as envisioned below. The below was written prior to that

India’s National Digital Health Mission (NDHM) is great opportunity to adopt a truly digital health platform. A pandemic staring at us and with the evolution of policy, standards & technology, a vibrant developer community, a workforce that can be trained, upskilled to deliver the digital services the timing has never been this urgent !

India witnessed massive success of digital payments in Unified Payments Interface (UPI) and has embarked developing a similar model for healthcare. However, fitting healthcare in UPI paradigm comes with its own challenges. In this article I list some of them. Let me know what you think

1) UPI doesn’t provision the user with a bank account. It provides a virtual id that links to the bank account. The custodian of the account is the bank. In NDHM there is a no such account. A new entity in Health Locker is needed, with an app as its user interface

2) In UPI once an asset is transferred, the ownership is changed. In NDHM even if an asset (read Personal health record – PHR) is shared, the ownership doesn’t change. Therefore to safeguard privacy & security, the asset should never leave the custody of the Health Locker. A recipient granted access must login into the PHR with their digitalID to view the shared assets. Even this is complex. The problem is the heterogeneity of the data. Not all users can be allowed to view all data. Expecting a patient to know the role of the recipient and share accordingly, is too naive. We are not talking selective sharing yet. UPI never had these issues

3) Assuming there will be multitude of lockers, the recipients may have to maintain as many logins, if not more, and is unmanageable. Therefore it is important to have one Digital HealthID with scopes, contexts properly attached to it, and proper audit/trail. UPI never had this problem. A lot of innovation is happening in this area, but the one I like & think that can work is a ieft.org protocol called Grant Negotiation Access Protocol (GNAP), proposed by Justin Ritcher. The most I like about GNAP is this :

No alt text provided for this image

Snip from a FHIR meetup youtube video. GNAP extends where OAUTH2.0 stops. As Justin Ritcher says :

To provide granular access, we must know what the grains are

This somehow is seen by some as digging a mountain out of mole hill. The argument begins by stating, “today we have none what is being stated, if it isn’t a problem today, how would it be, later ?” The short and straight answer to any such arguments past, present, future would be :

Ease of Access

Understanding this is not simple, often one needs to think like a bad actor and there are various scenarios, that we mayn’t foresee all of them. But it is enough to say this can be a difference between life & death and anything in-between. I can play scenarios, relate things from past, or even provide a multi-genre script that involves melodrama, romance, horror, comedy to really simplify it and explain. But that’s not the intent of this article

4) A Patient will expect to consume services like book appointments, order medicines, purchase insurance using their Digital healthID. UPI it was never the case

5) All of this is not to be confused with Health Information Exchanges (HIE/HIX). We still need it to exchange data between Insurers (payors), Providers, states, registries, regulators and so on..

6) Once this is sorted out we can figure out, the semantic interoperability, managing consents (app/SMS/IVRS), terminology, archival, selective sharing and so on

7) We, at Appiarise, are working on a modern day healthcare app aśvinau health that is modeled on the above thought process. We plan to launch it in phase wise manner starting off with appointments, tele-consultation, roles based access control (RBAC), calendar & scheduling, health records. It is expected to be launched soon

Here is a quick demo of the app

aśvinau health iSPIRT healthathon – YouTube

As it is often said.. solve the identity, the rest will fall in place

P.S :

1) Removal of jargons and generalizing is simple terms is deliberate. Views expressed are individual

2) Let me know if you want to try out the app

3) Let me know instead, you are interested in the muti-genre script I mentioned above. It comes with a price tag, I am not known for faster delivery times, and I wrote “zero” such scripts before :-)\

Venu Malyala
Venu Malyala

I am an IT architect & developer. I believe in IT enabling solutions for humanity. I founded Appiarise an IT Solutions company in April 2019. I am a HL7 India technical committee membe

The importance of public-private partnership for an outcome-oriented approach in diagnosing and treating breast cancer in India by Anusha Ashwin, @ashwin_anusha

Breast cancer is the most common cancer among women and 80% breast cancer incidents are recorded in women above 40 years of age. This is especially worrisome because the number could be an underestimate as currently only 15% of the population is covered by cancer registries.

Indispensable supercomputers for Coronavirus structure research and vaccine development by Anusha Ashwin, @ashwin_anusha

The Coronavirus causing the pandemic COVID-19 is wreaking havoc in our lives. This efficient infection causing machine, SARS-CoV-2, is comprised of only 29 proteins with a genome 1/200,000 the size of a human being. It is remarkably evolved to trick human cells in its quick propagation causing innumerable deaths and sickness across the globes.

National Digital Health Mission and Role of Future Ready Healthcare Professionals by Dr. Oommen John, @oommen_john

Background:

India has been making steady progress in leveraging information and communication technologies in healthcare for over two decades. Efforts to build and act in the health information systems and electronic medical records in both public and private healthcare settings have been underway. For example, the Centre for Development of Advanced Computing (C-DAC), a premier research and development organization of the Ministry of Electronics and Information Technology (MeitY) developed and deployed India’s first indigenously developed total hospital information system (HIS) software in the 1990s.

Prepping for a remote, contactless healthcare service delivery in India: The essentials by Anusha Ashwin, @ashwin_anusha

The increased need for an acceleration in digital transformation in a post-COVID world is a no-brainer to understand. Healthcare service providers were rather compelled to adapt and digitally innovate to face the unprecedented pandemic in as less than two to three months, pushing hospital IT infrastructure to go above and beyond to find new ways of attending, responding, and treating to in- and out-patients remotely.

e-Sanjeevani– Dr Sanjay Sood explains how milestones were achieved during pandemic by Anusha Ashwin, @ashwin_anusha

The Ministry of Health and Family Welfare’s digital telemedicine initiative e-Sanjeevani has proved its usefulness and easy access for the caregivers and the medical community, and those seeking healthcare services in the times of COVID-19 pandemic. This is touted as a big push for the ‘Digital India’ initiative laid down by the Prime Minister Narendra Modi.

Recently, as announced on October 29th by PIB, e-Sanjeevani reached a new milestone. So far, e-Sanjeevani has completed 6 lakh tele consultations. As of October 12th, the platform recorded 5 lakh consultations. It took e-Sanjeevani just 15 days to complete the last one lakh consultations.

Sophistication in AI/ML application for Diabetic Retinopathy diagnosis has tremendous research scope by Anusha Ashwin, @ashwin_anusha

India – better known as the Diabetes Capital of the World – has been battling with this non-communicable lifestyle associated disease for long. According to the International Diabetes Federation, India’s diabetes population totalled 74 million in 2017 and it is estimated to reach 134.3 million people by 2045.

Diabetes in India is an epidemic that presents itself with several other complications when left uncontrolled or untreated. And notably, complications in the eye and vision are the most commonly associated negative impact of diabetes in India. Among the complications in the eye, the most prevalent type of diabetic eye diseases is Diabetic Retinopathy – which on early diagnosis and intervention is completely curable.

Leveraging Healthcare Technology – To Improve Quality of Care by Harish Rijhwani, @Harish_Rijhwani

The advent of Covid-19 has brought Healthcare Information technology to the forefront. Organizations across the globe have been forced to look at different options to keep their revenues (especially outpatient) going. Telemedicine was conceptualized in the 1920s, till a few months ago it was considered as a target market for only rural areas. In many countries it was still in the nascent stage. The current world situation has forced organizations to consider telehealth/telemedicine very seriously

NDHM’s proposed Health ODE will enable a more inclusive framework for digital health services by Anusha Ashwin, @ashwin_anusha

Introducing

Anusha Ashwin, Consulting Editor

In her first artcile as the Consulting Editor of the Healthcare IT Experts’ Blog, Anusha shares a review of the NDHM’s proposed Health ODE to create a future ready digital health system.

The need for a future-ready digital health system has become even more urgent than ever before with the COVID-19 pandemic hitting us with a big bang. And to be future-ready, experts say that global healthcare systems need to be more open. Most countries around the globe are already convinced with this open source model, so is India.

The NITI Aayog, in 2018, had brought out the blueprint of the National Health Stack (NHS), which is a shared digital healthcare infrastructure, with a view to implement the Centre’s flagship scheme Ayushman Bharat and other public healthcare programs in the country.

In a nutshell, the National Health Stack (NHS) is a visionary digital framework usable by centre and state across public and private sectors. It represents a holistic platform that supports a multitude of health verticals and their disparate branches, and is capable of integrating future IT solutions for a sector that is poised for rapid, disruptive changes and unforeseen twists. When this was proposed in 2018, the aim to create digital health records for all citizens by the year 2022 was earmarked.

Smart Technology for fighting Pandemics – the Future of Contact Tracing Apps by Neha Raturi, Student Author

The pandemic of novel coronavirus that started in the month of December 2019 in Wuhan city in China, caused a grave health emergency around the world. In the absence of any vaccine or drug effective to treat the virus the governments began to search for alternatives to control and mitigate the burden of pandemic. Lockdowns, travel bans, isolations and quarantine and social distancing are the measures that are currently being implemented by governments to contain the spread. Pertaining to its high rate of transmission, the WHO also emphasized on the need to intensify active surveillance to identify, isolate and quarantine infected individuals [1]. The infected show flu-like symptoms that can further lead to severe respiratory conditions, but there also lies a fragment of population that might be active carriers and yet remain asymptomatic.

Leveraging NLP To Analyse Effects of Covid-19 On Baseline Demographics and Barriers to Compliance By Arpita Dutta – Student Author

It has been more than 8 months now since the COVID-19 pandemic. With cases skyrocketing, everything remains very uncertain till now. What we do have now is information, data and huge amounts of research going on globally (Kaggle currently has 220K scholarly articles which is approximately 17GB of data) Healthcare is a very dynamic field as many parameters keeps changing. It becomes difficult to keep a track of this, because there is a huge amount of data online. But how is one supposed to analyse such huge amounts of data with a plethora of information out there? Being a healthcare student, I realised that this is not just COVID-oriented problem, wherever there is data there will always be the goal to analyse it. But how easy would it be to analyse this data and provide a conclusion?

All Posts

Wearable tech is the future for senior adults By Karen Smith

Wearable technology can provide users with a lot of useful information, from heart rate to calories burned and even the quality of your sleep. In fact, a Melbourne start-up Nutromics, has created the first wearable smart patch that is about to track how your body responds to different food and has the potential to reduce the risk of diseases like Type 2 diabetes.

Older adults are more prone to diseases, such as Type 2 diabetes, and wearable technology is providing medical professionals with a way to monitor and treat diseases before they become a bigger threat.

Healthcare #Interoperability on #FHIR: A Collaborative Open Source Project for #Teleconsultation during #COVID19 pandemic by Aniruddha Nene, NCII

Background: Indian Healthcare IT

The common root cause 

When it comes to IT adoption, Healthcare globally has at times picked up behind other industries, in comparison with manufacturing, banking/ finance and other mature service sectors. India has been no exception. Private sector health insurance is struggling and bleeding over a decade and Government health insurance is just making a debut, targeting BPL population. It is not a surprise that the Care providers work in silos and have own priorities ahead of larger good for the community as a whole.

Leveraging Machine Learning Applications for reducing the drug discovery time by Pragya Sharma – Student Author

Pragya Sharma

The entire world has come to a standstill in 2020 due to the spread of COVID-19 pandemic. According to an article published in march 2020 the major cause of this panic is that COVID-19, the illness caused by a severe acute respiratory syndrome known as SARS-coronavirus 2, is much more  contagious and  deadly as compared to other infections, furthermore, there are no approved treatments or vaccines. Currently there are no FDA approved drugs or vaccines for the prevention and/or treatment of COVID-19 (1).

PARENTCARE: Simplifying long-distance caregiving for NRIs by Bharat Vasandani @bharatvasandani

The Indian diaspora (more than 17 million as per the UN in Sept 2019) have always been dependent on family and friends when it comes to arranging medical help for their parents in India. Now with more families than ever relocating for work and economic reasons, NRIs are finding it difficult to rely on their relatives. Covid-19 has further increased the problem as extended families avoid visiting each other. This has pushed NRIs to turn into long-distance caregivers.

HIMSS India Chapter submits comments to National Health Authority (NHA) in response to the proposed National Digital Health Mission ( NDHM) implementation By HIMSS India Chapter Public Policy Committee, @HIMSSIndia

On Wednesday, July 29, HIMSS India Chapter provided written comments to National Health Authority (NHA) in response to the proposed National Digital Health Mission (NDHM) implementation based on National Digital Health Blueprint (NDHB) and subsequent NDHM stakeholder discussions held by NHA.

Digital Healthcare – Laws & Regulations in India by Sujeet Katiyar, @sujeetkatiyar

Digital health is using technologies to help improve individuals’ health and wellness. These technologies include both hardware and software solutions and services, including telemedicine, web-based analysis, email, mobile phones and applications, text messages, wearable devices and clinic or remote monitoring sensors. Really it’s about applying digital transformation, through disruptive technologies and cultural change, to the healthcare sector. Digital health is a multi-disciplinary domain involving many stakeholders, including clinicians, researchers and scientists with a wide range of expertise in healthcare, engineering, social sciences, public health, health economics and data management.

Telemedicine – An Emerging Trend in Digital Healthcare Revolution by Priyanka Miglani

Digitization of healthcare is a reality today. The industry is evolving at a fast pace and disrupting care delivery and accessibility around the world. Digital technologies have facilitated and improved healthcare in remote and isolated locations. In places struggling with the scarcity of infrastructure and resources, health-tech allows access to specialized services.

A Review of the HL7 India Virtual Connectathon-001, July 2020 by Kumar Satyam – Technical Chair – HL7 India

July 3, 2020 was a significant milestone in the journey of HL7 India and for the health IT community in India. Over the past several months, we have been actively involving & educating the community through open houses, meetups, webinars and training on HL7 FHIR & APIs for healthcare. There has been spurt in awareness about interoperability and need for standard based data exchange. We at HL7 India have been striving to equip the implementers & decision makers with the right set of tools to enable them to build a digital future for healthcare in India. The first Virtual FHIR Connectathon is one more step in that direction.

Transforming how preventive health care and wellness is Perceived and delivered in India by Ramakanta Behera, @IHLcom

In India culturally, we follow sick care as it is driven out of fear, not preventive primary care. We generally do not visit hospitals and get our regular tests done until a Doctor has advised to further investigate our symptoms. Sometimes we keep delaying our visit to hospitals until the disease has taken over and symptoms are prevalent. 

#Telehealth and its play in Digital Healthcare by Ambarish Giliyar, @iamgiliyar

By ambarish giliyar, @iamgiliyar

Telehealth and its play in Digital Healthcare

Telehealth is the use of digital information and communication technologies, such as mobile devices, Cloud, Fitness devices, Health devices & sensors, AI-powered Messaging & Chatbot systems and more, to access healthcare services remotely and manage healthcare. These may be technologies you use from home or that your Doctor uses to improve or support healthcare services.

#DigitalHealth in the Aftermath of COVID-19 By Ankita Sharma

This report was first published by Invest India, its been re-published here with the Author’s permission.

Digital Health: A Sunshine Industry

The COVID-19 pandemic has brought to the forefront the critical need for cutting-edge technological tools and innovation in the areas of public health, medicine and wellness. It has reopened the realm of ‘digital health’ in the policy and public discourse, with consumers increasingly looking at the wide canvas of wearable gadgets, mobile health apps and Artificial Intelligence (AI), as well as robotic carriers, sensors and to electronic records. 

#Telemedicine: Hope, hype, or just jumping through hoops? A perspective for hospitals by Dr. Senthil @drsenthilp , Jai Ganesh and Dr. Sai Praveen @thinkMD

Understandably, telemedicine is an inevitability in these extraordinary times. It is predicted that telemedicine could soon replace up to 30%-40% of in-person consultations. Technology adoption to the propagated scale will bring immense changes to the health system. Here we discuss some of the critical factors for a hospital to consider.

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