Insights on DIAGNOSTICS AT LAST MILE By India2022, Authored by Dr. Vandana Sarda, @vandanasarda

Dr Vandana Sarda Blogs

EXECUTIVE SUMMARY

Our esteemed experts, Dr. Sreeram Sistla, Dr. Mirai Chatterjee and Dr. Shuchin Bajaj have pinned down the importance of taking diagnostics to the last mile, given that this is where it matters the most in terms of lessening the burden and cost of diseases such as Non Communicable Diseases (NCDs), for example. They have deliberated on the challenges in achieving this and have also taken a leaf out of their rich experiences, to suggest on as to how innovators can achieve this by aligning the incentives of all stakeholders. The speakers are unanimous in their belief that the indigenous innovations have it in them to be successful, provided they work at it. They came up with insightful observations not only on the technology front, but also on things such as HR interventions, the right mindset, efficient business models, etc.  All three have noted that the Ayushman Bharat scheme is turning the corner for preventive healthcare and that the MedTechConnect platform is doing its bit for the ecosystem. The key takeaways speak volumes about how much still remains to be done, lists the case studies on SEWA and Tata Trust models, as also the Cygnus story, which are all a pure delight to read, learn and get inspired from.  

Why #DigitalHealth will become the new normal by Sujeet Katiyar, @sujeetkatiyar

During COVID-19 pandemic, terms like telehealth, telemedicine, remote-patient monitoring, virtual care and digital health are thrown around very commonly, though these terms have been around for years, but the recent situation is accelerating patient awareness and physician adoption of these technologies.

#FHIR Important Concepts, Terms and Definitions by Manish Sharma, @msharmas

FHIR is the latest interoperability standard based on a RESTful API architecture published by HL7. HL7 has been working for over 25 years in publishing standards for Healthcare data interoperability. The move from the earlier HL7’s 2.x standards evolved to the Development of the RIM v3 and then to FHIR, has now allowed a paradigm shift to leverage web standards. The purpose of this article is to get the reader to understand the difference between the earlier versions of HL7 interoperability standards and then present the important concepts that will help you to understand FHIR concepts, terms and definitions.

Covid-19 – Healthcare Systems’ breaking point or tipping point? By Ambarish Giliyar, @iAmGiliyar

Healthcare systems world over are over-whelmed and struggling with the Covid-19 pandemic. The deluge of infected patients and suspects are stretching the healthcare ecosystem beyond their capacity. Telehealth & Virtual Care tools are being introduced to health systems to increase access and remote-screen people. This and more is happening in addition to the Consumerization demands that has been lurking for some time now.

Digital Health In India – Legal, Regulatory and Tax Overview by Nishith Desai Associates, @AntaniMilind et al

The current legal and regulatory landscape that governs Digital Health is scattered and ambiguous. To make matters worse, there is none or very little legal scholarship in the area of Digital Health in India. The scope of Digital Health is vast and covers various business models, which inherently makes it difficult to regulate as a whole.

This paper seeks to knit together existing laws and regulations into what may be called an “ad-hoc” legal framework for Digital Health in India. It is being written for those who are already invested in Digital Health as workforce or capital contributors as well as those who are still testing the waters. Since this is a research paper, it also seeks to raise questions and takes positions which are yet to be tested with the hope that it would set the tone for legal discussions in larger platforms

An Excerpt from the document

Aarogya Setu – What more could this bridge connect? by Dr. Senthil, @drsenthilp & Jai Ganesh

Is the Novel Corona Virus here to stay? The opinion is different among the experts! In the absence of a vaccine to prevent or medicine to cure, how effective are the lockdown and social distancing going to be in flattening the curve? While the world waits for answers, COVID19 has become one of the biggest mystery humankind has encountered in recent time. Lives of more than half of the world’s population have suddenly become uncertain.

Aarogya Setu, India’s flagship COVID app has become the most downloaded contact tracing app in the world. Should an app with such a tremendous reach be limited in terms of its utility only for the current crisis – the COVID? Or, do we extend its use for an e-healthy connect with citizens?

How a little virus has made a big change in Healthcare by Dr. Sunita Maheshwari

Post Covid: What will change in healthcare: Tele tele everywhere

When we started Teleradiology Solutions over a decade and a half ago, it was unheard of. The concept was new, untested. Radiologists were raw, untrained, unused to this new way of reporting diagnostic scans which was very different than being in person in a hospital. Bandwidth was expensive, unreliable and weak. However, pre covid-it had become a well oiled global teleradiology healthcare practice with smooth and robust IT enabled, radspa enabled workflows.  And Radiologists typically worked part or full time from home as per their personal preference. So when the 4 hour notice lockdown hit India, we could keep working-from homes in India, from homes in America, from homes globally. Suddenly, everyone realised the potential benefits of what we had been doing for what seems like forever!

Digital Health Tech Trends That Will Become Mainstream In 2020 by Madhavi Kanumoory

Before we talk about digital health tech trends, let’s look at what’s happening around us

From a consumer perspective:

  • About 65+% of the population uses mobile phones today, >50% of which are smart phone users and this # is only going to grow exponentially
  • Consumers “expect” information at their fingertips when they want it, where they want it and how they want it
  • Health awareness and focus – consumers today are empowered with abundance of information and there’s a much higher level of health awareness and focus on “well being”
  • People generally want to be healthy and have a fulfilling life rather than spend time in hospitals. A relevant paradigm shift is the fact that the hospitality industry has grown significantly with focus on wellness and luxury
  • There’s a huge shift in lifestyle – it’s about time optimization and how every minute of the day is spent. Underlying this shift is the way people are keeping themselves fit and healthy to enable the lifestyle that they wish for and this is happening by proactively monitoring their vitals, behaviours, exercise routines, eating habits, etc.

The 21 day miracle: Transforming Indian Healthcare: for everyone, everywhere, forever by Dr Sai Praveen Haranath, @ThinkMD

COVID19 has emerged as the single most impactful adversary that humanity has faced. Deceptively small, embarrassingly simple to dissolve yet destroying without pause. It’s not like we do not have a mechanism to avoid or even tolerate when infected. It’s not like we don’t know how to diminish its effects. We even know that millions can be saved by the simplest of no cost social measures including hand washing and social distancing . Despite all these efforts if the virus infects a small subset of Indians the health system will be overwhelmed. This is not because of any lack of effort on the part of the government or even the private sector. It is a question of numbers and having well designed infrastructure to tackle this scourge. 

Health Systems for a New India: eObjects Building Blocks by Dr. Pankaj Gupta, @pankajguptadr

Dr Pankaj Gupta

Here is a sequence of events over the last 8-10 years that lead to the eObjects. India has been majorly a paper-based Healthcare System. However, there have been pockets of success in transforming paper-based processes to electronic systems.

Making HL7 #FHIR work for India by Kumar Satyam, @kr_satyam

Kumar Satyam FHIR for INDIA

“Can I see your blood test reports from last month” – the doctor asked me. “I have it on my mobile” – I told him. I showed him the pdf report the lab had mail me on my email id. “Do you have earlier reports?”– he asked. I started searching my mailbox for previous reports but was unable to locate them. I asked him “Sir, if I give you my hospital Id, can you fetch it from your system. some tests were done in another branch of your hospital”.

Terminology Standards for Health Information Exchange in the times of SARS-Cov2 by Prof. Supten Sarbadhikari, @supten

To provide better and cost effective patient care, one needs to exchange healthcare information. For this to happen seamlessly, there is a dire need of Standards that facilitate this interoperability.

Innovative solutions for India to manage critically ill #COVID-19 patients, a five point agenda by Dhruv Joshi and Dileep Raman, @cloudphysician

Dhruv Joshi, Dileep Raman, Cloudphysician

The reality of the Indian healthcare system

The current onslaught of COVID-19 has brought to the fore numerous issues that healthcare systems face worldwide. India, with its COVID-19 case load trailing China, Europe and the US by a few weeks, is almost certain to encounter its healthcare system’s limitations in the coming weeks to months. Many countries today have witnessed a geometric rise in the number of cases of the virus owing to its infectiousness and unique transmission characteristics. Barring unknown climatic effects or significant mutations in the virus, it is likely to follow a similar course in the Indian population. The similarities unfortunately end here. 

Glossary of Terms – Epidemiology

Glossary of Terms in Epidemiology
  • ENDEMIC DISEASE. The constant presence of a disease or infectious agent within a given geographic area or population group; may also refer to the usual prevalence of a given disease within such area or group.
  • EPIDEMIC. The occurrence of more cases of disease than expected in a given area or among a specific group of people over a particular period of time.
  • PANDEMIC. An epidemic occurring over a very wide area (several countries or continents) and usually affecting a large proportion of the population.
  • OUTBREAK. Synonymous with epidemic. Sometimes the preferred word, as it may escape sensationalism associated with the word epidemic. Alternatively, a localized as opposed to generalized epidemic.
  • EPIDEMIOLOGIC TRIAD. The traditional model of infectious disease causation. Includes three components: an external agent, a susceptible host, and an environment that brings the host and agent together, so that disease occurs.
  • EPIDEMIOLOGY. The study of the distribution and determinants of health-related states or events in specified populations, and the application of this study to the control of health problems.

📝 Salient points from the Telemedicine guidelines for Family Physicians 🖱️by Dr. Devashish Saini, @RossClinics

Devashish_Saini

📜 General

  • A Registered Medical Practitioner is entitled to provide telemedicine consultation to patients from any part of India
  • The RMPs should exercise their professional judgment to decide whether a telemedicine consultation is appropriate in a given situation or an in-person consultation is needed in the interest of the patient.
  • The RMP shall uphold the same standard of care as in an in-person consultation but within the intrinsic limits of telemedicine.

Is India ready to face the #COVID19 Pandemic? by Jeyseelan Jayaraj, @jeyaseelanj

Jeyseelan Jeyaraj

India’s population is 1.3 billion as of 2020 based on the population forecast (1). India is home to 18% of the world population. As per the Mathematical Modeling of Infectious Disease Dynamics (EPI Model), at least 40% of the people are likely to be infected in the US. As per Prof. Lipsitch (2) a well-known Epidemiologist of Harvard school of public health, “40% to 70% of people worldwide are likely to be infected by COVID-19 in the coming year”.

#Telemedicine Practice Guidelines by @MoHFW_INDIA and some resources

Telemedicine Practice Guidelines

In March 2020, The Ministry of Health and Family Welfare, Government of India has published the Telemedicine Practice Guidelines for Enabling Registered Medical Practitioners to Provide Healthcare Using Telemedicine

Telemedicine Practice Guidelines, the need of the hour

Disasters and pandemics pose unique challenges to providing health care. Though telemedicine will not solve them all, it is well suited for scenarios in which medical practitioners can evaluate and manage patients.

Indian Healthcare Organisations and #HealthTech Startups Response to COVID19 [Live Updates]

Live Updates

Please note, this is not an exhaustive list, it’s being updated as and when we are coming across updates from various organisations. The list will be continuously updated. Rest assured there are many more Innovators working to provide solutions and services to Indians. We want to thank people working in healthcare organisations and others providing care and solutions during these testing times 🙏

MoHFW, GOI & WHO:

  • WHO:
    • 1. WHO COVID Alerts on Whatsapp: link
    • 2. Novel Coronavirus (COVID-19) Situation Dashboard: link
  • MOHFW, GOI / State Governments:
    1. Please call the 24×7 toll free National Helpline number 1075 for support, guidance, and response to health related queries on #COVID19.
    2. MoHFW, GoI Website, link
    3. MYGOV Corona Helpdesk Whatsapp Number: +91 9013151515, in partnership with Haptik
    4. Government of Goa in partnership with INNOVACCER Inc has launched a self check tool for COVID19 : https://covid-india.innovaccer.com/#/
    5. ICMR Website, link
    6. Government of Punjab COVA App, link
    7. The Ministry of Health and Family Welfare, GoI issued a document dated, March 2020, “BOARD OF GOVERNORS In supersession of the Medical Council of India” – Telemedicine Practice Guidelines: Enabling Registered Medical Practitioners to Provide Healthcare Using Telemedicine

Consumer-centric digital platform for integrated health care services by Ambarish Giliyar, @iAmGiliyar

…an approach for 2020 and beyond!

Healthcare Consumers’ biggest pain point today has been the difficulty in navigating the fragmented ecosystem! This fragmented ecosystem is leading to impersonal communication & transactions and complicated & time-consuming affair. Due to the increasingly personalized and convenient experiences with other sectors, Consumers have high expectations when it comes to the services they’re receiving from the healthcare industry, according to a new global survey from Salesforce Research.

The future of healthcare and medicine by Dr. Rohit Sharma, @Zinitheai

There is no denying the fact that healthcare costs very high. We all are just 1-2 Serious illnesses away from getting totally bankrupt and losing all your savings if luck goes bad and there is no insurance to cover it. Even if there is no financial constraint, getting access to a human physician and getting to satisfactory quality time with them is next to impossible for billions.

A Synopsis of MOHFW’s Guidelines for Tele-medicine Services for Ayushman Bharat Health and Wellness Centres (HWCs) by Manish Sharma, @msharmas

The MoHFW, Government of India has published the guidelines for telemedicine services for the Ayushman Bharat – HWC. The Guidelines were notified in August, 2019. This article presents the synopsis of the guidelines.

Manoj Jhalani highlighted the need to transform 1.5 lakh PHC and SHC into Ayushman Bharat HWC(AyB-HWC) based on the Goals defined in the national health policy, 2017 to achieve universal health coverage by 2022.

Data Analytics: The Straight-Lined Labyrinth that Entrapped the HIM Profession – @ahimaint

Skills in data analytics are critical to the future of health information management (HIM), yet there has been considerable confusion regarding how to articulate what data analytics means for the profession. In a survey of more than 3,300 HIM professionals, skills in data analysis were ranked among the top five most important skills for future HIM practice.1 

Healthcare, DOXIVA and #HIMSS20 By Tejas Deshmukh, @tejasvdeshmukh

Tejas Deshmukh Blog

Healthcare in the world’s most developed country US, someone asked me is it cost-effective? You know the answer, no, it’s one of the most expensive commodity in the US. US ranks 1st when it comes to per patient spending, yet the World Health Report 2000, Health Systems: Improving Performance, ranked US health care system 37th in the world when gauged on the parameter of patient outcomes. This rising healthcare costs with poor patient outcomes proves the theory that “more money does not guarantee better health.”

Health Data Analytics and clinical terminology systems like SNOMED CT by Prof. Supten Sarbadhikari, @supten

Healthcare, with its inherent complexity, deals with large volumes of data coming in. Well designed and used EMRs (Electronic Medical Records) can collect huge amounts of data. However, neither the volume nor the velocity of data in traditional modern healthcare may qualify as big data now. Only a small fraction of the tables in an EMR database may be relevant to the current practice of medicine and its corresponding analytics use cases.

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