Arnab Paul

#Blockchain for HealthCare Equity by Arnab Paul, @iArnabPaul

In a digital Age when cars drive themselves and CEOs hold meetings across continents in virtual reality conference rooms, engagement of the disenfranchised is a less attractive endeavor than the sleek apps, making it an outlier in the realm of tech solutions.

In our endeavour to promote digital india it should be our collective effort to bring healthcare to the disenfranchised and to the people who slip out of the cracks.

Most of us just don’t bother to take care of the elephant in the room, its time all the stakeholders joined hands and come up with a solution. For me personally Equity is of paramount importance in healthcare.The lack of focus on vulnerable populations in patient safety discounts the significance of the many lives lost, all precious to those who love them. we have yet to place strategic emphasis on the need to protect all. A man’s life lost to medical error then disguised as a heart attack, either intentionally or because of unconscious prejudice about the depth of his pocket, is more than a patient safety event. 
For the millions of people who have been exposed to discrimination based on their spending capacity and limited access to resources and denial of equality in humanity, such an event adds insult to tragic injury.We must connect in ridding our health system of all forms of inequality and ensuring that all people are protected from harm equally.
As hospitals and care systems work to improve quality of care and prepare for coming changes in the health care field, the ability to fully understand their patient populations and communities is critical. Collecting and using ethnicity, language, spending capacity data will help hospitals and care systems understand their patient populations and address health care disparities. While many hospitals are successfully collecting REAL data, fewer are effectively stratifying the data to shed light on health care disparities,
We need to systematically collect REAL preference data on all patients. We need to use REAL data to look for variations in clinical outcomes, resource utilization, length of stay and frequency of readmissions within our hospital. We need to compare patient satisfaction ratings among diverse groups and act on the information. Above all we need to actively use REAL data for strategic and outreach planning for the underprivileged.
Patient satisfaction is not a clearly defined concept, although it is identified as an important quality outcome indicator to measure success of the services delivery system
There is no clear consensus between the literatures on how to define the concept of patient satisfaction in healthcare.
In Donabedian’s quality measurement model
patient satisfaction is defined as patient-reported outcome measure while the structures and processes of care can be measured by patient-reported experiences
For everything in life we need some kind of metrics, some tools to measure the clinical outcome and the patient satisfaction. So to make up for it may I suggest we incorporate Tech enabled, Blockchain optimized patient feedback mechanism.
So what is the solution, how do we propose to go about it, well unlike Press Ganey & HCAHPS (the Hospital Consumer Assessment of Healthcare Providers and Systems), Press Ganey has stated that a minimum of 30 survey responses is necessary to draw meaningful conclusions from the data it receives and that it will not stand behind statistical analysis when less than 30 responses are received. 
If we all incorporate a blockchain Ecosystem & go truly real time in the patient feedback mechanism it would greatly enhance the whole patient experience and maybe help to manage solve some of the issues in real time. Wouldn’t it be just great if we incorporate Blockchain in the patient feedback loop, we wouldn’t have to wait for 30 odd surveys to be analyzed we could just go ahead and fix the situation right away if it warrants an action.
Another major issue is NO show and Missed Appointments
One study estimates, in US alone missed appointments cost US healthcare providers up to $150 billion a year.There have been instances that a Clinic loses money because of No Showand missed appointments.Patients not showing up can be costly to the health-care system. Offices lose out on revenue, and delaying care can lead to more expensive treatments later on.

“We very much believe it’s going to take a collaborative effort, and we think that this kind of technology integration is going to be a critical path for being successful in terms of breaking down those barriers for access to transportation for the patient community.”  David Baga, CBO, Lyft

Allscripts, Lyft and few other companies have joined hands to address this problem. The companies said they hope working together will reduce the number of people who miss medical appointments because of transportation issues.
But interesting it was found in another study giving poor people free use of ridesharing services like Uber and Lyft for doctor appointments doesn’t make them any less likely to become no-shows than patients who have to find their own way there, a U.S. study suggests.
So what are we missing here, I believe incentivising ( tokens ) is the key and Blockchain could play a major role. Blockchain in itself is not a panacea for all things healthcare but it certainly holds the key to transform the current healthcare service delivery mechanism and make it more transparent and efficient.
Ehealth or no ehealth, if its not able to solve the issues of equity & empathy than its no value prop only noise, maybe it would help become a excellent facilitator in healthcare delivery but it sadly would not be able to solve the core issue of equity and empathy.
The concluding part follows:
How Blockchain could be a gamechanger for healthcare

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[content title=”About Arnab Paul”]

Arnab Paul, CEO, Patient Planet

Globally-minded systems thinker, action-oriented and inspired toward optimizing health outcomes through innovation, creativity, cooperation. Passionate about facilitating the alignment among technology, people and processes to ultimately improve patient experience and the functioning of healthcare.

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Patient Satisfaction: IoT Enabled patient pathway by Arnab Paul, @iArnabPaul

They may forget your name, but they may never forget how you made them feel… Maya Angelou


Patient satisfaction is not a clearly defined concept, although it is identified as an important quality outcome indicator to measure success of the services delivery system

Ever since the Institute of Medicine’s 2001 ‘Crossing the Quality Chasm’ report codified patientcenteredness as one of six health care quality aims, patient-centered care has gained footing within the landscape of health care reform. There is no consensus between the literatures on how to define the concept of patient satisfaction in healthcare. In Donabedian’s quality measurement model, patient satisfaction is defined as patient-reported outcome measure while the structures and processes of care can be measured by patient-reported experiences




Many of our Linkedin friends would concur that even if we run a million dollar enterprise and have a fairly good experience on dealing with stressful situations in our everyday business life but when it comes to visiting the hospital we get cold feet – because of the element of unforeseen and unexpectedness of the entire process that we have to undertake and on top of that we as a patient community do not have a collective voice and it makes matters worse.

I believe we have a tremendous potential as a nation provided that we as a provider and receiver of healthcare services are on the same page, though it is easier said than done.Patient who visits a hospital is looking for value on investment (VOI) and the Provider is looking for return on investment (ROI). Healthcare providers have their limitations, financial and otherwise — but at least they are doing their bit and performing reasonably well. Since they have fixed resources at their disposal – the only thing humanly possible for them is resource optimization.

In India, we have already missed the bus when it comes to patient satisfaction surveys unlike our western counterparts. For everything in life we need some kind of metrics, some tools to measure the clinical outcome and the patient satisfaction. So to make up for it may I suggest we incorporate Tech enabled, IoT optimized patient feedback mechanism.

Various Accreditation bodies like NABH, NABL, CAP, JCI and ISO are functioning in the healthcare domain but these are mostly voluntary, these accreditations are a reflection that the entity has undergone high quality of audit in its internal departments, but does it say anything about the patient satisfaction or patient engagement, the answer is a big NO. In India, one could safely bet that 90% of the patients visiting the hospitals do not have the foggiest notion of what do these accreditation means, entities need to think beyond certifications and accreditation, entities need to educate people, create more awareness among the stakeholders specially the patient community, they ought to let the world know that these organizations have the benchmark this will inspire confidence in the patient community.

So in a truly democratic healthcare system the patient ought to have a voice and a mechanism in place just to ensure that his voice his heard and above all accreditation agencies must also factor in the patient voice.

Few days back I got a very interesting email from someone who heads the ‎Clinical Transformation and Analytics, Clinical Technology and Patient Safety Innovations at a Super Speciality, New Delhi, she enquired about the tech solutions that could be put in place to enhance the patients positive experience,it so heartening to note that the providers are seriously interested in improving the patients experience and by and large I presume most of the providers do want to improve the patients experience.

So what is the solution, how do we propose to go about it, well unlike Press Ganey & HCAPHS, I don’t know of any organization in India working towards the goal of providing patient satisfaction survey. Press Ganey has stated that a minimum of 30 survey responses is necessary to draw meaningful conclusions from the data it receives and that it will not stand behind statistical analysis when less than 30 responses are received. The entities mentioned above are highly detailed paper based patient feedback mechanism, in this time and age we need to think digital, think ahead.

If we go digital & truly real time in the patient feedback mechanism it would greatly enhance the whole patient experience and maybe help to manage solve some of the issues in real time. Wouldn’t it be just great if we incorporate IoT’s in the patient feedback loop, we wouldn’t have to wait for 30 odd surveys to be analyzed we could just go ahead and fix the situation right away if it warrants an action. 

The article was first published in Mr. Arnab Paul’s LInkedIn pulse page, it has been re-published here with the author’s permission
Author

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[content title=”About Arnab Paul”]

Arnab Paul, CEO, Patient Planet

Globally-minded systems thinker, action-oriented and inspired toward optimizing health outcomes through innovation, creativity, cooperation. Passionate about facilitating the alignment among technology, people and processes to ultimately improve patient experience and the functioning of healthcare.

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Putting patients at the heart of IoT in India, By Arnab Paul, @iArnabPaul

Patients are the most important stakeholders in the healthcare ecosystem and that they should be empowered to make informed choices.


In a broader sense, the “patient pathway” is the route that a patient will take from their first contact with a healthcare provider or a member of staff, through referral, to the completion of their treatment. It also covers the period from entry into a hospital or a Treatment Centre, until the patient leaves.


In healthcare, there already exists whole gamut of technologies in various states of maturity – wearable devices that are perhaps not yet ready to be used as clinical-grade, beta-versions of monitoring devices, inventory tracking systems already being utilized in hospital operations, etc. The innovations we will see in the coming years will push these to new heights and give health system operations the opportunity to be leaders in adoption of the connected world empowered by the internet of things. Willingness to explore the opportunities presented by this world will be the differentiator between those who leverage the capabilities for optimization and those who stick to what’s been just good enough so far.

Internet of Things (IoT) refers to any physical object embedded with technology capable of exchanging data and is pegged to create a more efficient healthcare system in terms of time, energy and cost. One area where the technology could prove transformative is in healthcare. The potential of IoT to impact healthcare is wide ranging. We’ve already seen an increasing movement towards fitness tracking wearables over the last few years. Imagine a world where your vital signs were being constantly monitored and fed back to your healthcare professional.

Many of us who advocate LEAN in Healthcare, we know that lean stands for removing all that is not required, Simply, lean means creating more value for customers with fewer resources. A lean organization understands customer value and focuses its key processes to continuously increase it. The ultimate goal is to provide perfect value to the customer through a perfect value creation process that has zero waste. The core idea of lean involves determining the value of any given process by distinguishing value added steps from non-value-added steps, and eliminating waste so that ultimately every step adds value to the process. To maximize value and eliminate waste, leaders in health care, as in other organizations, must evaluate processes by accurately specifying the value desired by the user; identifying every step in the process (or “value stream,” in the language of lean) and eliminating non-value-added steps, and making value flow from beginning to end based on the pull — the expressed needs — of the customer/patient. When applied rigorously and throughout an entire organization, lean principles can have a dramatic affect on productivity, cost, and quality.

With the deployment of IoT in healthcare it would enhance the scope of monitoring patients response, since huge zettabytes of data are going to be generated from the many monitoring sensors, if we are somehow able to remove the noise and work on the intelligence derived from it, and if we could somehow wed the intelligent data derived from IoT with the LEAN/ SIX SIGMA tools it would greatly enhance the quality of the patient care pathway. We would be able to do a better job of mapping his entire journey and improve on the patient e care pathway.

IoT in itself wouldn’t be a big help unless the information that is obtained from the sensors and other embedded systems are not synced with data analytics.

These are exciting times for Healthcare Delivery system, after proper deployment of sensors and by the optimum use of other remote monitoring system, suffice to say monetizing the data generated by the IoT would be the principle driver for enterprises and small businesses alike in years to come.

The article was first published in Mr. Arnab Paul’s LInkedIn pulse page, it has been re-published here with the author’s permission
Author

[tab]
[content title=”About Arnab Paul”]

Arnab Paul, CEO, Patient Planet

Globally-minded systems thinker, action-oriented and inspired toward optimizing health outcomes through innovation, creativity, cooperation. Passionate about facilitating the alignment among technology, people and processes to ultimately improve patient experience and the functioning of healthcare.

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Challenges and Promise of #IoT in Healthcare by Arnab Paul, @iArnabPaul

A critical path to improving healthcare efficiency is to shift focus from acute care to early intervention. Remote patient monitoring technologies would be just a small cog in the wheel of Connected health


The ‘internet’ of people changed the world well there’s a new internet emerging and it’s poised to change the world again this new internet is not just about connecting people it’s about connecting things and so it’s named the Internet of Things.


Ok so connecting things to the internet big deal right well it kind of is and here’s why because things can start to share their experiences with other things, you take things and then you add the ability to sense and communicate and touch and control and there you get an opportunity for things to interact and collaborate with other things so think of it like this, we as human beings, we interact and contribute and collaborate with other people in our own environment through our five senses we are seeing and smelling and in touch and taste and hearing, right well imagine things with the ability to sense and to touch and then add the than ability to communicate and that’s where the internet of people and the internet of things intersect. I believe like the internet revolution, IoT opportunity is transformative. 

However there are few challenges   Some of the challenges that I can think of is like the interoperability issues of different software programs we do have an issue of  Heterogeneity of sensors and networks also last mile gap in delivering quality of service & Security with regard to  Privacy and Governance.

Broadly Challenges could be categorized under

Integration:  Gadgets & Devices
The diversity of devices in the networks is another obstacle for the successful implementation of IoT in healthcare.  The problem lies in the fact that the device manufacturers do not have an agreed-upon set of communication protocols and standards. The lack of uniformity among the connected medical devices also significantly reduces the opportunities of scaling the use of IoT in healthcare.

Security: Data Transmissions at risk
The main concern for regulatory bodies and users alike is, of course, the security of personal health information that is stored and transmitted by the connected devices. Strict access controls are required to ensure compliance with healthcare regulations.

Analytics : Data insights
Even though the process of collecting and aggregating data comes with complications, healthcare IoT is responsible for accumulating massive amounts of valuable data it can be used to benefit the patients, however deriving the insights from immense amounts of data is problematic without sophisticated analytics programs and data professionals.

A critical path to improving healthcare efficiency is to shift focus from acute care to early intervention. Remote patient monitoring technologies would be just a small cog in the wheel of Connected health. Health and fitness monitoring will precede patient monitoring as the driver for IoT solutions in healthcare. IoT in healthcare holds great promise for the coming generations because it could just transform the quality of life of the aging population. IoT could feel a bit intrusive  at times for the current generations, but looking at the trends it would help the millennials and the aging populations both get really helpful insight about the status of their health and act upon them.

The article was first published in Mr. Arnab Paul’s LinkedIn Pulse post. The article is reproduced here with the authors permission.  

Author

[tab]
[content title=”About Arnab Paul”]

Arnab Paul, CEO, Patient Planet

Globally-minded systems thinker, action-oriented and inspired toward optimizing health outcomes through innovation, creativity, cooperation. Passionate about facilitating the alignment among technology, people and processes to ultimately improve patient experience and the functioning of healthcare.

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Healthcare IoT Strategy for Entrants & Incumbents by Arnab Paul, @iArnabPaul

The long-predicted IoT revolution in healthcare is already underway, as new use cases continue to emerge to address the urgent need for affordable, accessible care


We are still running around, jumping in the puddle of data mining and other data insights when we are hit by this new wave called ‘Internet of Things” . Typically in the healthcare system the  patients dont really care what sensors will record and transmit and to whom and to where and whether it follows the standard protocol, what they really care about is whether they will be able to get well soon and how this IoT is going to help him have a better quality of life and how soon that would happen.  

Similarly the providers dont care about the tons of data that will be accessible to him, he would be more eager to know the intelligent real time information that would help him diagnose any ailment. However, at the moment, the health monitors, wearables remain largely outside typical care channels. 

One common IoT-enabled wellness monitor, for example, creates, transmits, analyzes, and stores data—but in a database not linked to, and incompatible with, traditional health records.  However useful, the information is unavailable or even unknown to doctors unless patients volunteer it—and, indeed, physically bring it to a visit. There is a gridlock in the flow of information at the aggregate stage. 

Alleviating that gridlock—and integrating prevention and wellness monitors with existing electronic health-records systems—is key to taking full advantage of IoT-enabled devices’ capabilities and keeping people healthier longer. Established health care IT companies, will no doubt find these new business models threatening, considering the new entrants eager to join the fight for customer value.  It is critical that IoT Companies deliberately identify how IoT technology fits into their existing products and strategies, and enables the delivery of transformational innovation. 

Simply using the IoT to enable innovation is unlikely to create sustainable advantage.  Companies should identify areas of high unmet needs and clearly articulate the value they will deliver for their customers. Development should begin with a specific use case in mind and a clear vision of how each stage in the Information cycle will contribute to addressing customer needs. Strategy to access capabilities through in-house development, acquiring companies, or partnering will be necessary. 

In all cases, whether entrant or incumbent, the IoT strategy should be built from an understanding of which care settings and which gridlock the entity seeks to alleviate.  From there, choices as to whether to focus on the setting or the stage of the gridlock will determine the appropriate business model. 

The long-predicted IoT revolution in healthcare is already underway, as new use cases continue to emerge to address the urgent need for affordable, accessible care. 

The article was first published in Mr. Arnab Paul’s LinkedIn Pulse post. The article is reproduced here with the authors permission.  

Author

[tab]
[content title=”About Arnab Paul”]

Arnab Paul, CEO, Patient Planet

Globally-minded systems thinker, action-oriented and inspired toward optimizing health outcomes through innovation, creativity, cooperation. Passionate about facilitating the alignment among technology, people and processes to ultimately improve patient experience and the functioning of healthcare.

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Healthcare #IoT, what the future holds by Arnab Paul, @iArnabPaul

Things in healthcare, its popularity is undeniably on the rise in other industries


The world is continuously growing and changing. Various advancements have also occurred when it comes to the technology used in rendering healthcare services. Thus, there is no doubt that the healthcare industry has improved in the last decade but what are some of those improvements.  

The technology has also played a big role in patient registration and data monitoring. Before, people need to go seek a doctor and visit them personally for a consultation but now, it is very much possible for them to consult a doctor in the convenience of their own homes by allowing them to talk with their doctor through a video chat, as Telehealth has been introduced. 

Apart from that, there are also technologies that allow a healthcare provider to monitor their patients in their own mobile phones. It’s not only that for they are also now capable of sending and receiving patient’s information in their mobile phones as well. All of these have been made possible, as wireless connectivity exists. 

Devices that can help monitor one’s health of the one wearing it have also been highly available in the market.  As a matter of fact, there are even sensors that are capable of collecting data that would of course help their doctor be informed in case there is something abnormal with their patients. This allows them to provide the right medication and treatment to their patients fast. On the other hand, although great improvements have been made in the healthcare industry, one can still expect that a brighter future awaits in the next years or decades.  

Within five years, the majority of clinically relevant data will be collected outside of clinical settings. It has been said that healthcare in the future would become more personal. Thus, one can expect that personalized medicines or medicines that have been created specifically for an individual would be available. The way doctors diagnoses their patient’s disease and provides treatment to them would also be changed as data would become more accessible in the future, combined with the use of more hi-tech devices. As more people are being conscious of their health, one can expect that more tools and equipment would be available in the future.

Internet of Things

in the IoT paradigm everything in the world is considered as a smart object, and allows them to communicate each other through the internet technologies by physically or virtually. IoT allows people and things to be connected Anytime, Anyplace, with anything and anyone, by using ideally in any path/network and any service.Internet of Things could be the driver for health care’s new visage and revolutionize patient care transcendentally. Few ways how IoT can be used in healthcare industry  

1) Remote patient monitoring

Remote patient monitoring (RPM) uses digital technologies to collect medical and other forms of health data from one individual in one location and electronically transmit this information to the health care providers. RPM can help reduce the number of hospital readmissions and lengths of stay in the hospitals. 

2) Clinical care

Hospitalised patients whose physiological status requires close attention can be constantly monitored using IoT driven, non-invasive monitoring. Sensors are used to collect such information and using cloud to analyse data and then send this analysed data to caregivers. It replaces the need for the doctor to visit the patient during regular intervals for check up. This will also help to improve the quality of care through constant monitoring.

3) Device monitoring

An IoT connected device metal device can notify when there is a problem with a device.  This will prevent the device from shutting down and avoid patient rescheduling.

4) Outpatient Monitoring

This IoT solution enables doctors to capture health parameters and advice patients remotely. The patient’s hospital visit is therefore limited and needs to visit only on need basis. This solution helps hospitals manage hospital beds and consequently increase revenues while at the same time delighting customers.  

Although, IoT implementations will likely raise concerns around data privacy and security. While most of today’s devices use secure methods to communication information to the cloud, they could still be vulnerable to hackers. 

While we have yet to see a huge number of adopters of the Internet of Things in healthcare, its popularity is undeniably on the rise in other industries.

The article was first published in Mr. Arnab Paul’s LinkedIn Pulse post. The article is reproduced here with the authors permission. 

Author

[tab]
[content title=”About Arnab Paul”]

Arnab Paul, CEO, Patient Planet

Globally-minded systems thinker, action-oriented and inspired toward optimizing health outcomes through innovation, creativity, cooperation. Passionate about facilitating the alignment among technology, people and processes to ultimately improve patient experience and the functioning of healthcare.

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