How Doctors in Rural Area Can Use Technology

India’s healthcare system, much like the healthcare systems across the globe, is witnessing an overhaul. Increased use of technology and greater digitisation efforts are being taken to make our healthcare system more organised, efficient and effective. While this holds true for the urban areas of the country, India still has a very large rural population that still is wanting basic healthcare facilities and hardly has access to good doctors. Given the pace at which urbanisation is increasing, it is almost dismal to know that even today, when India is helmed as one of the fastest growing nations and produces some of the greatest intellectual capital across the globe, the World Health Organization’s ‘2000 World Health Report’ ranks India’s healthcare system at 112 out of the 190 participating countries.

What is abundantly clear is that it is this rural segment that can benefit the most from the Digital India initiative as it aims to connect rural India with the rest of the country through the network of high-speed Internet. The Digital India initiative also aims to increase digital literacy and plans to connect all the villages across the length and breadth of the country through mobile networks by the end of 2018. To put it in numbers, by 2018, if everything goes as per schedule, then 44,000 villages who are currently cut off completely from all technological developments, will also be able to reap the benefits of the technology and digitisation.

Presently, the rural healthcare infrastructure suffers from a dearth of qualified doctors, inadequate medical facilities, insufficient specialised care, non-access to basic medications. With 60%, that is almost 700 million people, facing this grim healthcare situation, it is high time that technology is leveraged efficiently to close this widening healthcare gap. Without getting into the details of the nuances of the public healthcare system and its areas of improvement, let us, simply take a look at how doctors in rural areas can leverage technology and improve patient outcomes.

Telehealth

According to the World Health Organization, the stipulated doctor to patient ratio should be at 1: 1000. In India, this stands at 1:1700. Along with this, there are approximately are 6-6.5 lakh doctors working currently in the country. By 2020, this number needs to increase by 4 lakh more to balance out the doctor –patient disparity. Most of the rural population has to travel an approximate 20 kilometres to access good doctors. Greater adoption of mobile and better internet connectivity in villages can shorten these distances leveraging telemedicine facilities. Multi-specialty hospitals such as Medanta have operational telemedicine services to help healthcare accessible to all irrespective of their geographical location. Individual doctors too can leverage mHealth and telemedicine to reach out to a large rural population. The patients can consult with specialists when the need arises using telemedicine.

EHR

Personalised care, too, should not be a luxury afforded only by the urban population. Doctors in rural areas can also offer personalised care by leveraging EHR systems to increase their efficiency and quality of care, record and store valuable data and manage critical healthcare information. Using technology, doctors can make sure that they can access this data anytime and anywhere. This can help greatly in disease management, sending timely reminders to the patients for health checks or medications and also for conducting health assessment and research. It can also help rural doctors eliminate dubious healthcare practices by educating the rural population about good healthcare practices and give them the ability to understand when they need to seek medical help.

Big Data

Rural India is a goldmine for clinical data. Leveraging big data and data analytics, doctors can look at identifying triggers and causes for poor health. For example, India has one of the highest rates of maternal and neonatal death. By looking at these data patterns, doctors can identify the causes leading to this and then can push for addressing these issues. Lack of qualified doctors, inadequate nutrition of expecting mothers, poor hospitals which are lacking even in basic infrastructure, lack of medications etc. are just some of the points that have been identified as the cause of maternal deaths in India based on the data story. Clearly, digging deeper into the data will provide greater insights and help in identifying risk factors, both social and environmental, and help in improving clinical outcomes.

Mobility

In India, several healthcare organizations have started using mobile phones and IVR services to educate the expectant mothers about the care they need to take and make them aware of the best practices in sanitation. Medical helplines allow patients to ask questions to medical experts and get the answers. With a severe shortage of doctors in rural areas, many times, health care workers attend to patients. These health care workers can access important health related information through national healthcare portals and help the patients.

Doctors in rural India can further leverage technologies such as remote diagnostics, HIS, healthcare informatics and EHR etc, to bridge the gap that divides rural and urban healthcare and help a very large piece of the population access improved, cost-effective, and affordable healthcare. Looking at the rate at which digitisation is increasing in India, we can surely say that with the right use and adoption of technology, the rural healthcare system will definitely take a turn for the better and make a million lives better.

How Technology Can Transform Doctor-Patient Relationship

The doctor-patient relationship is on the cusp of disruption. The increased availability of information, technology adoption, the rise of smartphones, better carrier networks, and increased internet usage are all contributing to the rise of the ‘involved patient’. Susannah Fox entrepreneur in residence at the Robert Wood Johnson Foundation says, “Consumers only used to get a filtered drip of information. What the Internet did was pull open that funnel and give people more access — not complete access — to health information.

No longer are patients passive consumers of healthcare. Today, they want to manage their own health journeys, make their own health choices, keep track of their wellbeing and access clinical support that they feel is right for them. Almost 90% of the millennial generation look for medical information on social networks before they make their healthcare decisions – it is a testament to the fact that the locus of control is moving from the hands of the physician alone and into the hands of the individuals seeking care. With the help of technology, healthcare providers too, are looking at improving patient engagement along with increasing efficiencies and improving operational costs.

Physicians today are looking at mobile phones to boost patient engagement and optimally utilize their time in between commutes. A report from Research2Guidance shows that almost 80% of physicians now use a smartphone or medical app. Since an increasing number of mobile apps are now being developed keeping the regulatory and compliance requirements in mind, the healthcare community comprising of doctors, private practices and hospitals are now finding it easier to use mobile devices across the healthcare spectrum. James Avallone, Director of Physician Research at Manhattan Research aptly states, “As we move to an outcomes-based model of healthcare provision…, remote monitoring and telehealth are going to drive an extension of the point of care. We’re seeing physician attitudes really align with policy.”  In this blog, we take a look at how technology is helping doctors and patients foster a better working relationship.

Health Information Management

Given that most patients have online access, they can leverage technology to access their health records. Technologies such as cloud give both the physician and the patient access to health records such as scans, X-Rays, pathological reports, patient history etc. anytime and anywhere. This ensures that neither the patient nor the doctor wastes any time looking for and filtering the right healthcare information when they need it. With health information management systems, doctors can get a comprehensive view of a patient’s health history and are aware of any problems or issues that the patient might have forgotten to mention during a consultation. Such technologies make sure that the consultation time is used productively which make doctor-patient interactions smoother and more effective.

Improved Communication

Technology is also helping doctors and patients improve interactions with each other. With more access to their health-related information, patients feel more in control of their care as they are able to understand their conditions better.

  • Post consultation updates that can be automated and sent via SMS’s ensure that patients have access to all vital pieces of information that are essential for managing their health.
  • Improved doctor-patient interactions not only impacts the patient’s experience with the doctor but also make sure that they follow their practitioner’s directives better.
  • Access to health data also gives patients the chance to ask relevant and more focused questions to their doctors and helps them gain an understanding of what their health data is saying from the physician.
  • With technology, patients can now discuss their medications, side effects, alternative medicine, lifestyle changes etc. with their doctors more accurately.

The role of the doctor thus has evolved from being an authoritarian care provider to one who is more of a mentor and an advisor. The doctors too are able to facilitate these interactions easily as getting access to current and updated patient data and records are at their fingertips owing to smartphones.

Pre and Post-Operative Care

Technology goes a long way in advancing patient outcomes by improving pre and post-operative care and improves the surgical pathways.

  • Doctors can use technology to help the patient understand risks and benefits of a particular surgery before an operation with the help of evidence-based suggestions.
  • With the help of direct messages, doctors can intimate the patient on the necessary precautions and measures they need to take before a surgery.
  • Health information exchanges can become more streamlined when clinical data in the form of medical records and investigation results can be efficiently shared with the right stakeholders before surgical intervention making the pre-operative process smoother for both the patient and the doctors.
  • Doctors can also use technology to deliver tailored post-operative care plans which include expected length of stay, post-operative care, self-managed symptoms, and side effects etc.
  • They can complete symptom assessments electronically that can help in effective discharge planning and send electronic alerts to their patients regarding medicines and consultation reminders once they are discharged from the hospital to make health management easier and effective.

Chronic Disease Management

Technology goes a long way in chronic disease management. Mobile health applications help people with chronic diseases become more accountable towards their health. Interoperable applications enable doctors to gather healthcare data to track their patient’s behaviours and send out timely reminders to help them manage their conditions better and decrease hospital readmissions. With such technology, medical staff can send out educational interventions by providing objective data and helps the patients manage their condition better.  Almost 93% of doctors believe that mHealth applications can improve a patient’s health and 40% of doctors believe that mHealth technologies can reduce the number of visits to a physician.

Risk Management

Mobile health applications also give physicians access to health-related data which helps them identify potential candidates who are ‘at risk’ of a particular disease. For example, accessing health data to identify patients who have been susceptible to the flu at a certain time of the year can help the doctor take a more preventive approach towards healthcare. The same data can be put to use to even identify patients who are at risk for chronic diseases such as diabetes, coronary diseases etc.  and preventive steps can be taken to reduce risk and promote better health.

Clearly, technology has been a big influencer in the changing doctor-patient dynamics. However, while leveraging healthcare technologies, it is essential that the application fosters interoperability between the patient and the doctor, is easy to use and is secure. Technology is allowing both patients and practitioners more control over health by offering reliable data, access to clinical support, and high information levels. This is helping patients get closer to medical science and health management than ever before by increasing transparency and participation and is helping doctors improve the quality of their patient interactions, reduce wait times and better patient outcomes.