The Shifting Goalposts Of Popular Health Parameters And What Those Mean For Us

Here’s the irony we all seem to live with – while technology is giving us more and more opportunities to stay ahead of time, somewhere it is also making us too dependent on circumstances. The changing focus on health concerns rightly compliments this argument. While every person, irrespective of profession and gender, ideally needs to take care of health and stay fit, this is all the more true for working professionals who deal with long and stressful work hours. Consequently, diabetes, cholesterol, and thyroid top the list of most common health concerns faced by the working class.

Change in Health Parameters

Earlier the parameter set to identify if a person was diabetic, for example, was if the fasting blood sugar level was above 140 (i.e. 140 milligrams of glucose per decilitre of blood). However, in 1997, the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus brought down the number to 126. This was probably more from a preventive point of view wherein; experts felt that sooner a condition was treated better the chances of a person from avoiding the dreaded health condition altogether. Unfortunately, this decision meant that all of a sudden almost 1.6 million people who were otherwise “healthy” (since their blood sugar level was in the previous good range of 126-140) suddenly were declared diabetic. The same goes for measuring cholesterol. While the cholesterol level earlier was considered a risk at 300, over the years as research progressed it came down to 240 and eventually has settled at 200, thus bringing in almost 42 million people in the category of high cholesterol patients.

The other health problem which is seen to greatly impact the population is thyroid. Thyroid, too, was always a concern but never with the same gravity that it demands now. Hypothyroidism affects about 4-5% of the people across the globe and in India, one in ten adults go through it. Statistics state that women are much more at a risk and need to take precautions from early on. Such numbers further promote research and force the medical fraternity to take the results even more seriously. However, the more focus the problems get, the more the number of people seem to “suffer” from it.

Change in the Treatment Outlook

As a result, the treatment patterns also have considerably undergone a change. Everyone now stresses on preventive measures vis-à-vis earlier times when a health problem was treated as and when it occurred. It could be because of the fact that since there is so less time to spare, people prefer taking extra cautions to stay healthy rather than later spend time making visits to a doctor. From the doctors’ perspective, they would prefer avoiding an unwarranted health scare by prescribing medicines to counter a possible situation than having to deal with it at a later stage. It also implies monetary profits for the healthcare business sector. That makes the increasingly lowered threshold levels slightly difficult to accept. But for the common man, the risk seems too great compared to money spent.

Resultant Situation

More importantly, what this situation has resulted in is an over-cautious generation. Lowered ideal health range levels may make people take cognisance of their eating habits, exercise routines, and so on. But they also forget the fact that excessively worrying about a certain health aspect will not take away the problem entirely; while cholesterol is the primary cause of a heart attack it can also occur due to unhealthy lifestyles, smoking, etc. Another example is of the BMI (Body Mass Index). In the beginning, BMI was essentially used as a measure for body weight, and, thus, to basically remain in the healthy bracket. It helped in predicting cardiovascular diseases or nutritional competencies. Now, as with other health parameters expanding their scope, so has this simple figure. Health specialists have lately arrived at a Waist-Hip Ratio (WHR) which when used along with the BMI apparently better predicts more serious disorders such as diabetes, lipid problems, atherosclerosis, and so on.

In some ways, this sounds greatly helpful. Yet, it is also important to remember that over-diagnosis can be problematic as well. Imagine the number of medicines one consumes these days. Somewhere it makes the body immune to certain strains of those medicines and hence when the real need arises, it is doubtful if that medicine will really have a positive effect. Many times, people even ignore the side effects of taking extra medications, just to ward off a future possible concern. The number of treatments available is endless as well. It is thus up to the educated us to decide whether we will allow ourselves to be supposedly called “unhealthy” and where to stop in this vicious circle.

 

This Is What an Integrated Healthcare Experience Looks Like

The Indian healthcare industry is very fragmented. The whole ecosystem is largely manual and paper-based. Patients, today, have to go through a lot of hassles and stages to get a proper medical care. This leads them to be frustrated and irritated owing to factors such as long wait times, specialized physicians that are not easy to get hold of, and a medical system that is not easily accessible. The overall healthcare system in our country is at a very unorganized level. Patients need to take care of all documentation and records such as reports, x-rays, prescriptions, notes from doctors etc. manually and be responsible for all of them. This is a result of the fact that we do not have one integrated platform where all the information and content can be readily available and easily accessed by patients, doctors, physicians and anyone else who may be involved in the process of the treatment.

How can an integrated healthcare experience benefit the patients?

However, in recent years, the face of healthcare industry is changing and people are coming up with more healthcare options than we have ever been exposed to. India’s healthcare system is working towards technology-enabled collaborations to incorporate advanced techniques and ideas in the processes. These introductions aim towards creating a fully integrated healthcare system which will

  • Provide comprehensive solutions to all the individual entities such as patients, doctors, physicians, clinics, hospitals, laboratories, and medical stores.
  • The application and use of such a system will enable faster and more efficient communication between patients and doctors and make the entire system more smooth.
  • The use of cloud-based and mobile-based tools for storage and access of information will make them easily accessible at any time from any device. Such an experience is what can be defined as an integrated healthcare experience.

Better patient care at lower costs

Integrated care aims at taking a more comprehensive approach offering the patients with higher-quality and more efficient care that better meets their needs.

Along with that, it also tries to reduce the costs involved in the treatment by analysing the overall situation and taking the right steps at the right time. It can work around different approaches but the ultimate aim is to provide the patients with what is best for them.

In the case of patients suffering from chronic diseases, integrated care works towards creating a symbiosis between primary and secondary care to ensure more appropriate use of health care resources. It aims towards ensuring the availability of all types of services such as physicians, specialists, nutritionists and other health professionals for patients on a single platform.

With an integrated system, patients will be able to undergo diagnostic tests and get prescriptions filled in one go. They will be able to store a complete health history of themselves as well as their families online, thus avoiding the hassle of preserving physical documents.

Smooth communication between doctors, caregivers and patients and optimised costs

Another feat integrated care works towards achieving is to improve communication between a wider range of services. This facility will allow the patients who have undergone a treatment or surgery at a hospital to get discharged at an earlier time than the usual. They will then be provided with follow-up services and appropriate care. The aim is to reduce the hospital stay once the patients no longer require close treatment, thus reducing costs and optimising the overall process.

Patient Finance and Insurance Management

Patients will be also able to keep track of their healthcare finance management by quickly accessing their insurance credentials, insurance details, reimbursement that can be claimed through their insurance by accessing all the information on their mobile phones.

 Self care

Through access to all the healthcare analytics data, the patients will be able to decrease the risk of costly emergency interventions and thus reduce the chances of death. The insights provided by the integrated healthcare management system will allow the patients to keep a constant check on their health without having to visit your doctor each time. Old patients suffering from chronic diseases will be able to easily track their medications, get medication reminders, and reduce the chances of wrong medications.

While healthcare industry has developed a lot in the recent years and has seen many technological transformations, there is always scope to develop the existing services and aim at achieving higher levels of integration. Integrated healthcare systems provide a full continuum of services in a user-friendly manner, creating a one-stop environment to eliminate the cost of intermediaries, promote wellness, and improve overall health outcomes.

 

Chubby is not ‘cute’: Why Indian city kids are getting fatter and what we can do

image courtesy: www.topnews.in
image courtesy: http://www.topnews.in

Obesity in children has become this ugly fact disguised as a cute trait among Indian families. It is defined as a 20% excess of calculated ideal weight for age, sex and height of a child. Obesity is visible when there is an excess of accumulated fat in the subcutaneous tissue (below the skin) and other parts of body. A study in 2010 found over 42 million overweight children below the age of 5, globally. A staggering 35 million of them are from urban areas of developing countries. What this means for school children across the globe: as good as 10% of them (between 5 and 17 years) are obese.

Obesity in India

Considering the traditional Indian diet was supposed to be balanced and nutritious, the situation in India has gotten even worse. Nearly 15-20% of children in India are obese and about 30% more are on the edge and are likely to fall into the obese category.

About 10% to 30% adolescents are obese in India. The most dangerous concern, according to this study, is that as many as 60% to 70% of these will remain overweight / obese even in their adulthood. If obesity runs into adulthood, it may result in diabetes and other cardiovascular issues. Continue reading Chubby is not ‘cute’: Why Indian city kids are getting fatter and what we can do

Do we care enough?

As an employee at a major multinational in the United States, I remember my first visit to the doctor’s office. I had woken up to a sore throat and visited the doctor the same day. The doctor checked my breathing, took a throat swab, prescribed an antibiotic and sent me on my way. I thought nothing of the visit until I checked the bill to my insurance provider. Imagine my surprise when I saw that my provider would be paying $110 not including the cost of my medicines, or a little more than Rs. 5,800. It left me with an incredibly unsettled feeling and many questions. Nine years after that visit, today a routine primary care checkup in the US costs $176.

As an Indian, I appreciate that a visit to a doctor here in any city costs anywhere between Rs. 50 to Rs. 500 ($10). Incredibly, the quality of primary care we deliver is still the same. I’m also willing to bet that a significant portion of those dollars paid went towards an unnecessary but mandatory test of my throat swab and indemnification of the doctor against the remote chance of me initiating a lawsuit. Such is an environment where fear of legal retribution commands a premium from exactly the same people who it was supposed to protect in the first place.

Which is why it’s a little disturbing to spot a new trend here in India where we irresponsibly name and shame our doctors. Social media and other forms of participative media encourage patients to share their experiences with doctors. Unfortunately, popular review sites are also breeding grounds for negativity where the posters share only their negative experiences.

Mainstream media too plays a significant role in attempting to shame doctors and their profession. I recall an episode of Satyamev Jayate where host Aamir Khan interviewed a family who had lost a dear one to alleged medical malpractice. What was sad was that the Star TV team did not make an effort to ask the doctor at the center of the accusation for his version of what had happened. This isn’t an isolated incident.

Of course, we shouldn’t excuse our doctor’s for their mistakes. Instead, I ask but a simple question- why shouldn’t we investigate and represent facts for what they are before embarking on a public campaign that could destroy a career? My argument is not meant to protect doctors who intend to harm, but for the doctors who had only the best of intentions and have made a mistake. If we judge going only by the outcome, then many of our doctors are guilty for simply practicing their profession. Such is the nature of what they’ve been asked to do.

I’ve known doctor’s to get attached to some of their patients even when it could mean going against what they’ve been taught. The patient could be a newborn, or someone suffering from a terminal disease. Similarly, when all other avenues are hopeless patients can only place their faith in their doctor. Through the eyes of the patient, the doctor truly must play the role of God. How can we expect them to be perfect? In fact, I can imagine that many doctors have a personal ‘near miss’ story where they compromised the well-being of their patient, but a colleague or simply good fortune intervened and the error was found out before it was too late. No one can be expected to humanly perform at the highest levels. Software engineers write bugs, doctors make errors and even voters occasionally regret their choices in leaders. People do fail, and when we do we reflect on our mistakes and feel terrible about them- thankfully.

Here at Savetime, we realize this fact full well. Patients have come to expect our doctors to have the cure, so much so that a job well done is now ordinary. We don’t agree. To fulfill our vision of creating India’s largest platform to bring doctors and patients together – we’re creating tools that will help you share both types of stories- the ones that will give you goosebumps, as well as those stories which you won’t get to hear. Tools that will hopefully help patients relate their experiences carefully. We won’t pretend that we don’t have a role to play. We believe the impact of our work will be felt in raising the overall intelligence of the patient community, better protection against malpractice and most importantly our confidence in the part of the healthcare system that is working well.

We wish all our doctors on Savetime the best for doctor’s day.

Santosh Dawara, User Growth at savetime

Santosh drives user growth at savetime and is a tech-entrepreneur. He enjoys creating products that help users think, create and achieve amazing things with the web. An industry veteran, he’s played roles with BlackBerry smartphone makers, Research in Motion and has taken India’s first online movie tickets aggregator live.

Building the Patient Community – Join us, Join the Revolution

A lot has been said and written over the years about the state of the patients in India and about the Medical Industry as a whole.

How patients suffer due to non-availability of doctors in remote areas, negligence of doctors, due to adulterated drugs/bad manufacturing practices, not being able to afford the medical costs, etc.

Every day when you open the newspaper or switch on the news channel there is some or the other story about the patient’s plight, government ignorance towards medical malpractices and such.

Near home or another scenario is a friend or family member falls sick and suddenly we need to find the doctor. And the word doesn’t stop at that, we don’t only need to find the doctor but there is a need to find the ‘right‘ doctor when it comes to our near and dear ones. How many times you think before taking your old parents to a doctor? How scary is it when you have to take your two year old kid to an unknown doctor for vaccination?

Will the doctor be good? Will he treat my parents with compassion? Will he put my kid at ease before the vaccination? Does the doctor specializes in treating the condition for which we are reaching out to him? How much will the doctor charge? Will there be unnecessary tests that the doctor will recommend? and hundreds of other such questions come to our mind. Probably the most important of them “Will the doctor be able to cure me soon?”

So faced with many questions before choosing a doctor to go to, the only solace we can find is if some of our friends, or family have been to the doctor before and if they can share their experience with us. How many times have we ask or have been asked this question or a similar one “Yaar kisi acche ENT ko jaante ho kya?” And if even one person knows a good ENT and suggests, that’s the best that you can expect as of today.

Though the patient community in India is huge it is also unorganized. The information flow except for the traditional word of mouth is absolutely nil. Even with the advent of social technologies and leaps in communication media in the country, there is a dearth of information and interaction within the patient community.

And due to the lack of information the patient community suffers. A person who is looking for the ‘right‘ pediatrician for his kids ailments finds himself alone with no information and tries out his luck similar to a gambler in a casino, with whichever doctor he finds. He has no clue if the doctor is well qualified, if he is affordable, compassionate or what are the experiences of other people with him.

The time has come when “We the Patient Community” should rise, should get together and start a revolution to end this era of information drought, fight against the malpractices, painful experiences with the existing medical system, help bring to justice the wrong doers because of whom we or our loved ones have to suffer sometime or the other and most importantly we help and collaborate with fellow patients to make their lives easy and arm them with information to take the right decision when it comes to doctors or any other medical service(s).

Savetime.com is trying to support this revolution by building the first ever platform for patient community where patients can interact, share their experiences, favorite doctors, help out fellow patients and contribute in many other ways to the community.

Your participation in this is requested. To start with you can go to Savetime.com, search for the doctor you have been to and share your experience in the ‘recommend‘ section for community to benefit from it and being able to take the right decision. And if you consider your doctor to be the ‘right‘ doctor for you, do mark that doctor as right as well.

As this age-old video brilliantly displays the concept of ‘ekta‘ Oneness, or Solidarity, we will also need to practice the same. We will need to be ‘One‘ in this journey, help out each other, fight against malpractices, injustice as one then only we would be able to make a difference.

Abhinav

Abhinav is CTO at savetime.com. Besides the work he likes to be involved in several different exciting things.  Technology interests him but more than that the usage of technology to solve real world problems excites him more.  Working with teams to achieve difficult targets and in the process helping individuals realize their full potential is one of  his skills. He is an ardent blogger and social media enthusiast. When not working, he is either blogging, reading or bicycling.