Dr BS Bedi, Advisor-Health Informatics, C-DAC, Government of India, has streamlined telemedicine centers and standardised mHealth services with effective framework of IT into the industry.
In conversation with Divya Chawla and Shally Makin, he speaks about mHealth and its role in reaching to the rural population despite lack of awareness
What is the current status of use of mHealth in the country?
Mobile health has permeated to most of our population. Today, ICT is being used in every field and with mobile technology becoming cheaper day by day, there is a huge increase in number of mobile users. According tao TRAI, by December last year, there were 750 million mobile users with 18 million of them increasing every month. Once this tool is available to most of the people, this tool can be used with ICT, making it more efficient. The network providers have been successful in reaching even to the rural areas and creating a mesh by joining the poor to all the facilities.
What are the various government-funded healthcare projects in India?
Government majorly focusses on connecting the poor with high-end services like mHealth to save people in case of epidemics and making people aware of how to keep good health. Access to health information is the precursor to planning and managing diseases. Out of the primary, secondary and tertiary health, rural health workers operate in 310 primary health centres. These health workers created database manually but with introduction of computers and technology, the databases are now organised and created on computers at block level in specialised primary healthcare centres. The connectivity is reaching to the interiors, empowering healthcare delivery system in India. With technology, we have the potential to reach people at their households through mobile handsets. During an epidemic, there is pressure on DMO to provide figures. The lack of information is now being planned and collected by the health information system. For this, technology has empowered health workers in Mallapuram district in Kerala through C-DAC in collaboration with DIT and Media Lab Asia. There are 200 blocks for experiment, using mHealth application for keeping good health and mobile phone for consultation. IT shows successful results which will engage in taking the information to the next generation. Within a month the current status of the ground level reality can be available to the planners.
How can government leverage technology to the illiterate and BPL to avail such service?
Technological problems are much easier to solve in India. Many technologies have been introduced by C-DAC and other agencies. To access the information, national health information is shared in local languages already. It may not be that difficult or rather a major challenge in implementing the application to the existing mobile users. In today’s world, technology and network providers in the league, has tapped this issue. With introduction of handsets in local languages, there is a clear cut solution to this. Also, the application is now integrating into the next generation with providing information through voice communication and consultation in local language, depending on the state which provides various schemes according to the population prevalent. The language problem can be managed in the overall logistic management.
There is a great potential for mHealth in the coming years to save lives in our country. There are projects being planned with IIT Kharagpur and Government Medical College, Calcutta with the empowerment of doctor and his accessibility to the patients
Do you think mHealth can stand for sharing info on chronic diseases?
The potentialities have been realised and special care is taken in case of chronic diseases. Corporate hospitals such as Apollo have made it possible by merging with Aircel to provide health through mobile. Such super speciality IT savvy hospitals give expert advices
to the patient on diseases such as cancer. The facility provided to the masses is 24X7 and one can consult for any symptoms and receive advice by using IVRS or experts in case of an emergency. This corporate hospital has recently tied up with NHS which provides algorithms for authenticated information.
Do you think telecom provider will share reliable info with users? Do we have any standards for monitoring?
So far I am not aware of any particular rules, policies or regulation enforced for this application. Although, medical ethics by ICMR, telecommunication act and IT act of India do enforce their terms and conditions to be followed by the doctors as well as the moderators and service providers.
What are the challenges suffered by mHealth providers which refrain them from extending their reach?
There are majorly 2 challenges faced by this application so far—privacy and authorisation. Privacy is a need of the patient, who is sharing information about his health and the medical records stored in the software. The other is authorization of the service providers. But he believes that with the advent of technology and experts, these two can also be surpassed.
How much do you think mHealth will contribute to healthcare in the coming years?
There is a great potential for mHealth in the coming years to save lives in our country. There are projects being planned with IIT Kharagpur and Government Medical College, Calcutta with the empowerment of doctor and his accessibility to the patients which gives a greater possibility of mHealth into the market. It will provide all the facilities including accessibility of records, emergency alerts, and full technology for particular handset compatible with x-rays etc. We cannot compromise on healthcare delivery and need treatment information to be authenticated. The doctor cannot miss a treatment because he is not accessible to the patient and his records. Also, we need to keep a check on the technology as we cannot cause error in medical records or x-ray picture leading to false diagnosis. Presently, there are 2 samples, 300 – 400 T.B and HIV patients in each, for paediatrics using this service with all the safety measures being taken care of.
There is a clear lack of evidence that demonstrates the practical and monetary benefits of mobile healthcare, a reason for less participation of industries and people in to the sector?
The kind of penetration this application is doing, irrespective of rural or urban divide is opening up tremendous possibilities of taking care of some of the weaknesses of healthcare delivery. It is very important to explore this area and integrate into the national health program in some way or the other so that the whole program of healthcare delivery is strengthened. I am very hopeful that time is not far when this going to happen. I do not agree of any monetary or practical reasons or less participation. The only reason is less attention being given by the private sector due to lesser opportunities although public private partnership would be great aspect in strengthening the application with spreading the base to whole country.