April 2010

“We are now a nation of connected people”

Sam Pitroda
Advisor to the Prime Minister

Government of India

An inventor, entrepreneur and policy maker, Sam Pitroda spearheaded the communications revolution in India. He has been internationally acclaimed for using telecommunications in building the nation. A lot of his initiatives have been aimed towards bridging the global communications divide. In an exclusive interview with eHEALTH, Mr. Pitroda throws light on some of the key aspects of development of a strong health IT infrastructure for rural India and shares insights about the future plans of the Government in this sector.

How do you plan to improve rural health by taking IT to the village level?

I have great hope, today, because finally, we are a nation of connected people, which is a landmark in itself. How to capitalise on this, now, depends on us. It took us twenty years to achieve the fi rst big step, which is to connect everybody. We, now, need to think about the next big step and decide whether to follow the same path or do things differently. The main challenges lie in how to structure all steps and improve health and education in governance and make a substantial dent in it. The content does not need to be created with the help of information technology, because that has already been done. The key challenge is to create the infrastructure. We fi rst need to make sure that adequate broadband connectivity is available, because as video plays a great role and it demand good broadband connectivity. We, also, need to take broadband to the panchayat level. With this infrastructure in place, I believe the change has already begun. Panchayats across the country require good broadband connectivity and in every panchayat offi ce, there should at least be two bright youngsters of the local level, who can organise everything.

What initiatives are being  taken by the Government for development of an IT infrastructure in rural areas?

We, already, have fi bres in place by companies such as BSNL, MTNL, Bharti, Reliance, Tata, and many others. All these companies have their independent fi bre networks and it does not matter whether they are public or private because they all chip in. The predominant vendor in this space is BSNL, simply because they have the reach. One of the primary steps that we are now undertaking is to map all these networks in GIS to track the gaps. Further, we need to go to all 450,000 panchayats to understand the additional requirements. Once this is done, we will be able to have a clear picture on what exactly is required and this is the key exercise we are doing right now.

How does the Government plan to fund these initiatives? 

Fortunately, we currently have a lot of cash lying with the Universal Service Obligation (USO) fund, which amounts to almost INR 18,000 crores. Every year, almost INR 6,000 crores is being added to this fund by the telecom companies because they are not being able to meet their obligations in the the rural areas. We are now looking at using this fund for development of IT services in the country. In spite of the high healthcare spend in the US, the country is struggling in this area.

How can India learn from this and have good reforms in place?

I can answer this question, based on my personal experiences. Unfortunately, I have a number of diseases and everytime I go to a hospital, I spend a lot of unnecessary time on giving my personal and health details. Each hospital visit requires a lot of protocols to be followed and the process becomes very time consuming. For getting tests and check-ups done in various departments generate several bills as each department is only concerned about making their bill. Further, the reimbursements on these bills are covered differently, which causes a lot of chaos.

In the US, things became unmanageable because they had a vendor-driven system and there were no standards in place. With all due respect to all experts in the US, the situation was not being approached in the right manner.

As a patient, all I need to know is details about my medications, doctors, allergies and where my data resides. It is useless to provide all these details each time I visit a hospital. Implementation of IT can be the only solution to all these problems. With the help of IT all personal health records, of a patient, can be maintained electronically. This will specially help in the case of emergencies, where with the help of instant access to a patient’s health records the care provider can provide timely and effective treatment. In my point of view, this is a simple approach and not rocket science, but still nobody is doing this. IT implementation will help in uncomplicating a patient’s life to a great extent. These are my views as patient, and not as an expert. There is also a need for health related information to be available through mobile.

The general view is that whatever is good for the US, is good for all, but this is not true anymore.

Can the Government consider making electronic health records mandatory, in the country, to address these issues?

It is important for electronic health records to be simple and not complicated, which is not the case in the US. The number of protocols followed while creating and using an electronic health record in the US, only confuses the patient. There is a need to have a simple set of electronic health records and a set of specialist health records, which the doctors can use to tag health information of different patients, which is a critical component.

Is the Government looking at setting aside some part of the healthcare budget for the development of healthcare IT in India? We want to have a complete IT infrastructure for the country. Healthcare infrastructure will be virtual. We will provide broadband connectivity and all physical infrastructure will be shared by health IT, without having them pay for it because it will be a virtual network.

How do you see the future of health IT in India? 

In India, there is a lot of enthusiasm and talent and we need to mobilise this for the development and improvement of IT services. There is a need to start collecting data. We already have working groups in place that have set up infrastructure on health portal. More people now want to join these working groups. I am confi dent that by the end of this year we will have a plan in place.

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