Today, if a person with a monthly salary of Rs 12,000 goes to a private hospital for his wife’s delivery, he may end up spending his one year’s income. An admission into a hospital with dengue fever will dry up the year’s income of many, an accident can wipe out all assets of a family, and an admission in an ICU can put the entire family in a precarious financial condition.
Most suicides take place due to the economic burden of loans taken to meet emergency health needs. Nearly 70% of expenditure on health in India is borne by individuals — highest in the world. One of our peculiarities is that though quality healthcare is available and affordable, we accord least priority for health till an emergency.
The big question is if the Government alone with just 1.5-2% of budgetary allocation to the health sector can meet the health needs of the people? Are we properly utilising the budget and are we leveraging information technology to make healthcare more affordable, available and accountable? It is in this context that the role of Health Information Technology (HIT) becomes important.
Here are some of the instant benefits of using HIT that would act as a force multiplier in improving healthcare in Telangana:
e-health records: The biggest impediment to health planning is lack of data on health needs, disease burden and its spread. The government does not have accurate data as almost 70% of healthcare is provided by the private sector. There must be a legislation making it mandatory for online reporting pertaining to outpatient, inpatients, disease burden, surgeries, pharmacy among others so that a virtual databank is available to help plan better and execute healthcare in a cost-effective manner.
Smart Health Card: Like Aadhaar, all citizens should have a smart health card containing entire health data from womb to tomb, including birthplace, delivery mode, immunisations, medications, procedures and admissions. Such data can improve healthcare manifold.
e-pharmacy: Pilferage, misuse, abuse or disuse of medication is a key problem in public institutions. e-pharmacy with smart card tracking, inventory and emergency drugs can help track and plug loopholes.
e-diagnostics: HIT can help make diagnostic facilities available in remotest areas with mapping of areas, centralised sample collection, online reporting and virtual tests. Professional opinions can be given instantly and the private sector can offer various choices and price options.
e-admissions: This can help reduce the waiting periods, thereby effectively addressing overcrowding of hospitals and increasing the output with the same number of beds.
e-referrals: Can provide advance information to secondary and tertiary health centres thereby avoiding delays in admission for emergency cases.
e-mobile diagnostics: Instead of setting up diagnostic facilities everywhere, a mobile diagnostic centre with connectivity and telemedicine facility can help overcome non-availability of specialists and equipment. A couple of mobile units with facilities including for ultrasound, Pap smear, X-ray, blood sample collection and ECG can serve an entire district. The introduction of telemedicine can help get a specialist opinion at the doorstep of the patient. A seamless data system that connects primary, secondary, tertiary healthcare institutions, ambulatory services, doctors, pharmacy, diagnostics — where electronic records can be shared — would go a long way in bettering healthcare.
e-billing: Electronically wired billings will ensure that transparency is maintained, costs compared and cost-effective measures implemented.
e-earning: Healthcare can earn good revenues if services are rendered on a par with the private sector but at an affordable cost. For example, public institutions can tap Aarogyasri funds, Central Government Health Scheme, private insurance sector, private paying patients and medical tourism, which can help build public institutes on a par with or better than the private ones.
e-audit: Government funds are not charity, every penny we spend must yield results. This is best done with electronic data availability and data analytics.
To establish e-healthcare in Telangana, enabling policy decisions need to be taken first. Better salaries, paying clinics, incentives and strictly non-practising legislations help attract and retain good healthcare providers. A pilot project of both incentive and disincentive modes to create the next level of healthcare system in Telangana can be considered.
Infrastructure issues, including provision of hardware, software, data analytics, high-speed connectivity, internet, intranet, data transfers or sharing, wireless personal digital assistant or mobiles, must be addressed to develop Telangana Health Information and Administration Network (THIAAN). All healthcare providers — right from Asha (Accredited Social Health Activist) worker to superspecialties — need to be trained for effective application of technology.
HIT application needs to set goals like financial viability, improved patientcare, improved efficiency, better administration, improved patient satisfaction, attracting quality healthcare personnel, and of course, cost-effective healthcare.
Telangana already boasts many firsts like TS-iPASS, a self-certification system of approvals for industries. It now needs to move to the next level and establish THIAAN, which can propel healthcare to a new level in the State.
(The author is a surgeon and TRS MP representing Bhongir)