Role of ICT in healthcare

Geetanjali Saha, Student, PGDM – Healthcare Management, Goa Institute of Management shares her views on the evolving role of ICT in Indian healthcare and its potential to reform the sector

India, has a current population of 1.25 billion. By 2050, it is expected to reach 1.6 billion. So, the public health planners of the country have a big challenge to cater to. The performance of the health sector is suboptimal because of an increased burden of factors like political instability, underdevelopment, weak institutions, scarcity of resources, inadequately developed social sectors and evident social inequalities. However, with an increase in population, healthcare service resources will not increase in the same proportion. There are big geographical disparities in health and wellbeing of the population along with demographic and epidemiological transitions that take place. This demands non-stop spatio-temporal adjustments in plans and readjustment in allocation of healthcare resources. Though the government has made huge budget expenditures under ambitious schemes like NRHM, accessibility to low-cost healthcare is poor. Technology has a huge potential to grow capacity in this sector due to low-cost innovation, low-priced mobile phones and more ‘inclusive’ solutions that fill crucial gaps in health information and access.

To tackle these challenges, the process of health planning needs to evolve by the use of ICT in healthcare delivery and distribution and public health decision making at every level. This will ensure delivery of right health services to right people at the right place as well as on right time. ICT has the capacity to influence all aspects of the health sector. For instance, in public health, management of information and communication processes are very crucial and are assisted or limited by the availability of information.

Of late, the use of ICT has seen a remarkable growth. In India, e-governance has been institutionalised, the use of ICT has become a norm for several government departments. ICT helps patients become more involved in their own care. This becomes more significant in managing chronic conditions such as asthma, diabetes, heart disease etc. People in remote areas sacrifice a day’s work and wages in order to get to a doctor for minor ailments. In such cases, primary healthcare costs can be reduced by be facilitating innovation in telemedicine. Telemedicine can also streamline processes and decrease administrative overheads, thereby leading to creation of new, high-tech markets and jobs. It is also being used for education, research and data management.

Though India has the benefit of a strong IT force as well as indigenous satellite communication technology along with trained human resources, still the application of telemedicine is at quite a nascent stage, particularly in the public health sector. However, with increased efforts, telemedicine could play a pivotal role in delivering specialised healthcare to the remotest corners of the country. Telemedicine can provide the advantages of tele-diagnosis in the areas of pathology, cardiology, radiology and dermatology. It can also essentially lead to operationalisation of CME programmes.

There are various advantages of incorporating ICT in healthcare such as better access to total and accurate EHR that collect information to improve diagnoses, prevent errors and thus save precious response times. It also leads to greater patients’ engagement in their own healthcare. Further, it improves population-based knowledge in a country such as India. ICT ushers in an augmented administrative efficiency in a nation where the public health infrastructure is in absolute mess. For instance, administrative tasks such as filling forms, processing billing requests represent an important fraction of healthcare costs. Health IT can help to streamline these tasks and thus substantially reduce costs, as well as decrease the number of personal visits to doctors. ICT in healthcare can assist remote consultation, diagnosis and treatment through telemedicine.

Examples of successes

India has witnessed varying success across states with the application of ICT in healthcare. This is because of different levels of engagement by way of latest technologies.

An important example is the use of Personal Digital Assistants (PDA), a pilot based project, by ANMs who are important links in the primary healthcare system as seen by the NRHM. This has decreased paperwork and increased data accuracy by making it certain that the data is available in electronic form, even in rural areas with restricted broadband connectivity. The PDA sends out data through wireless communication networks which can later be entered into a larger database using the internet.

In Tamil Nadu, to bolster information practices in primary healthcare with the objective to improve processes concerning healthcare delivery for the rural community, HIS saw an efficient and effective launch. This system develops the capacity of health staff to work on computers which in turn leads to better governance of the health sector and enhances delivery of healthcare to the community.

A health programme, ‘Aarogyam’ was launched in UP as an end-to-end community-based digital health mapping project. It allows citizens residing anywhere in India, using any telecom network, to access their health profile information. The programme provides a health database for a future healthcare strategy. Under NRHM, there is the Mother and Child Tracking System (MCTS) where the project focusses on keeping a track of each pregnant woman, from registration to post-natal care.

GVK EMRI is another example. It handles medical emergencies through the ‘108 Emergency Service.’ It is a free service that is delivered through emergency call response centres. It has ambulances across Goa, Andhra Pradesh, Uttarakhand, Gujarat, Tamil Nadu, Assam, Karnataka, Madhya Pradesh, Meghalaya, Chhattisgarh and Himachal Pradesh. Healthcare services in these states have remarkably improved, especially in remote areas, w.r.t. the response times and number of cases treated.

Challenges and opportunities

In India, public health IT systems exist in silos. Several state health departments make their own IT solutions to fulfill their programme reporting needs. As a result, the systems do not aid in integrated decision making. Therefore, it results in a lack of standardisation in architecture, data standards, disease and service codes.

It is evident that significant challenges and opportunities exist in India. These include growing healthcare needs of an aging population, a shift towards community-based care, costly technologies, need for improved quality and accessibility and the longing of people to be better and directly involved in decisions concerning their health. Information related to health plays an important role in determining the ways of meeting these challenges. The Indian healthcare sector provides ample opportunities for low-cost innovation and the application of technology to improve health outcomes. These opportunities exist due to brick-and-mortar infrastructure gaps, training of ICT-illiterate health professionals, capacity building and lack of primary healthcare staff.

Hence, ICT can play an essential role to improve healthcare for individuals as well as communities. ICT can help bridge the information gaps that have surfaced in the health sector in developing countries like India by providing novel and efficient ways of accessing, communicating and storing information. The gaps between health professionals and the communities served by them can be addressed by implementing ICT in healthcare. Further, with the development of databases and similar applications, ICT has the potential to improve health system efficiencies and thus prevent medical errors.

A smart, careful and contextual integration of ICT in delivery of healthcare service should be a prioritised strategy to aid complex health needs of a country with than a billion people.