In the public health domain, medical evidence can be created only through a strong data integration system. Angshuman Sarkar, Principal Consultant, ThoughtWorks, in an interview with Raelene Kambli explains the relevance of this subject
What do you mean by integration of services in the public health domain? How each stakeholders can be part of this integration?
So far, people in the healthcare space worked in isolation. Digital tracking system were developed and used only for monitoring and evaluation of specific health programmes, for example the insidious programme for the mother and child tracking system.which is deployed only at the community health centre level. If the patient moves to another district, or state then healthcare providers loose all the information stored at the community centre as there is no connect or integration of data between these stakeholders. The patient in this regard become the only bearer of the information.
To solve this issue, the government came up with different health cards where the information on vaccinations, treatments etc., is documented. Since, these cards are hand written there is a possibility of damage or of these cards getting lost in transit, which means, we cannot rely on these health cards for any kind of evidence.
Therefore there is a need to develop an ecosystem based on data integration that involves all processes at every level. Be it community health, district level, state or at the national level, keeping in mind the patient needs.
How important it is to think beyond monitoring and tracking system while designing digital platforms for public health?
It is very important to think beyond tracking system while designing products. There is certainly a need to develop IT systems that can integrate various informs collected by different tracking system to provide data which can be utilised to make medical decisions.
For example, if I have my entire medical history then I can seek medical advice from any doctor sitting in any state or district. This technique will be useful for the rural population in India. The state of people living in the rural areas is such that they cannot even explain their medical conditions properly. Moreover, as the information does not flow between the IT system, patients bear the cost of re-test and excess diagnostics. Therefore a platform that can address these issues will be of great help in the public health domain.
What about security of data?
Yes, security of patient information is paramount and technology providers need to take this very seriously. At ThoughtWorks, data security is one of the key things we focus on.
Do you think that technology solutions like yours can be utilised to generate evidence?
Certainly, our solutions can be leveraged to create evidence for strengthening our public health system in India.
A major challenge that technology players face is the reluctance of healthcare providers to utilise such technologies. How do you go about convincing doctors?
We build our IT system keeping in mind healthcare providers and patients. In my experience, I have seen how difficult it is to convince healthcare providers in the rural areas to understand these applications. Therefore, we design our solutions to be user friendly. Also, we provide training to them.
Moreover, all these doctors need to send some reports or the other. We actually, go about explaining the benefits of these applications and show them that documenting these report digitally saves time and their efforts. Basically give the doctor the systems that they need which can save their time and extra efforts.
What are the pre-requisites for integrating data for public health?
We will always have IT systems that will be developed for a specific purpose. But they should all be able to talk to each other using intra-operability standards. If the data captured at a community centre level does not flow upwards then the doctor sitting at a primary level will never be informed about the medical decisions. Training is also an important element that solution providers need to keep in mind. Data security is another important element which cannot be ignored.
So, do you think there is a need for building intra-operability standards for IT solutions in India?
Yes, I absolutely believe there is a need for assimilation of a comprehensive standard as there are too many players available in the market. People are confused which one to choose. A comprehensive intra-operability standard will help to make the right decisions.
Scale is another challenge that technology players face in India. How do you fix this problem?
This has to be done at the very planning phase of a health programme. Providers need to think how they would leverage technologies to scale their health services. Also, timely upgradation of technology is essential for any technology-based health programme.
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