Thirty-five-year-old homemaker Seema Jain (named changed) couldn’t feel her legs. Just minutes earlier, she had been riding her Honda Activa towards the market area, when a Tempo Traveler suddenly emerging from a bylane and hit her vehicle’s rear wheel, throwing her off balance and to the ground.
Bystanders had called an ambulance and as she was being hauled in, she felt something was wrong. Her legs felt unnaturally numb, while the rest of her body was in mild pain from the shock of the accident.
The doctor in the ambulance stabilised her and seemed to acknowledge that she had no sensation in the legs.
Seema doesn’t clearly remember what happened next, but that the entire procedure – of going from the ambulance to the hospital, being treated by doctors and finally being discharged – was rather smooth, unlike what she had heard of about patients involved in accident cases.
It was almost as if the doctors knew who she was, what her ailments had been, and then administered the most appropriate treatment to which her body responded well.
For duty doctors at the new digital hospitals in India, this situation is routine. Their ambulances are fitted with ECG machines with inbuilt blood monitoring devices so that the doctor on board can save precious time by running the necessary tests and gauging patient medical history even before reaching the hospital.
Data recorded onboard the ambulance is transmitted via 4G technology to hospitals, which is then matched against the patient’s electronic medical records (should they be available) to identify what course of treatment would be suitable in the current situation.
In Seema’s case, her medical records were available with the hospital, thereby enabling a course of treatment as soon as she got off the ambulance.
The backbone of this healthcare transformation is patient data. Hospitals across India have had access to patient data for a while.
But what has changed is that they are now using this data to create programs for preventive care, improving care outcomes, reducing re-admissions, and improving patient engagement and satisfaction.
How Patient Data Is Being Leveraged
For instance, Kokilaben Dhirubhai Ambani Hospital (Kokilaben Hospital) uses patient data to understand the workload of various medical specialists employed, seasonal variations in in-patient admissions, and forecast local disease patterns.
By tracking aspects such as length of stay, emergency admissions, and work flow at departments like radiology and pharmacy, the hospital’s management has been able to improve their patient engagement strategies as well as operations.
The hospital also tracks metrics pertaining to re-admissions so as to create intervening preventive health programs and reduce re-admissions.
Technology is key to making healthcare patient-centric. We are experimenting with several technologies to improve patient experience, hospital interactions and medical outcomes.Rajesh Batra, Chief Information Officer (CIO), Kokilaben Hospital.
Located in a bustling road at the heart of Bangalore, Manipal Hospital is not new to technology.
In 2015, they became the first hospital in India, and among the first few in the world, to adopt IBM’s Watson platform for oncology diagnosis.
In a recent study conducted by the hospital involving 600-plus breast cancer cases, it was observed that concordance between the recommendations provided by Watson and that by the Manipal Hospital’s oncologists was as high as 90%.
This means patients now have the advantage of seeking diagnosis from the Watson platform, in addition to a specialist oncologist at the hospital.
The Watson platform was tutored on the cases by accessing clinical data of patients already treated at Manipal. All cases considered in the study were approved by the scientific committee and the ethics committee constituted by the hospital, before being fed into the Watson platform.Dr Anoop Amarnath, Chief Medical and Information Officer, Manipal Hospitals
Manipal Hospital has also been analysing its Health Information System (HIS) data, particularly on the progression of kidney diseases in patients.
On comparing Kidney Function Test parameters between patients in India and patients in the West, it was found that the rate of kidney deterioration in a Caucasian diabetic patient was 1% but that in an Indian diabetic patient was 4%.
This helped the hospital devise a program for early intervention in diabetic patients in India.
It is a significant development for healthcare in India, as most guidelines on public health published globally are based on studies conducted on American/European populations, hence not always accurate for India.
By leveraging Indian patient data, healthcare organisations can issue accurate health guidelines for India including variations for local population in each city and state.
Medi Assist, India's largest third party administrator (TPA), manages health benefits claims for over 15% of India's population and in doing so, is privy to large amounts of patient data.
This data is being used by insurers to improve insurance policy design by analysing the costs, ailment-wise spend, city-wise medical spend, and out-of-pocket expenses incurred by members, among other aspects.
Further, wherever appropriate, preventive healthcare programs, including fitness and wellness programs, are being offered to the insured to reduce future cost of care and lower premium amounts for health insurance.
Our aim is to create a comprehensive healthcare exchange that leverages structured data to cater to the varying needs of the entire ecosystem in a secure and reliable manner.Prashant Jhaveri, Chief Business Officer, Medi Assistance
A health exchange is a digital platform designed to improve health outcomes for populations.
In an ideal scenario, hospitals and doctors would use the platform to share verified patient information; patients could access their medical information securely in digital formats; and healthcare payers, including insurers, corporate organisations or even patients themselves, would have full visibility into the cost of care.
This would also enable individuals to make better lifestyle decisions and also access healthcare services of their choice online. Senior management in corporates providing health insurance to their employees would be able to make informed decisions related to their health portfolio; government decision makers can utilise this data to design public healthcare schemes.
While the health exchange concept is in its nascence in India, the US has had a similar platform for several years now.
Centered around the “Triple Aim” – better care of individuals, better health for populations, and lower per capita costs – it strives to offer best practices in diagnosis and treatment to patients regardless of the clinician, provider organisation or payer.
All of this relies on gathering accurate patient data, starting with patient history and adding quantitative and qualitative data throughout patient interactions.Jonathan Handler, President, Jonathan Handler Associates
Jonathan Handler Associates is a provider of IT solutions to the healthcare industry in the US.
The US has seen many population health programs implemented on the basis of patient data collected by such healthcare systems.
A population health management program in Nashua, New Hampshire, that focuses on care coordination for substance abuse patients has reduced overdose and fatalities by 34 percent while saving nearly $2 million in utilisation costs.
Similarly, studies in Camden, New Jersey, showed how the same patients were readmitted to hospitals repeatedly for treatment indicating the need for intervention and preventive health mechanisms.
While Indian hospitals are stepping up their adoption of technology, the government is facilitating large scale health programs which rely on technology.
The National Health Policy was just released a few months ago with focus on preventive care through usage of technology and methods like preventive screening.
The government has also released standards for electronic medical records (EMR) and medical devices which will help hospitals adopt technology faster and in a more streamlined manner.
Further, most government insurance schemes are set to be cashless, giving the right incentive to care providers to adopt technology and leverage patient data to improve care.
With the government, hospitals and health insurance providers investing in technology, the future is bright for a healthier India.
(Dr Vikram Venkateswaran is the Founder and Editor of Healthcare India, an online platform that strives to create awareness and improve healthcare in India. He can be reached on Twitter @drvikram)
(This is an opinion piece and the views expressed above are the author’s own. The Quint neither endorses nor is responsible for the same.)