Bringing Back the Joy in Health Care
There was a time when the world thought that there is no way one could deal in cash without going to a Bank. Today my septuagenarian father, a career banker who spent his entire work life sitting amidst paper and people in his bank branch manages all his banking needs online. Something, even as a senior banker in his time, he would have never imagined. Health care is going through the same transformation. One may think that Health care is the last digital frontier where the digital physical divide will not breach, but the divide is blurring every day. Technology solutions are making it more and more possible for patients to manage their health needs without having to visit a hospital. But I think the real problem is not whether the solution is physical or digital. It is about whether it can bring back the joy in receiving and rendering health care.
Stress of Care
Health care is a stressful business. According to a Harvard study, 5.2 million medical errors occur in India annually. It is not easy on anyone. Patients are stressed. They have to run around for tests, report collections, consultations, procedures, discharges, post consultations. Through this process, they also feel that they don’t get adequate communication on diagnosis and prognosis. Going online and seeking information leaves them with more confusion than clarity. It is not an easy world for care givers as well. Nurses have to constantly keep measuring patient vitals and other parameters and keep updating multiple notes through the day. Multiple doctors have to come together to treat the patient, in addition to communicating with the patient and family, they have align with the entire care team, other treating doctors, nurses, and with the huge shortage of medical talent in the country, there is constant pressure on the health care systems, it is difficult for them to keep up.
There has to be a better way:
Imagine a world where a patient can see all his updates on a mobile app, maybe the family can even see them on video when they are in intensive care units etc, Imagine if nurses don’t have to measure any patient parameters, rather there are devices which measure them and provide them with exception updates; imagine if doctors can see what’s happening to their patients 24x 7; and don’t need to go on rounds to understand their position, Imagine… But the reality is, none of this has to be imagined anymore. These technologies have already developed. They are being used. For example, in Narayana Health, doctors use an mobile app called the Aadi where the entire team of doctors who are caring for a patient can see all the updates in a WhatsApp type platform. They see patient vitals and other readings, diagnostic and test reports with exceptions flagged, opinion from other doctors, 24x 7. This is only a beginning. Collaboration and communication in care giving is solving itself and this will change the outcomes of health care significantly.
Digitising the Patient Life cycle
The lowest hanging fruit is the digitisation of the patient life cycle. If one were to caricature a typical patient or patient care giver, surely one would imagine them as people carrying various files from various hospitals and diagnostics ranging over several years. In a 5 minute consultation with the doctor, how reasonable it is to expect the doctor to synthesise the summary of these 100s of pages and provide an accurate action plan. From the time the awareness for the need of the care comes, the patient life cycle has multiple steps. The initial diagnosis and differential diagnosis, the battery of tests, the consults and cross consults, procedures if any, dealing with insurance/mobilising cash, post procedure management and ongoing care. Today, there are many tools that are disrupting this space. The most important one is the Electronic Health record (EHR). The National Health Authority of India is building the Ayushman Bharat Digital Mission or ABDM which has been pioneering EHR at a national level. EHR will be a game changer for the medical field. It will enable seamless flow of information. The doctor will be able to see what matters and it will provide easy fungibility for patient. Unlike the west where they have been stuck with monolithic architecturally complex EHRs, India has an option to create something more new age, cloud enabled and fit for purpose systems and definitely, ABDM is thinking along these lines. The other aspect is just the process of care. Currently, the system functions with lack of transparency and trust between patient, hospital and insurance or payor as one may call. Clear communication pathways enabled by technology between all three stakeholders can go a long way in building a more seamless care experience. There are many startups working in this space to establish better processes. All of this will definitely bring about greater patient
experience.
The Magic of Data
Analytics is the next big theme in the world of healthcare. Using the power of data, better monitoring of clinical initiatives better analysis of outcomes will become commonplace. At Narayana health a pilot is underway with the help of Medha analytics ® to assign risk score to patients based on a myriad of parameters driven by varied data inputs, which significantly reduce the risk of adverse outcomes. This is a small drop in the art of the possible for analytics. A very strong EHR and digital capture of all patient information is fundamental to leverage the power of analytics to it is fullest potential. Having the power of cohesive data driven insights and past experiences from across the globe, it is like a super power to the medical community.
In Summary
The next stage of evolution in health care is at the Intersection of human imagination and machine intelligence. It is only a matter of time that clinical pathways will have a necessary component of an AI consultation to not just ensure comprehensiveness of diagnosis but demystify medical care. We are entering a fundamental transformational phase in the Health Care Journey. Technology will bring back the Joy in Care Giving, Peace in Receiving Care and Improve quality of care by Geometric proportions. It is for us to evangelise, embrace and enliven the change that has already arrived.
Stress of Care
Health care is a stressful business. According to a Harvard study, 5.2 million medical errors occur in India annually. It is not easy on anyone. Patients are stressed. They have to run around for tests, report collections, consultations, procedures, discharges, post consultations. Through this process, they also feel that they don’t get adequate communication on diagnosis and prognosis. Going online and seeking information leaves them with more confusion than clarity. It is not an easy world for care givers as well. Nurses have to constantly keep measuring patient vitals and other parameters and keep updating multiple notes through the day. Multiple doctors have to come together to treat the patient, in addition to communicating with the patient and family, they have align with the entire care team, other treating doctors, nurses, and with the huge shortage of medical talent in the country, there is constant pressure on the health care systems, it is difficult for them to keep up.
There has to be a better way:
Imagine a world where a patient can see all his updates on a mobile app, maybe the family can even see them on video when they are in intensive care units etc, Imagine if nurses don’t have to measure any patient parameters, rather there are devices which measure them and provide them with exception updates; imagine if doctors can see what’s happening to their patients 24x 7; and don’t need to go on rounds to understand their position, Imagine… But the reality is, none of this has to be imagined anymore. These technologies have already developed. They are being used. For example, in Narayana Health, doctors use an mobile app called the Aadi where the entire team of doctors who are caring for a patient can see all the updates in a WhatsApp type platform. They see patient vitals and other readings, diagnostic and test reports with exceptions flagged, opinion from other doctors, 24x 7. This is only a beginning. Collaboration and communication in care giving is solving itself and this will change the outcomes of health care significantly.
Digitising the Patient Life cycle
The lowest hanging fruit is the digitisation of the patient life cycle. If one were to caricature a typical patient or patient care giver, surely one would imagine them as people carrying various files from various hospitals and diagnostics ranging over several years. In a 5 minute consultation with the doctor, how reasonable it is to expect the doctor to synthesise the summary of these 100s of pages and provide an accurate action plan. From the time the awareness for the need of the care comes, the patient life cycle has multiple steps. The initial diagnosis and differential diagnosis, the battery of tests, the consults and cross consults, procedures if any, dealing with insurance/mobilising cash, post procedure management and ongoing care. Today, there are many tools that are disrupting this space. The most important one is the Electronic Health record (EHR). The National Health Authority of India is building the Ayushman Bharat Digital Mission or ABDM which has been pioneering EHR at a national level. EHR will be a game changer for the medical field. It will enable seamless flow of information. The doctor will be able to see what matters and it will provide easy fungibility for patient. Unlike the west where they have been stuck with monolithic architecturally complex EHRs, India has an option to create something more new age, cloud enabled and fit for purpose systems and definitely, ABDM is thinking along these lines. The other aspect is just the process of care. Currently, the system functions with lack of transparency and trust between patient, hospital and insurance or payor as one may call. Clear communication pathways enabled by technology between all three stakeholders can go a long way in building a more seamless care experience. There are many startups working in this space to establish better processes. All of this will definitely bring about greater patient
experience.
The Magic of Data
Analytics is the next big theme in the world of healthcare. Using the power of data, better monitoring of clinical initiatives better analysis of outcomes will become commonplace. At Narayana health a pilot is underway with the help of Medha analytics ® to assign risk score to patients based on a myriad of parameters driven by varied data inputs, which significantly reduce the risk of adverse outcomes. This is a small drop in the art of the possible for analytics. A very strong EHR and digital capture of all patient information is fundamental to leverage the power of analytics to it is fullest potential. Having the power of cohesive data driven insights and past experiences from across the globe, it is like a super power to the medical community.
In Summary
The next stage of evolution in health care is at the Intersection of human imagination and machine intelligence. It is only a matter of time that clinical pathways will have a necessary component of an AI consultation to not just ensure comprehensiveness of diagnosis but demystify medical care. We are entering a fundamental transformational phase in the Health Care Journey. Technology will bring back the Joy in Care Giving, Peace in Receiving Care and Improve quality of care by Geometric proportions. It is for us to evangelise, embrace and enliven the change that has already arrived.
