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Healthcare Technology Public Health

Is India taking care of its senior citizens

Last week I was at Hyderabad for a conference where the focus was on the elderly. India has roughly 120-130 million citizens above the age of 60, and this number is going to rise further due to better healthcare facilities and greater awareness of health. I also got a chance to visit my aunt, who had just recovered from fluid in the lungs. The whole visit to Hyderabad was an eye-opener for elderly care. I think we have a serious challenge in this space and currently, we have more questions than answers.

During the conference, I spent some time connecting with other healthcare professionals like Varma from Intel Health Innovation Group and Vikas Bhalla from Philips. I also had the opportunity to lead a panel discussion on how technology is helping increase access for senior citizens.

In the panel with me were, Dr. Mahesh Joshi, CEO Apollo Homecare, Vikas Bhalla – Director (Ultrasound,) Philips India and Rajagopal G – Founder CEO, KITES Senior Care. Raj and Dr. Joshi have worked extensively in senior care, both at the hospital level and services. The crux of the discussion was the breakdown of the family system that has led to a serious problem, with regards to caring for the elderly. This is more of a social problem. But it gets compounded by the fact that there is no one to care for the elderly. No one to care includes no one to monitor if they have taken their medicines on time or if they are keeping up their doctor’s appointment.

Also, we just don’t have the right number of qualified people to care for the elderly. Medical and Nursing schools are producing professionals who mostly cater to emergency cases and those that need chronic conditions. We are grossly under-equipped to take care of the physical and mental wellbeing.

To add to this we just don’t have the process in place to take into account, continuous monitoring using wearable devices. Also, there is no structure to incorporate that data into the health data to make the right decisions.

While there are many questions there have been some efforts in this space. A leading hospital in Bangalore is working on a model for remote patient monitoring of senior citizens at an old age home.

Gurgaon based Suvida is another venture in this direction where the Suvida Care Manager accompanies the elderly care recipient to the medical facility, takes detailed notes, including a personalized Visit Summary, and accompanies the care recipient back home, Suvida to become the first end-to-end medical coordination company, with a built-in unified user-first EMR (electronic medical record) system, so users don’t have to depend on individual medical facilities for their records.

While these are all steps in the right direction, the scale is clearly not enough to meet the demands of the nation. So the question to you is, is India really taking care of its senior citizens?

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Public Health

The real cost of obesity in India

India has always been a land of plenty. Historically it was a land that controlled almost 25-30% of global GDP. It is no surprise then that ancient texts write about obesity in uncertain terms. As a matter of fact practices like Yoga developed in India as a holistic system for physical and mental wellbeing.

During the colonial rule India suffered and so did the health of its citizens. Obesity was replaced with starvation. The Bengal famine during 1943 was the epitome of what all was wrong with the colonial rule and administration. The situation continued after independence, the PDS and rationing system ensured that food was available but in limits.

But 1991 changed all that. With global liberalisation India was an active market to many of the food companies. Nestle, Unilever, General Mills, among others introduced many of their global successes in the country. The net result combined with the growing purchasing power of the middle class has resulted in an epidemic that affects 5% of the population today. It also lays the foundation for systemic conditions like Diabetes and circulatory conditions like cardiovascular diseases.

According to reports from the Indian Heart Association India carries almost 60 % of the cardiovascular disease burden of the world. In terms of obesity again India sees more instances of abdominal obesity. During research on 22 different SNPs near to MC4-R gene, scientists have identified an SNP (single nucleotide polymorphism) named rs12970134 to be mostly associated with waist circumference. In this study, more than two thousand individuals of Indian origin participated and the aforementioned SNP is highly prevalent in this group. Also, obesity seems to affect women more than men in India. According to research done by CADI Research, Obesity among women seems to go higher with increasing BMI.

So what’s the real economic cost of obesity?

  1. For starters, I think it is not necessary for people to spend to consume more if they are already obese. Consumption of food should be “means to an end” and not the other way around.
  2. Obesity forms the basis of the other two lifestyle diseases killing India- Hypertension, and Diabetes. Just last week a very serious colleague from my office had a stroke, his condition was exasperated due to diabetes and obesity.
  3. Studies in India estimate that, for a low-income Indian family with an adult with diabetes, as much as 20 percent of family income may be devoted to diabetes care. For families with a diabetic child, up to 35 percent of income is spent on diabetes care.
  4. If you have Diabetes for five years you would have spent around Rs 1,50,000 on diabetes treatment only. After 10 years you would have spent Rs 4,00,000 and after 20 years you would have spent Rs 15,00,000. The increase in cost with time is due to the increase in complications.
  5. To add this the direct cost of diabetes is around Rs 1,00,000 which includes the cost of direct consultation with doctors and the numerous tests that have to be performed.
  6. Then there is the opportunity cost. Is it estimated that a loss of Rs 50,000 per annum per individual due to sick leaves?

So essentially we have a interesting situation, where we spend money to consume and then spend again on healthcare services.

So how can we change this around

  1. Get aware of the disease burden. If overweight then start, looking at dedicating 1 hour per day on exercises. Something as simple as walking daily is a good start.
  2. Lose the habits, drinking, smoking, junk food is again adding to the costs.
  3. Get regular tests done, this avoids surprises and helps you plan to cover for the disease burden. At a minimum, you should get HB1ac test done quarterly.
  4. Pick up Yoga, I have been practicing Yoga for the last 5 years and have immensely benefited from the practice

The cost of healthcare is only going to go up. Just remember that steps taken today can reduce the cost tomorrow, whether to act or not is totally upto you.

Sources

  1. https://cadiresearch.org/topic/obesity/global-obesity/obesity-in-india
  2. https://edition.cnn.com/interactive/2017/10/health/i-on-india-childhood-obesity/
  3. https://timesofindia.indiatimes.com/life-style/health-fitness/health-news/What-is-the-cost-of-diabetes-care/articleshow/49843288.cms

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Public Health

Ayushman Bharat Yojana : Decoded

Last month saw the launch of the Ayushman Bharat Yojana by Prime Minister Shri Narendra Modi. It is a bold and ambitious step in the history of healthcare reforms in the nation. For the first time, a government has gone beyond lip sympathy on such a large scale. So what is this scheme all about and how can you participate, let’s discuss this in the next few paragraphs.

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Healthcare Technology

Emerging technologies on showcase at the next Philips Digital Health Conclave

The promise of emerging technologies and its implications on healthcare have been a topic of discussion lately. I strongly believe that if designed properly, a health platform leveraging technologies like AI, IoT and Blockchain would reduce the inefficiencies in the system. Today we have pockets of implementations across India, but the next 5 years would see healthcare system-wide implementations. As we go into this new era, what are the key aspects that one needs to cover to make that transition?

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Healthcare Technology

Philips launches global start-up acceleration program for AI in healthcare

Following its successful health technology start-up acceleration programs in Bangalore last year, Philips has opened applications for its global start-up acceleration program. The theme for this global program across multiple locations, including, US, Europe, India and China is AI in Healthcare.