Public Health

The dismal state of Public Health In India

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According to latest Human Development Index(HDI) report released by the UN, India has done very well in the field of education. In last ten years there has been a 28.5% increase in the number of children going to school and this has been a remarkable achievement.

But unfortunately Public Health continues to suffer and the indicators are not positive. Though smaller states like Kerala, Delhi and Goa have been able to provide both preventive health and nutrition services the much more populous states like Uttar Pradesh (UP), Bihar and Madhya Pradesh (MP) continue to languish.
UP for example now boasts of a world class formula one circuit, but continues to have abysmal primary health infrastructure. This is the divide in India which i am never able to understand.
Providing primary health, adequate nutrition and sanitation are the basic requirements that a citizen asks of its government.
India’s record on public health are also very dismal. In a report published in 2006, India’s public health expenditure as a percentage of GDP stood at .9% while the private contribution was almost 4.2%. Similarly our per capita public expenditure on Health is close to $80 but the private out of the pocket expense is around $100. The report can be accessed here
So clearly the government has decided that running an Airline is a priority but not providing basic medical facilities. But I wonder if this is a viable situation which will have implications for the future. With a young population it is important for public health facilities to be upgraded, immunization provided and stress laid on nutrition.
I believe the best way out of the mess is to provide most of these facilities in the schools. As the percentage of children going to schools are increasing, most schools could also double up as a public health facility with focus on primary care and nutrition.
Some years ago Mr MG Ramachandran the late Chief Minister of Tamil Nadu had stated the mid day meal initiative to give added incentive to parents from poor back grounds to send their children to schools. The same scheme could be used to provide a balanced diet to the children.
Indian politics and governance has a habit of making up strategy as we go along. Health unfortunately is a matter of strategic importance and government will do well to wake up to it.
Healthcare Technology Public Health

The emerging role of analytics in Healthcare

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Why has healthcare analytics become very important in healthcare?
Well the reasons are three fold.

Firstly , IT adoption in healthcare industry is on the rise. In the US even before Obama care cam e into the picture, many healthcare providers, physician groups and community health centers had started adopting IT. In Europe NHS was at the fore front of concepts like ‘One Patient, One Record’. Though the NHS strategy has undergone a change but the objective remains to digitize Healthcare. Continental Europe has been adopting IT at a faster rate than US or UK, with countries like Holland, Belgium, Norway and Germany leading the way. Not to be left behind India and China are on the same route.

Secondly there has been increasing adoption of IT standards in Healthcare. Many hospitals are on HL7 and with the adoption of ICD 10 by the US, most Healthcare providers and Insurance firms will be on the same standard. Similarly there are moves to bring the Medical Devices and Pharmaceuticals on the same standards as the EMRs so as to enable the interoperability of data.

Thirdly, Due to IT adoption and introduction of standards there is tonnes of data available. Technically there are three sources of medical data available to a hospital or care giver.

  • The patient record and medical history
  • The hospital records that are available with the care provider of treatment regime for similar diseases
  • Online medical encyclopedias and dictionaries

Now a good treatment regime should involve information from all three sources. and here is greatest scope for analytics. A good clinical decision support system based on analytical technology will be able to help the physician to narrow down on the disease and chart a course for an effective treatment regime.

The objective of a healthcare provider is to improve clinical outcomes and to restore functionality. And I am sure that analytics would come in very useful in meeting that objective.