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Healthcare Technology Uncategorized

Patient Experience in the Digital world

In January 30 2020, India recorded its first case for Corona Virus popularly known as Covid19. Since then India has seen a series of lockdowns and as we inch towards somewhat of a partial recovery, the question around the state of our healthcare system has become centre stage again.

Since the 1940’s where the Bhore committee gave its recommendations for developing the healthcare structure in India, as a nation we have been playing catch up with demand far exceeding the supply in terms of doctors, diagnostic equipment, hospital beds and medicines.

In addition the wellness programs have been struggling and preventive measures have not been very successful. In this context the corner stone of the healthcare system in India has become the hospital.

What determines a successful healthcare intervention is patient experience. Today with the advent of telehealth and the guidelines given by Medical Council of India, it becomes even more important for hospitals to focus on patient experience and add to the growth of the industry.

What determines a successful healthcare intervention is an excellent patient experience #Healthcare #DigitalHealth

What is Patient Experience?

Private hospitals have long tracked patient satisfaction ratings, but they didn’t always carry great significance. While all hospitals want happy patients, most hospitals have been historically plagued with the “doctor knows best” mentality — a mentality where clinical outcomes outweigh “touchy-feely” indicators such as patient satisfaction or overall patient experience.

However, in recent years, some leading institutions in India have begun to focus more heavily on providing an outstanding patient experience. Drivers for this include growing consumerism and transparency for healthcare services and increased interest from both consumers and providers in patient-centred care.

Why Patient Experience is important to Hospitals?

Healthcare consumers increasingly view their experience with a provider as a key consideration for determining if they’ll return to or recommend the provider, largely because it remains one of the few ways consumers can differentiate providers. Over the past few decades, clinical outcomes have improved dramatically, and patients no longer view favourable outcomes as a key differentiator as these are expected. What remains is the patient’s overall experience, which encompasses everything from customer service to patient-centeredness and care coordination among providers. 

Also given the growth of Tele Health, it would become even more important for hospitals to focus on patient experience in order to create a favourable experience and create the hook that would bring patients and others in the community back to the hospital.

The key is how you make the patients feel

Key Parameters of Patient Experience in a Hospital

While there are many parameters that determine patient experience, we have tried to list down a few key ones that might influence the satisfaction index more than the others.

  1. Patient Appointment Experience
  2. Patient Online Portal
  3. Social Media and Digital Out Reach
  4. Facility for the In-Patient Service and Emergency Service
  5. Patient’s Access to medical Records
  6. Patient Information
  7. Clinical Outcomes
  8. Value Added Service

“The art of medicine consists of amusing the patient while nature cures the disease”

Voltaire

While many of these parameters are difficult to understand or assess, as part of this report we have identified Social Media as a parameter that we would like to evaluate. In order to do so, we have identified 6 Hospitals across India. These hospitals are

  1. AIIMS
  2. Apollo Hospitals
  3. Fortis
  4. Manipal Health
  5. Narayana Health
  6. Kokilaben Dhirubhai Ambani Hospital

We have tried to mix it up between hospitals from the government sector and private sector and also among general hospitals and super speciality hospitals. Below is our analysis of the key parameters between the social media presence of these major hospitals.

I believe that Social media is an indicative parameter. It shows whether there is a foundational maturity in the digital program of the hospital. Also, a lot of patient experience is visible by the comments and interactions with the hospital’s social media channels.

The findings of our analysis are captured in the report below.

Download the Report

Would be happy to discuss and see how you can build your digital experience for patient engagement. Do write in to discuss.

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Public Health Uncategorized

Why India needs to stengthen its primary helthcare system

While COVID rages on globally and across India a more spirited debate ranges in my mind. Was there a way to anticipate and proactively move on infectious and non infectious conditions in India?

One thing that COVID has exposed is the gross unpreparedness of the Indian healthcare system to deal with pandemics. But it also exposed how little we knew about the situation on the ground. Data available is inadequate and most of the data especially from the villages and districts is not captured.

At the front line for the fight against disease and other illnesses is the Indian Primary Care system. This system is mostly run by ASHA (Accredited Social Health Activists) If something is coming our way, they are the first to know. And while they have been around since the recommendations of the Bhore Committee recommendations were given in 1943, it is easy to see how they are ill-prepared to deal with anything.

This is some data that I have been able to ascertain from public sources.

Number of ASHA Workers 9,00,000
Number of primary health centers 25,000
Average Salaries of ASHA Workers INR 2,000/PM
Average costs incurred by ASHA WOrkers INR 800/PM

So this is the on-ground scenario. These workers have to fill multiple forms for child care, maternal care among others, and then they have made 10-15 home visits per day. There are key reasons why ASHA workers are important.

  1. They are local to an area, they understand the local customs and traditions
  2. They have the trust of the community, communitites in rural India do not like to discuss their health with strangers
  3. While are part timers, going from home to home makes them the best eyes and ears for the healthcare system

But given their situation and low pay, would it be interesting to see what we can do to help their situation. The government is spending close to INR 5000 Crore on the Ayushman Bharat Program. Next year the outlay is close to 10,000 Crore. But at a fraction of this cost, we can increase the pay for the ASHA workers and get much better coverage to prevent patients from getting hospitalized.

In the coming days, I would be focusing on how we can strengthen the primary care system and improve the overall effectiveness of the ASHA workers while providing them better remuneration for their tasks.

We did this video to talk about the challenges of the primary healthcare system. Below is the recording for the same.

As always we look forward to your comments and suggestions on the same.

References

https://thelogicalindian.com/story-feed/awareness/asha-workers-rural-healthcare/?infinitescroll=1

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Public Health Uncategorized

Privacy Concerns with the Aarogya Setu Application for Covid19

Just this week, we recorded the second episode for the India Health Talk, with Dr Sumeet Kad. During the recording we ended up discussing the privacy concerns around Aarogya Setu, the contact tracing application launched by the Government of India to track Covid19 cases in the country. Aarognya Setu today has more than 10 Crore downloads and is the largest contact tracing application in the world. How do we balance the privacy concerns with managing a pandemic like Covid19? Alo what can we learn about other applications across the world in this space?

While I understand the concerns, in my opinion, during a pandemic we may need to give up some control over our data and privacy for the greater good of society. Pandemic is a national emergency and Covid19 is probably the worst example of it. But using privacy to derail the efforts to combat Covid19 is not a good idea. In the long run this may be our downfall.

Below is the full recording of the episode. Do let me know your thoughts as well.

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Telemedicine services critical to the wellness of senior citizens in India

On my 43rd birthday, I received an unexpected gift with the Medical Council of India along with Niti Aayog released the guidelines for the use of Telemedicine in India.

It was ironic as MCI and other state associations have been fighting a battle to stop teleconsultations and putting regulations around it. But the coming of Covid19 has changed all that.

Today after a long time we have a spurt in telemedicine providers in India. Industry experts like Bharat Gera former CIO of St Johns Hospital, are working with bodies like Telemedicine Society of India to put in a process to benchmark the functionality of these providers.

In the long run, I see this as a very positive move for senior citizens. These individuals fight it difficult to access healthcare. Especially as they have chronic conditions that need management, right from transportation, to long hours in the waiting room.

To discuss this and other associated topics, I got together with industry experts like Ravi Ramaswamy from Philips to discuss the impact telemedicine would have on seniors. We were joined by Dr Neeraj Bhalla and Dr Vallikiran to discuss the impact on areas like Cardiology and Psychiatry respectively.

The recording of the session is below.

I believe that Telemedicine is a boon to seniors. There would be a learning curve with respect to getting used to the platform, training to caregivers, and then managing concerns like security. But I think Telemedicine is here to stay.

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Public Health Uncategorized

National Health Blue Print 2019

Niti Aayog in July 2019 has finally released the digital health blueprint policy for India. The focus of the digital health blueprint is in line 2017 National health policy which focuses on long with a strong emphasis on the care continuum. National health policy also plays a lot of emphasis on the Triple Aims that include

1)Accessibility

2) Affordability

3) Quality of care

National Digital Health blueprint truly recognises that there is no one entity or organisation that can solve the Healthcare problems of India it calls the blueprint for the entire Healthcare system this is a strong departure from the traditional ideology that the government is the sole provider of healthcare for all citizens.

National health blueprint focuses on three major components

  1. Digital health infrastructure number
  2. Digital data
  3. Standards and regulations

Meeting key healthcare objectives

The key objectives of the national digital health blueprint include establishing the core data model for storing and using healthcare data that would be generated from this ecosystem. Standards for the infrastructure required for its seamless integration using standards for all the components of the ecosystem.

The other interesting aspect is creating a system of Personal Health Records, based on international standards, and easily accessible to the citizens and to the service providers, based on citizen-consent.

There is also a provision for declassifying data for usage for analytics and doing population health management. In addition to these, there is guidance on governance, leveraging information systems already in place.

Finally, the 4 building blocks of the policy are

  1. Identification- Identifying the citizen and ensuring that his corresponding health data is mapped to his id. This is possible through Personal health identifier and through the health registries
  2. Citizen in the center- All access and control of the data lie with the citizen. This is enforced through consent manager, Anonymizer and Privacy Operations Center.
  3. Interoperability- Data should be available through health information exchange and National Health Informatics Standards.
  4. Access – Governed by Mobile First and a Digital Web portal strategy

I would encourage you to download the blue print report and study the implications of the report for your self. Looking forward to your comments.