Sunday, 11 May, 2008

India's foray into telemedicine face difficulties

India's attempts to make a foray into the world of telemedicine has not made much headway, especially due to foreign data processing laws and difficulties in certification of qualifications of Indian telemedicine providers, the Planning Commission has said. Rising costs and dearth of medical personnel have created pressures for public health care providers in developed countries to explore the possibility of electronic delivery of services across the borders and they looking for opportunities to outsource diagnostic services to private health care providers. What is relevant is the emergence of opportunities for Indian service providers to supply telemedicine services to developed countries in such segments as diagnostics, dermatology, opthalmology and psychiatry, a high-level group of the Commission observed in a report. The group notes that a number of telemedicine centres are already operating in the country. In 2001, the Indian Space Research Organisation launched a pilot project that connects 78 hospitals in remote areas to super speciality hospitals in the cities. In a recent study it has been reported that supply of telemedicine services from India has not taken off in a big way, except to the United States and Singapore. The client base of telemedicine business in the US has increased in recent years to scores of hospitals and the National Healthcare Group of the Singapore has tied up with Indian telemedicine institutes for providing teleradiology services to designated hospitals in Singapore, the study said. The potential with respect to the European Union has not been translated into actual business as yet on account of a number of factors such as data protection laws of EU members states and difficulties in certification of qualifications and accreditation of Indian telemedicine providers by the authorities in EU member states. There are issues as well that come in the way such as malpractice policies, liability insurance and jurisdiction issues for settling disputes that might arise. One of the main problems impeding growth of supply of telemedicine services by Indian service providers is the large variation in the quality of medical professionals with graduate and post-graduate qualifications produced by institutions across the country, which is a major constraint in receiving recognition from oversees medical authorities, the report said. However, with the government's decision to recognise degrees from foreign universities of English speaking countries, the problem would be addressed to a large extent. Telemedicine has also opened up possibilities of professionals providing expert healthcare services in remote rural areas from their locations in cities, the report said.
Source: economic times

Medical Tourism in India- Benefits and threats

Our ancestors traveled to hot springs and other water bodies for their medicinal value. Rich and famous especially from developing nations have always traveled to advanced countries for the best treatment. But today, these journeys seem to have another purpose, holidaying, and are categorized as ‘medical tourism’. Another peculiarity is reversal of tourist traffic from developed nations to third world for cheaper treatment. But it is confusing how a sick person can be on a holiday and enjoy leisure like any other tourist. Ignoring this fundamental question, medical tourism is being promoted across the world.Medical tourism, an unexplored segment, is still in its infancy in India. About one and half lakh tourists visited India in 2003 for special treatment and/or advanced surgery, as compared to one million to Thailand, and they have mixed response and experience. This figure increased by about 30,000 in the following year in India. They prefer India because it is affordable as compared to treatment in their own countries. Private hospitals are making deliberate efforts to attract medical tourists for better profits. The Ministry of Health and Family Welfare and the Ministry of Tourism have set up a task force to design a strategy for health tourism. However, popularity of traditional Indian medicines is no more a secret. Kerala has been offering ayurveda services from many years to both international and domestic tourists. OpportunitiesAs per a study conducted by McKinsey & Company and Confederation of Indian Industry (CII) India can serve one million medical tourists every year and generate revenue ranging from INR 50 billion to INR 100 billion by 2012. Its biggest pull is lower costs even for advanced treatments. One pays a fraction of what one spends in the West. India can offer a bunch of services including ayurveda, homeopathy, mediation, yoga, and allopathy for better living and enhanced health benefits unlike any other medical tourism destinations.
If these estimates are to be believed, there would be many consequent benefits and opportunities to be harnessed skillfully as motive and needs of a leisure tourist and a medical tourist are diametrically opposite. A leisure tourist visits India mainly for fun and relaxation, while a medical tourist wishes to get rid of an ailment. A comprehensive and dynamic approach is required to serve this new breed of tourists. An alliance of various sectors including tourism, pharmaceuticals, hospitals, hotels, food suppliers to hospitals, restaurants, etc is a must. Hospitals need to cater to specific food habits of medical tourists from different cultures. Hotels have to provide rooms with extra/special facilities and specially trained staff to look after their ailing guests or patients recuperating from surgery or other medical procedures. Private hospitals are likely to generate huge profits which would be considered as exports. In view of success of private ventures, public hospitals’ management may have to pull their sock up to capture a small piece of the cake. Finally, some of public sector hospitals may become better places for both domestic and international patients. The tourism players would have another category of tourists to look after and extra source of income. However, medical tour packaging needs collaboration with different principals like hospitals besides the traditional ones. Multiplier effect would be strong and have wide spread reach. Development of medical tourism segment would help, to some extent, in reversing the brain drain especially those of doctors and other medical staff as hospitals with foreign trained personnel would be preferred. With increasing number of patients, new jobs at various levels would be created. Hospitals may acquire a status of ‘Hospital-cum-Hotel/Medical Hotels/ Treatment Hotels/Health Hotels’. Another reason to travel abroad is need for immediate treatment for which they might have to wait for a few months to a year in their own country. Non residents of India (NRI), people from poor countries (Bangladesh, African nations) and developed nations could be prospective client for the Indian health-care sector. ThreatsThis vibrant picture has many holes warranting serious attention of major stakeholders. To begin with, ‘medical visa’ and associated immigration norms need attention. Increase in demand for medical services from foreign tourists may lead to price hike. It may adversely affect Indians who are not as rich as foreign tourists earning in dollars/GBP/Euro and can certainly afford to pay a bit of extra for treatment as compared to locals still saving substantially. The image of India vis-à-vis other Asian countries is not that strong. I wonder how tourists who otherwise fantasize India as a country of laidback attitude, underprivileged, and poor hygienic condition would like to be treated in Indian hospitals just for the sake of lower cost. The number of medical tourists to India would also depend on how many patients are actually willing and can afford to travel abroad when they are sick. This reminds me of one incident (there are many more) that may also happen in hospitals and may have far reaching implications. I bought a leather purse from a shop in Colaba, Mumbai. I handed over seven notes of one hundred each to the shop keeper and was expecting forty five bucks back. But he returned only forty. When I counted and found five less, I checked with him whether there was a mistake in counting/billing. He replied with a broad smile, no we mainly sell to foreigners and they do not demand small change. He found the demand strange as INR 5/- has no value probably for foreigners and those catering to them. If same thought occupies hospital owners and staff, what will happen to Indian patients who earn far less than their counterparts in developed countries? Preference would be given to foreigners for the sake of profits as private hospitals are eyeing at medical tourism segment to increase their profits like other business communities. This needs to be dealt with in advance. In local health care sector, as existing infrastructure is not sufficient to fulfill the needs of Indians, arrival of foreign patients would add more competition and difficulties. Star hospitals’ capacity is under-utilized, while public hospitals are over crowded. Especially a technology based approach would hit common Indian hard as many of them can not afford advanced technologies imported from the West. Why health care providers and governments of countries from where medical tourists hail would let their business go to their rivals? For instance, British government has already taken preventive measures by putting three hours flying limit for patients wishing to visit foreign medical destination. To become the leading medical tourism destination, India needs special infrastructure, good connectivity between principal cities, fast immigration process, accreditation of Indian hospitals and world class hospitals. Further, how the Indian government plans to handle cases of medical negligence as one bad case/incident draws undue flak from developed nations. What about post treatment/surgery issues after returning to homeland? Whether patients can afford to come again and again to India if needed? What about tourists suffering from contagious diseases? Estimates for medical tourism sector look very optimistic but to achieve them requires resources and serious commitment. All stakeholders have to ensure that foreign patients should not be given undue importance overlooking locals as it would set a bad precedent on the pretext of ‘Athithi Devo Bahav’.
Source: Associated content

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