Monday, 16 March, 2009

Healthline, WebMD and a Dream to match magnitude

Yesterday evening, when I was sipping my best cuppa of Coffee...My friends rang me..What time dude..Rememeber we need to meet and discuss..the same..How profitable a business is ehealth...My head was spinning though, I still said Yes...After I came back I thought I should write about Ehealth as a concept and profitability.

For years, thousands of people around the world have been publishing small Websites dedicated to a specific health or mental health topic. Maybe it was a site devoted to colon cancer, or breast cancer, or traumatic brain injuries. Maybe it was a site full of information about depression, or mania, or borderline personality disorder. Thousands of people toiled hundreds of thousand of hours to create these small, informative sites, linking to other great informative sites or which are already successful and all that, but does that works?

In late 1996 and early 1997, companies started forming around the idea of compiling a whole bunch of health or mental health information onto one site, and making money by selling targeted advertising on these mega-sites. It was happening in other industries, such as news, entertainment, and technology, so it made sense to give it a try in the healthcare industry as well. Except that a person's health is probably one of the most important and valuable things we all hold dear. These companies didn't quite get that at the time. But they would.

Before you knew it, venture capitalists were circling around these companies, seeing a profitable business waiting in the wings (since healthcare in the U.S. is nearly a $1 trillion a year industry). Only one company really understood what it would take to grab a significant portion of that pie (Healtheon), while the others thought it could be done through appealing to consumers to come visit their site over that of all those smaller sites or the NIH or NIMH directly. They talked in Internet jargon about "value-add" and an "electronic medical record" (which was later changed into the more nebulous and softer-sonding "personal medical record"). Everyone thought that people like you and I would think nothing of trusting our valuable medical data to these for-profit, commercial companies to store.

And so they arose. and WebMD were actually somewhat late players to the game, but each found a way to wiggle their way into an already-crowded e-health marketplace. through its brand name recognition (although I still get the "Who's that?" when I'm talking to people) and WebMD through a cash-infused acquisitions budget, allowing them to gobble up other key players (such as the popular Sapient Health Network). This was in 1998, and already some people could see the writing on the wall for some of these companies if they didn't have a more sound business strategy than simply pursuing consumers with congegrated health information.

Why the plans are just Good plans sometimes?

Of course they all had plans, business plans, but the problem with these plans is that they were all geared toward what the investors wanted to read and hear. They hired others to help them develop a coherent strategy, but didn't listen closely to everything those consultants had to tell them. Most of these companies had little or no healthcare experience.(I still don't know why people dont look for Doctors with ehealth exposure, They just end up hiring IT guys or online marketing people..)

This is the mistake that most ehealth enterpreneurs make, Having your own dedicated staff is essential and then even major tasks you will simply pull off.If You see morphed from an electronic medical record software company into a consumer healthcare portal. That's a heck of a transition to undertake, and a difficult one to pull off successfully. Yet with proper staff, team lead and Ehealth specialist, they managed to do that.


Also many people ,from my friends list were interested in knowing about the success of WebMD.Well, WebMD played it smart and bought an entire company that specializes in medical and health information just to get unfettered and exclusive access to its content library. WebMD finally realized that in order to survive as a company, they needed a more comprehensive strategy than just repositioning health information and selling advertising. So they found a partner and a match in Healtheon, who acquired WebMD in 1999. The companies also struck partnerships with other content providers to flesh out components of their Website.

Similarly, created a clinical trials area after partnering with a clinical trials company. Of course, this presents new types of problems when that area offers only trials from that one company's database. That means consumers visiting that area will never see the vast majority of clinical trials they could sign up for.

Here there market research was lacking, Presence of mind is a big factor in internet setups.When Drkroop was doing all this, for consumers, the NIH already had offered an open, comprehensive clinical trials database. And, oops!, forgot to let consumers know that they were getting paid for each successful clinical trial referral. (In fairness, stopped this practice shortly after it was brought to light in a negative press article in the NY Times, and now offer a more open, but clearly not very comprehensive, clinical trials database. They still do not help consumers find information that doesn't have by providing a link to the much larger NIH database, though.)

The latter is not a good practice though! One should think about visitors convenience above all.

Healthcare Today has taken a shift from Facility centric healthcare model to consumer centric one..

Wednesday, 11 March, 2009

Why to promote Ehealth?

Let us look at Five big points first..and then we will understand how they are interrelated.

Health care Delivery system in India

India is a vast country of 1. 4 billion population

• It consists of 29 states and 6 Union Territories governed by a federal system

• Health is a state subject which follows a three tier system – primary health centre catering a group of villages, Secondary level health centre located at district level and medical college hospitals constitute the tertiary level located in the big cities.

Telemedicine in India:

Potential of ICT to improve health care

 65% of 1100 million will be literate by 2015

 60% of rural India has access to TV coverage.

 650,000 existing PCOs ® internet kiosks,.

 400,000 villages already have telephone connections.

 Internet users in India 2m Dec 2001, 8.5m 2003, will grow to more than 10 million by 2010.

Need for Telemedicine

• Non availability of facilities / skills / technology locally(rural /remote area)

• Urgency of treatment

• Inadequate opportunities for CME

Challenges and Barriers

• Reliability of connectivity

• Need for speed- (Bandwidth)

• Legal / Ethical issues

• Licensing

• Data Security/Patient confidentiality

• Standards

• Learning Curve

• Resistance to change

• Sustainability

• Scalability

According to industry analysts, any hospital with a minimum capacity of 100 beds is a potential IT buyer. It is estimated that there are over 1,000 hospitals in that category in the country. National Association of Software manufacturers are services

Companies (NASSCOM) believes that healthcare organizations in India will spend around INR 100 million on IT in the current year.

The major component of this will be hospital management systems and networking hardware required for processes like telemedicine. Even with such a small scale of operations, some significant changes are being made nationwide that will strengthen telemedicine initiatives and the healthcare industry as a whole. The most important initiative being, the standardization of exchange of health information between different entities within the healthcare sector. The Ministry of Health & Family Welfare and the Ministry of Communication and Information Technology are jointly creating a national health information infrastructure, for easy capture and dissemination of health information. To support this infrastructure, necessary steps are also being taken in creating a legally safe environment that will protect the privacy and confidentiality of health information .

Steps are also being taken to educate various stakeholders of the healthcare industry about the need for complying with health information standards. The above-mentioned initiatives of the government are indirectly going to bolster the growth of cross border e-health services.

Healthcare is becoming more and more regulated in developed countries such as the USA. Healthcare payers and providers are willing to outsource work easily to countries/companies that comply with health information standards and have a robust legal framework for privacy and security of health information. In principle, telemedicine has bridged the urban rural divide by taking healthcare to interiors of India. There are more than 150 telemedicine initiatives today most of it are supported by Indian Space Research Organisation and IT Ministry. On an average close to 6 (range of 2-10) telemedicine encounters take place per day in each of these centers.

These figures are very low considering the dearth of healthcare services in the same areas of India. However, a start has been made. These figures are only going to increase as the technology costs are falling regularly, e.g. telecommunication costs have reduced by 3 times since the last two years.

e-health services are being adopted by healthcare provider organizations in India gradually. The growth of e-health services has given rise to the need for a new breed of healthcare professionals, healthcare administrators and healthcare technologists. This industry needs people who can understand any two of healthcare, business and technology. Historically the healthcare industry has been the last adopter of technology, the same has been the case with healthcare education. Even till today, many of the medical, dental, nursing, pharmacology and other healthcare degrees do not have courses on information technology.

The industry has grown to such a size that people from non-healthcare backgrounds are being recruited and trained. Interestingly, a lot of youngsters with traditional healthcare degrees such as MBBS and BDS are exploring career options in e health. As technology is pervading more into our education system, learning is becoming “anywhere and anytime”. E-learning enables students to study and appear for exams at their convenience from any place they want to, as long as they have a good internet connection. Some forward thinking companies such as Medvarsity have started offering healthcare courses to healthcare students and practitioners.

It is helping medical students to prepare for higher studies through online courses. It also has courses directed to both students and practitioners. e.g.- courses in subjects such as emergency medicine, health insurance, etc. E-Health service companies can get business more easily if their employees’ qualifications are recognized by their clients. Since majority of revenue comes from American companies, many companies are encouraging their employees to enroll for online healthcare courses recognized by American educational institutions and associations. In the coming years India is going to have more e health activities considering the present trend.

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