Sunday, 6 December, 2009

Mobile based Healthcare Models for Emerging Markets

The Mobile Healthcare Industry summit brought up all the stakeholders to discuss and share views on the best practices all across the world. The Post Conference Workshop led by me on “Mobile Healthcare Models for emerging markets” provided a participating opportunity for all players in the ecosystem to clearly define and strategize Challenges as well as opportunities in countries like India, South Africa, Kenya, Indonesia etc. I was pleased to see the overwhelming response and enthusiasm.

Some Key points that were discussed were why emerging markets? What is the role of mhealth in India, Africa etc.? Who will pay? Why will they adopt mhealth systems?

Pretti Lounamaa and Seppo Luede

suggested some very initial points to approach these methodologies. First, Size the market, when we are talking about market we are not only talking about the addressable market but also the number of stakeholders and customers who are willing as well as able to purchase or are interested to deploy. This was the thought that led us to reach to the next point of minimum base infrastructure available and required.
Dr Ruchi Dass- mhealth is quite new and thus the competitive indicators to develop or define a market size from the bottom up are absent and information about health providers, task force and expenditures from the top down lacks detail for India and other such developing countries. We Live in India where most of the people still don’t have their Birth Certificates. So we moved to Market opportunity and I suggested to start from somewhere like Joining Hands with Big hospital chains like Apollo. So we positioned mhealth as end to end as in to start with Education/awareness--------à Monitoring---à Data Access------à Disease tracking/Emergency------à HIS---à Diagnosis/Consultation. With a Doctor to patient ratio of 1:900, this looked like a reasonable solution to start with.
Per Ljungberg et al, have developed some very advanced and useful solution related to prevention and remote monitoring of patients, some of them also address wellness. Here, Per mentioned that how mobility appropriateness is necessary and how it is dependent upon a balance of technical performance, cost and efficacy. Talking about Bandwidth problems and connectivity issues, Per suggested that there is no point waiting for the 3G and other such advanced technologies to get deployed in developing nations, Some simple solutions can bring success to the overall approach as well.
Dr Ruchi Dass- Mhealth, ehealth, Telehealth and everything similar are facing the Silo based problems today as was clearly mentioned by Neil Jordan of Microsoft in his speech. Something is compatible to PDA, something to Laptops and something to mobiles. I feel that the technology should be backwardly compatible as well. It is difficult and practically impossible to scrap Windows 99, 2000 and XP when Vista arrives. Mhealth is not only aimed at moving to new healthcare delivery models but also to strengthen and transform the existing weak health systems. Some very simple solutions of Mhealth are Healthmate by Airtel in India, DrSMS by Kerala IT mission in Kerala, India and SIMPILL in Africa.
Dr Mohammad Arif Ali- Dr Ali suggested some systems overviews in particular like Success and Failures of Electronic Medical Records, What were the factors affecting? What are the advantages and disadvantages of Open Source software in terms of a Developing country perspective? Understanding Social Behaviors in a new country is as important as understanding the Government Policies. Dr Ali cited some such examples.
Dr Ruchi Dass- Mobile based primary healthcare management system in which each family/individual will have an up-to-date data will prove to be a valuable tool for maintaining, analyzing and interpreting enormous data. It will also be used to provide personalized attention to the consumer. One such example is:

Manfred Kube,
stressed that the healthcare industry is realizing inefficiency in the system and is moving towards a system in which connected applications aggregate, visualize and manage medical data on web-based platforms. He narrated some good examples of Data access which would provide clear picture for patients, doctors and service providers to all aspects of a patient’s health. Manfred wanted to understand the self care and home care market in India.
Dr Ruchi Dass- With so much of disease burden in India, Inefficiency should have no room, as it further delays access and cover, but big hospitals or Insurance providers show hesitation in buying and deploying a solution such as electronic health records etc. for two main reasons:
1. There is no public support for insurance companies as well as hospitals to do this, not even any motivation. Also they feel that it is a futile practice as Apollo group will never share their records with Escorts group or Fortis group and vice versa, so there should be a third party managing the same.
2. In case the third party comes as a Government regulation or policy with a different structure, this investment of the hospitals in medical records will go futile.
So, I suggested the role of Telecom operators in this, in managing something like this and charging consumers for the value add. See one example from HealthNet Global .

John French -The presentation on Corporate Wellness was good and I would like to recommend Traffic light concept for Danger, Moderate and Healthy interests me the most.Wellness industry is growing at a very fast pace and basically most of the people who need mhealth technologies help are Old Age people who are not mobile, These people may need remote monitoring, emergency aid and other help at their convenience and this will be possible using technology and mhealth in near future.
Adesina Illuyemi explained that Health care delivery in the developing world often relies heavily on public sector services that reflect the political structures. Different provinces, districts and villages will have different health authority and facilities. Scaling up of the Healthcare systems is required, but these new models should be cost effective, made using appropriate technology and should be scalable. Cross sectoral public policies have constraints may include government bureaucracy and poor communication, connectivity and transport. He said that strengthening Healthcare systems in developing countries is a formidable task.
Dr Ruchi Dass – The obstacle that need to be overcome include appropriate model of healthcare financing, building physical infrastructure, assuring access to medications, qualified and dedicated workforce and efficient use of technology, including wireless and mobile technology. To ensure broad access to needed services adequate financing is required. The WHO recently suggested that $ 34 per person in spending on health could provide essential health services in low income countries to address major communicable and other diseases.
Mhealth may be able to support new systems of care that offer both generic and personalized health information in a more accessible, lower cost ways. Mhealth could decentralize effective care strategies into a community setting and develop larger networks for care.

Thanks for the participation!!!

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