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Tuesday 21 October 2014

Healthcare On Mobiles: Women Achievers in Information technology 2014

Healthcare On Mobiles: Women Achievers in Information technology 2014: I feel proud when my name is included with the leading ladies in India today- Facebook, Walmart, Amazon and others. I however feel equally concerned about the future of IT in India.

While I represented as the only lady to represent the healthcare industry, it is indeed a truth and a realization that we need much more of IT across industries. At INTEROP, I had the privilege to meet with Prof F. C Kohli. "Those were the days when we were provided with Russian computers. These computers used to heat up after every 4-5 hours and then we had to shut them down and let them cool off before we can use them again", said Mr F. C Kohli recalling his initail days toying with these machines called Personal computers then.

Friday 12 September 2014

Women Achievers in Information technology 2014

I feel proud when my name is included with the leading ladies in India today- Facebook, Walmart, Amazon and others. I however feel equally concerned about the future of IT in India. While I represented as the only lady to represent the healthcare industry, it is indeed a truth and a realization that we need much more of IT across industries.

At INTEROP, I had the privilege to meet with Prof F. C Kohli"Those were the days when we were provided with Russian computers. These computers used to heat up after every 4-5 hours and then we had to shut them down and let them cool off before we can use them again", said Mr F. C Kohli recalling his initail days toying with these machines called Personal computers then.

Those who have never heard his name- Well! Prof. F. C . Kohli is frequently referred to as the Father of the Indian Software Industry due to his significant contribution in Indian IT industry. Padma Bhushan, Faqir Chand Kohli completed 90, on March 19, 2014. It was a day to celebrate for many Indians whose life he has touched directly or indirectly. A workaholic, who scoffs at the concept of retirement and fading into the sunset and is deeply engaged in using technology and systems approach to solving societal problems at 90!

Mr Kohli continues to be proactive, focusing his energies on education. His current efforts are around using computer aided sounds and images to impart basic literacy, particularly to illiterate adults, in a matter of months.

I clicked a Selfie and Yes, I was lucky! It was "Teacher's Day" and I got this opportunity to be blessed by him as a "Woman Achiever in IT". Information Technology isn't that old in the country. I still remember my First Personal computer- Bulky with Cassette and Floppy drives!

The 1980s liberalization of the Indian informatics industry took place in the context of continued high levels of state involvement, but there was evidence that the character of that involvement was changing.In 1991 the Department of Electronics broke this impasse, creating a corporation called Software Technology Parks of India (STPI) that, being owned by the government, could provide VSAT communications without breaching its monopoly. STPI set up software technology parks in different cities, each of which provided satellite links to be used by firms; the local link was a wireless radio link. In 1993 the government began to allow individual companies their own dedicated links, which allowed work done in India to be transmitted abroad directly. Indian firms soon convinced their American customers that a satellite link was as reliable as a team of programmers working in the clients’ office. Today, advancements in IT has been of benefit in creating more jobs in India but the real revolution is yet to begin.

Those were the days. Quotes from Mr F.C Kohli:

"When we started, the Indian software industry was primarily focused on exports and 40 years later, it still continues to be so. The domestic market accounts for only 15% of the software industry's $100 billion annual turnover. The country has too few computers. This is because there are no computers in Indian languages. China has computers in mandarin, but India, for historical reasons, has stuck with English. The computer is but a tool and Indians should be able to use this tool in their own language. You express your ideas best that way. Innovative thinking comes in your own language. After all these years of speaking in English, I still dream in my own language.

Most people in India seem to have been carried away by the spectacular success in IT services ($ 70 billion exports in 2012-13 according to RBI). A decade ago, some politicians even started calling India, quite prematurely, an 'IT Superpower', in their own inimitable style. However the man who started it all is far removed from such pompous statements. He has been painstakingly advocating that India cannot be a significant player on the global technology map without a developed hardware industry.

He said, "Right now, India does not have a hardware industry. But we will have to develop one, once the computer reaches the masses. Using technology, I can go and make the small shopkeeper more efficient that a supermarket mall. A computer can handle a shop's supply chain management, from purchases to inventory control. It can bring down costs and collect customer data. In the USA, local shops don't necessarily close if WalMart comes to town. We need both."

Ignoring your own produce- There is a huge talent that we produce in India. Number of graduates- three million a year, about 450,000 are engineers; 600,000 and more are commerce graduates and 1.1 million from humanities. We have 95 agricultural colleges and 15 agricultural engineering colleges, where do they go? They are not in villages; they are not in agriculture, it means we are not interested in what we have produced.
Practically Illogical Industry- ‘What computer has done for the country? Almost all the software is exported, we have about $50-60 billion out of exports and $10 billion revenues from the indigenous market, out of that again half the software is from Microsoft, Oracle and others, which we import and sell. So if we really see, hardly any software (made and sold) within the country.
If we are depending on IT, Do we have computer literacy? Everybody is making profit by exporting software and who wants to dirty their hands and focus on India? It is not easy to develop software for India, we have 22 languages, China has 2, Saudi Arabia has only one i.e. Arabic, and so software finally has to be made in local languages like European do. Our states are bigger than the many European countries, so you can’t even say that everybody should learn one language, we also wants to keep the diversity because it is an asset.
Skewed Numbers- The limit is your imagination.- If 900 million people of India becomes computer literate, than you need many more PCs than now, every year now, 6 million PCs are sold in India, which are imported or locally assembled. Then we need 25 million PCs a year, for that kind of number, we need indigenous hardware industries. We also need micro-electronics engineers for hardware industries, India is producing less 200 engineers and small country like Israel produces more than 1000 a year, when we will we be to produce 3000 to 5000 micro-electronic engineers?? Intel is having its design centre in Bangalore they are designing their 6 core chips here and not in the US.
The Indian IT industry is still young and the growth process is not going to stop anytime soon. It will certainly become more sophisticated. There will be new players, niche players, specializing in different applications. We are still doing a lot of lowend work for the global market, though we are also into some high-level development. The domestic market will also throw up low-end work. If you can't find growth avenues despite all this, it is a managerial problem.
Interop Mumbai, debate and Keynote
ET- Interview with Dr Kohli

Wednesday 11 June 2014

No Big data in Healthcare?

The big data revolution is here, on an aggressive growth path, and the patient might truly be the biggest beneficiary of next wave. But hey! Where is that data?

1. More than 65% of data across the globe stay non-digitized.
2. 68% of digitized data isn't integrated with channels or inter-operable systems.
3. 99% problem in delivering effective healthcare is in bad data, old data and No data.

The health care system is filled with dreamers, from compassionate nurses and doctors to technology experts, researchers in the lab to people like us- mHealth experts. After careful evaluation of facts, we have arrived at this hypothesis:

The need to fully engage patients as a member of the care team is fundamentally about encouraging individuals to become more involved with their healthcare, so they will be motivated to make behavioural changes that can positively impact their health status. Today we do it in 3 ways:

1. Public health programs- where we don't spend much on pervasive technologies but paper, photocopies, fuel, per diem (per day) of health workers and volunteers.

2. Disease management/Wellness programs- where a patient buys self-help health check-ups like "a dress from fashionandyou.com" based on prize and tests that he has heard off or just go for a master health check-up .

Or a Hospital that puts a Diabetes patient on to a DM program which means 3 visits/month on to a clinic for repeat diagnostic tests, doctor consultation, Diet plan and exercise regimen. 90% patients show non-compliance here and the churn is more than 70%. All the data of-course will stay with the hospital and they will never share it with other Doctor or hospital.

3. By downloading an app, signing on to a health portal or designing a regular and timely healthcare plan and stick to it. (Surprisingly 23% people do manage their health like this). The problem is that it is very hard to track, monitor or quantify success or deterioration in the absence of proper matrices and without a Doctor's help at the other end.

If my healthcare data doesn't reside in a cloud, what will BIG Data analytics do for me?

I am unlike Retail, Banking, Advertising or any other vertical where there is loads of digital data. In Healthcare, there is very little data.

Any phase in the evolution of patient care cannot take place without sharing secure data with a wider group of constituents in the healthcare continuum. The need of the hour hence is:

1. Data Collection: There is a need to up the public health game by efficient data collection. Episurveyor--->;Magpi (DataDyne), Commcare, Formville, Cellife are some examples of such applications that exist today. Using a cell-phone to complete questions allows for information to be analysed in real time, built in skip logic, and the capturing of other media not possible on a paper form.

2. Provider + Government + Health Insurance Push- Obviously you can’t do much about 60% population of India where either there is no computer or no literacy. The need of the hour is to build healthcare models on ubiquitous technologies be it mobile phones, radio, community broadband centres, Zila panchayats, Schools, UID Kendra or areas where there can be a patient dashboard available. In the USA, with strong meaningful use process, organizations are required to offer patients online access to their electronic medical information.

To meet the MU2 requirements in the US, a provider must notify at least 50% of its patients of online access to medical records. In addition, the provider must have more than 5% of its patients view, download or transmit their health information as well as another 5% of patients send a secure electronic message to the provider organization. They do this via an online Patient Portal. Not only is the Patient Portal functionality a requirement for meeting MU2, but it extends a tremendous number of additional opportunities for the patient and provider.

With support of the provider, patients can use a computer or mobile device to schedule their own appointments, pre-register, select payment plans, share lab results, and of course, view their medical information. Each of these functions helps the patient become more involved in their care while eliminating costs associated with scheduling, sharing results and records, eligibility verification, collections and prescription renewal functions.

3. Attaching Data to Channels and Analytics- As per CHMI data every year we run more than 100+ technology driven healthcare programs in India (50+ of them are mHealth programs). Most of them show success and impact but fail to scale as funding or Government support run out. The data as well as the effort goes waste.

There is a need to connect redundant systems with appropriate channels, knowledge blocks and derive influence out of these. While the availability of Mobile apps, patient portals and digitisation of health records does not necessarily translate into active provider or patient use, the technology is emerging as the key platform for various efforts around patient engagement such as access to medical records, communication with providers, education, wellness tracking and e-visits.

We need a system that will incorporate registration of births, deaths and cause of death. Maternal and infant death reviews, nutrition surveillance, particularly among under-six children and women, service delivery in the public and private health system, hospital information services besides improving access of public to their own health information and medical records.

Big Data analytics can clearly provide---;Great Insights (i.e. trends, impact, markers and analysis)------; A clear Business objective-----------;Change management------;Good project management----;Desired quality and results? (this one is debatable!)

The Big Data Success story (Prospective):
In the United States, the independent Blue Cross and Blue Shield were planning to provide healthcare financing for almost one in three citizens. But accurate research data is critical to providing effective treatment, improving outcomes and helping reduce spiralling costs.

Blue Cross and Blue Shield faced the challenge of creating the world's largest healthcare informatics data warehouse to enhance benchmarking capabilities and enable advanced predictive analytics.

Blue Health Intelligence
A renowned IT company designed, developed and implemented a system, dubbed Blue Health Intelligence that would integrate data from up to 40 member companies. They built an overall architectural design incorporating "continuous certification," providing the most comprehensive source of accurate healthcare research data to be found anywhere.This company is CSC.

Warehouse Is Key
The data warehouse is key to the Blue Health Intelligence's overall 10-year strategic plan. No other consortia-based analysis tool exists at this scale: The warehouse is capable of processing medical and other types of claims for 90 to 100 million people, while providing the client with huge competitive advantage. Recognized by both BHI and industry as a one-of-a-kind solution, the BHI data warehouse will lead to greater healthcare transparency by delivering unmatched detail about trends and best practices.

This certainly sounds good! Big data analytics help have a direct dialogue with consumers, provide tailored healthcare, perform surveillance and risk analysis, reduce maintenance costs, offer population wise and enterprise- wise insights and customize offerings in real-time.

IBM is teaming up with the New York Genome Center to develop Watson so that it can help tailor treatments to specific terminal cancer cases, using what IBM calls "cognitive computing."

Comments welcome.

Health Information Security and Privacy Collaboration (HISPC). http://healthit.hhs.gov/
Meaningful use american recovery and reinvestment act, hrsa.gov
Privacy and security guide, Healthit.gov, The Office of the National coordinator for Health Information technology
CSC corporation, Blue shield, Blue Cross, Predixion software, Logicworks.net
DataDyne presentation by Joel Selanikio; Dan Stoke, Vice President of Client Sales and Service, Intellect Resources
A Health Care Provider’s Guide to the HIPAA Privacy Rule: Communicating with a Patient’s Family, Friends, or Others involved in the Patient’s Care.
Andrew Gill, UK retailer Waitrose takes a different approach to in-store loyalty cards & big data

Saturday 1 March 2014

Healthcare On Mobiles: Featured post- mHealth fighting malnutrition

Malnutrition is a byword in the forested hills of the Melghat region inhabited mostly by Korku Adivasis. Every year 400-500 children between the ages of 0 and 6 die in the region, comprising Chikhaldhara and Dharni taluks, according to official figures from 2005.

The Problem: Thousands of kids die every year in the tribal area of Melghat (Maharashtra, India) due to lack of medical attention and nutritional support. Increased incidence and rapid spread of infectious diseases such as pneumonia, typhoid, and dysentery are primary cause of high child mortality. Situation worsens during monsoon when the food supplies are low and the communicable diseases are at their peak.

Melghat is also a place known for high infant mortality rate. Some reasons for the health crisis in Melghat include lack of infrastructure, under-equipped and under-staffed public health and ICDS centres, the tradition of early marriages and early motherhood, lack of sanitation and clean drinking water facilities and the tribals' blind faith in bhumkas (quacks).

Failed Operations of the past: When the Maharashtra government first recorded the figures of child deaths due to endemic malnutrition in the remote villages of Melghat, shocking numbers were revealed.Almost two decades later, even though the government figures show a substantial drop in the number of malnutrition deaths, social activists and health-coordinators working in the impoverished area say that the authorities pass off such deaths as still-births.

The reality continues to bite with the data recorded just before monsoon this year, indicating 509 malnutrition induced deaths during past year, until March 2011. Every year, hundreds of children of Korku tribe in the tehsils of Melghat in the Satpura ranges fall prey to starvation and malnutrition. While the government records indicate figures ranging from 400-525 in the last five years, health activists working among the tribals tell a different story.

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