Healthcare On Mobiles

mHealth India | Press releases India

2012-01-07T07:34:00.000-08:00

HealthCursor, a niche mhealth consulting company based out of India aimed at delivering Insight Driven Healthcare solutions while realizing the promise of a connected health future was launched today. Through HealthCursor Consulting, clients in the India, Middle East and North Africa will have access to leading experts based in the region, while also benefitting from the company's strong links with practitioner communities and regulatory bodies in developing countries. HealthCursorConsulting is launched in direct response to growing demand from clients in the region for mHealth consulting services, and is a natural complement to the Founder's expertise in Healthcare IT business management and financial services.

"We are putting in a team together to innovate and deliver new value by improving health outcomes and look past standalone systems and find more ways to connect fragmented healthcare ecosystems in developing countries and support new forms of care delivery, "said Dr. Ruchi Dass, Founder of HealthCursor. "This enables unprecedented capabilities to provide the right care at the right time for a whole new breed of healthcare."

Mhealth - Counterfeit Drugs India

2011-02-01T10:40:00.000-08:00

WHO tells a story “By April 1999, reports of 771 cases of substandard drugs had been entered into the WHO database on counterfeit drugs, 77% of which were from developing countries. (Data analysis showed that in 60% of the 325 cases for which detailed data were available, an active ingredient was lacking.)”

Bad medicines don't just threaten lives; they undermine the entire medical system.

What is being done?

There are distinct aspects to deciphering and de-complexifying the counterfeit pharmaceutical supply chain. One that is probably more in use today by almost all pharmaceutical companies worldwide is the product-based tracking methodology which incorporates the use of high technology systems to identify counterfeit products in the market. These technologies include tamper-evident packaging, holographics, bar codes and the more recent RFID.

Indian Scenario

People buy two tablets and never a strip. The unique number idea doesn’t work here.

Chemists know that they are buying counterfeit drugs- they get better margins on them.

Chemists don’t want to find out whether they are selling counterfeit drugs?- Barcode thing doesn’t work here. Same stuff with hologram and all.

Interventions are required at the distributor level or best at the consumer level.

Roger Bate says “According to an investigation I just conducted with the Legatum Institute and the International Policy Network, the situation is as bad with at least some of Delhi's wholesalers. We found that 7% of all tested samples were substandard and 3.6% were likely counterfeit. It's probable that the drug supply in poorer areas is even more contaminated.

A strong majority of Indian pharmacists interviewed in our investigation admit that fellow pharmacists knowingly profit from the sale of counterfeit drugs. Nearly all of the pharmacists interviewed claimed to have been propositioned by counterfeiters at one time or another. Last year alone, counterfeit drugs were seized by authorities in Bangalore, Mumbai, Delhi, Jaipur and many other Indian cities. In 2008, about half of the medical products that were confiscated by European Union customs officials originated in India.

I believe in Simplicity….

Solutions should be uncomplicated - According to a study published by researchers of the University of Lleida (UdL) in the scientific journal Sensors, the sensor of some optical mice can be used to easily and cheaply detect counterfeit euros – Something like this for Drugs packaging can be great!!! http://www.sciencedaily.com/releases/2009/11/091117094935.htm

Or;

If we really have to go that precise in judging counterfeit and fake drugs, there is a specific way out for which testing centers can be set up. We all know about Raman spectroscopy- I know it from our chemistry labs. The investigators describe development of a new form of Raman spectroscopy, a mainstay tool for identifying molecules, which can probe deep layers of material that are well beyond the reach of conventional Raman spectroscopy. The method, spatially offset Raman spectroscopy, can analyze through paper packaging, plastic containers, capsule shells, and tablet coatings to verify the ingredients in a pharmaceutical product, the researcher’s state. http://www.sciencedaily.com/releases/2007/01/070129140741.htm

Innovative Transponders-The Radiopharm Project -The most innovative is the tagging of transponders on item-level (incl. write and read processes), not only on case or pallet level. It was aimed to get an identification of every single transponder, despite the disturbing influences of liquids and metals. This requirement creates new challenges, especially for the RFID technology that occurs in the pharmaceutical area. The co-workers of the IFT built a test rig for multiple test scenarios as a demonstrator to proof the technical realization of the developed system.

With this test rig, it can be determined if the transponders could be reliably accessed independent from the dosage form (like liquids, tablets, ointments), both for item identification and bulk identification. As a result, it is possible not only to illustrate a production line of a pharmaceutical manufacturer, but also the verification process after order picking at the wholesaler. By the use of these systems customers will have a higher security when buying drugs.

In the SWOT analysis of Big Pharma majors, Counterfeit was reflected as a common problem. I just finished working on a Counterfeit drug detection model. Cost per counterfeit drug test Rs 1 only.

Interested Companies/researchers can reach me at drruchibhatt@gmail.com.

mHealth India- Proof Of concept

2011-01-11T02:11:00.000-08:00

Recent quote: “In the years to come, mHealth applications will be distributed primarily through healthcare distribution channels like hospitals and specialized healthcare product vendors and not the app stores as is currently the case, and that traditional will become the predominant distribution channel.”(Source: research2guidance)

Well this sounds promising. However, we all know that the success of a mHealth business model doesn’t depend on the distribution channel but on what you give for the money you take and in turn sustainability of that service”.

Positives: Growth of Smartphones market in India

India is witnessing a rapid growth in the smartphones segment. India shipped 4.8 lakh units of smartphones during Q3 CY2009. The top three smartphone vendors during Q3 of calender 2009 were Nokia, HTC and RIM. Together, these vendors had a share of nearly 90% of the Indian smartphones market in terms of unit shipments during the period July-September 2009. All the major handset makers like Nokia, HTC, LG, Motorola, Samsung etc are focusing on smartphone market this year. Launch of 3G technology in the Indian market will further accelerate the growth of Smartphones. With the number of smartphone users witnessing an upswing, prices are expected to see a phenomenal dip.

This means that after 5 years almost every value handset will have smartphone features..

How does these statistics affect the Business Scenario?

The end consumer will be immensely benefited. Smart phones will provide cost-savings, increased efficiency and a better quality of life. To give just one example, smartphones are being used as smart-health sensors, allowing heart patients to stay at home safely, while having their heart issues controlled and monitored by medical staff. In this way smartphones increase the patient’s quality of life and, at the same time, save healthcare costs.

...If we look at the mHealth business cases back in 2008, we will realize that with more value chain participants and higher costs of execution, there was very less reward (whether in the form of revenue gains or operational efficiencies) to go around. It therefore became progressively more difficult to achieve the financial impact that provides momentum and leads to partnership with larger players. Therefore today, with smartphones and other robust systems playing a volume game in mHealth, the latter will not be elusive anymore.

Efficient healthcare systems based on robust infrastructure like smartphones will drive revenue for all stakeholders in the next 5 years.

Which stakeholder will lead this Business?

It will be Mobile Operators/Carriers. Here is why:

Operators Define Connectivity: The progression of mHealth will largely be dependent on innovations in telecom and the speed of implementation of the same. 4G /LTE (Long-term evolution) will revolutionize the way data is sent over wireless networks. In the near future, I envision a scenario where a consumer can set up a telehealth appointment and get a physician consult leveraging the high speed wireless connection and high-def video conferencing capability right from his handset.

Hands on experience: Operators have a proven track record of implementing innovative technologies on a large scale (2G/3G/4G capability, smartphones connected to “app stores” with thousands of applications etc) and adapt them to different geographies in a highly competitive market.

Knowledge of Local customer needs: Deploying telecom solutions in various geographies and complying with local regulations, legal framework has enabled operators understand the local customer and their needs. Partnering with operators will enable organizations deliver specific solutions that meet local customer needs.

Already, Mobile operators have tremendous influence and strong relationships with handset manufacturers, and they should leverage this position to bring to market phones and other devices that can provide the mHealth and other mobile services consumers in developing countries need.

What is the way ahead for the torchbearer?

For POC, Operators should pro-actively seek out opportunities to improve health outcomes by initiating public-private partnerships, teaming up with governments and NGOs to address pressing national health issues, and collaborating with software providers to develop targeted healthcare solutions. Joint projects help ensure that key stakeholders are on board, increasing the potential for successful outcomes. As we discuss above that smartphones and robust healthcare systems will lead this foray, we can now afford and allow “n” number of stakeholders to get involved.

An Ideal mhealth Business Model Organization should be this way:

(Missing link= Yellow)

We should remember that while some of the role players will play a bigger role in driving the mHealth market, each and every player is a key ingredient in making this a service that the end-user will consume.

mHealth and Network security

2011-01-10T01:10:00.000-08:00

1. What are the major trends you’re noticing in healthcare mobility?

In a country like India where Doctor to patient ratio is 1:900, Doctors are a few and work is like 24/7. Patient demands low cost, timely and quality healthcare coverage. For Healthcare enterprises, Patient Data is critical to collect and manage and hence mhealth is primarily aimed at bridging the economic divide in terms of healthcare. Mobility is the key here- Many Healthcare enterprises which are spread over 10-20 establishments in India are now using VPNs as the enabling technology which allows Doctors to use standard public Internet ISPs and high-speed lines to access closed private networks. A simple use case for this is to access Virtual Patient Health records and there are other wireless technologies designed specifically for use in the provision of healthcare, like:

Standard Mobile enterprise services used by health-care workers, such as remote access to e-mail and health-information systems;
Mobile Applications to meet a specific need of medical workers, such as mobile prescriptions and remote diagnoses;
Applications that play a direct role in the provision of care, such as mobile data collection and wireless transmission of health data; and
Consumer-targeted applications to encourage health and help prevent illness.

2. What are the security concerns around these trends?

Security of patient data is important. Even if you comply with HIPAA, it doesn’t have that depth and breadth of protection which is required as health care is comprised of exceedingly complex information environments that demand comprehensive patient data security approaches especially when the data is shared across networks. For a simple use case of accessing a patient’s Virtual Electronic Patient Records with a wireless device, there are 3 main security issues to address:
1. To Authenticate & authorize from the wireless to the wired network
2. Secure Data share in transit
3. Integrity & Good Resolution in the information that is requested and visualized by the users/doctors.

3. Is there a security risk re: healthcare mobility that is overrated or underrated? What are they?

Not overrated actually. Healthcare mobility is the key. As manpower is scanty in hospitals, therefore in scenarios where large volumes of background traffic needs to be sent from automated programs talking to other automatic programs, IPsec here serves the best. End to end security is however required in several Govt Health missions where there are a lot of private partners in the value chain and secured/encrypted communication is a must. SSL enabled VPN is useful here. With SSL, a secure tunnel is established directly from the client to the resource the client is accessing. With true end-to-end security, no data is sent in the clear, either on the internal network or on the Internet. Everything from the client to the resource is securely authenticated and encrypted.

4. What are the security concerns around sensor technology, portable medical devices and wireless health applications – and how will they be mitigated?

There are several security concerns and hence before we deploy mobility we need to understand that fully automated Remote Access VPN Management is necessary. Solutions should be easy to use and efficient as well. A holistic remote access solution is required to integrate all essential technologies regarding security and communication. Hospitals and Healthcare enterprises are looking to upgrade and hence low switching costs is the major driving force coupled with greater efficiency and ease to use and deploy.

5. What role will IPsec play in mobile health security?

Two parties who wish to create an IPSec tunnel must first negotiate on a standard way to communicate. Since IPSec supports several modes of operation, both sides must first decide on the security policy and mode to use, which encryption algorithms they wish to communicate with and what type of authenticate method to use. IPSec and WPA EAP-TLS solutions are very efficient against MITM, impersonation and session hijacking attacks. Both solutions are not efficient against DoS attacks. It is possible to successfully perform DoS attacks using freely available tools. For systems where availability is essential, it is necessary to complement those solutions with more mechanisms that reduce the risk of such attack. It is thus necessary to use tools like Intrusion Detection Systems (IDS) and vulnerability scanners. Because IPSec sits at the network layer not only is all your network traffic encrypted, but all users gain access to all company resources as if they were physically resident in the office connected to that LAN. Hospitals may or may not want partners or temporary remote employees to be part of their network. The network may only need to have a small portion of its traffic secure. Hospitals may not want to encrypt everything from the remote client to the corporate network. Also scalability is a problem with IPsec. On the other side, SSL proxies enforce much stronger authentication methods than a back-end resource could ever support natively. Many Web servers today do not natively support authentication methods other than SSL.

Inference: Solutions require high degree of integrational ability and interoperability that makes it possible for Healthcare enterprises to deploy these software products in an already available IT infrastructure.

Mhealth in India- Pharmaceuticals

2010-11-01T02:46:00.000-07:00

The Technology Driven data channels offers a key opportunity for pharma companies to restructure their sales and marketing model, improving their relationships with physicians and increasing compliance among patients. At the same time, patients are demanding a greater role in treatment decisions and seeking information from a range of online sources, resulting in a new age of consumerism in healthcare.

If you take a look at the screenshots below, you will realize the biggest problems for Pharma companies today where mhealth can be a solution. Courtesy- Businessmonitor.

Potential areas where Mhealth can be of use and can be deployed to tap the captive market driving non linear revenue.

As far as returns are concerned in the Pharma sector in India, India has one of the largest pharmaceutical markets in Asia, currentlyvalued at US$16.32bn. However, due to the country’s vast 1.17bn population, individual spending is actually very low. Pharmaceutical expenditure in 2009 was 1.24% of GDP,
which is just below the global average of 1.40%.

Chemists are Doctors....

The separation of the prescription and OTC medicines remains problematic, given the large volume of prescription drugs available over the counter.

Counterfeit is Easy....

Given that a number of essential drugs are already imported due to their low profit margins at home, the move to include more drugs under the price-fixing system has potential to worsen access to products and put the local industry at a disadvantage. This would open the door to regional competition, especially from parts of South East Asia. Furthermore, industry sources claim the change may also encourage the counterfeit industry to the overall detriment of both legitimate pharmaceutical industry and public health. The development of the healthcare system should improve the situation with the respective sectors gradually becoming more clearly defined.

Market Problems:

While prescription drugs account for approximately 85% of sales, the share of drugs prescribed by a doctor is likely to be far lower...
Alimentary tract, antibiotics and respiratory drugs are some of the most prominent prescription segments...
Cardiovascular and nervous system remedies, with vitamins lead the OTC sector.
Traditional and Ayurveda medicines very popular.

Policy Problems:

Prescription-only drugs are listed in Schedules H and X, which are included in the Drug & Cosmetics Act.
Schedule G drugs – mostly antihistamines – do not require a prescription, but must carry a warning label.
Drugs listed in Schedule H, X and G cannot be advertised to the public. Schedule K medicines (‘household remedies’) can be sold in certain non drug-licensed stores, but only in villages that have fewer than 1,000 inhabitants.
All drugs that are not classed as prescription can be sold as OTCs, although the OTC category is not legally defined.

Awareness and Advertising Problems:

Pharmaceutical advertising is regulated by the Drug & Magic Remedies (Objectionable Advertisement) Act, which bans advertising of certain conditions and misleading marketing.
The Organisation of Pharmaceutical Producers of India (OPPI) and the DCGI’s office have produced a joint Voluntary Code on OTC Advertising, with the OPPI also creating a Code of Pharmaceutical Marketing Practices.
While there is no formal ban on medical advertising, prescription-only drugs are not advertised by the industry, which is a general agreement. However, the DCGI is considering issuing a formal notification regarding the practice.
*Vigilance Problems-The WHO has described the lack of adverse event reporting in India as ‘alarming’. The New Delhi-based federal regulator employs only 25 staff members to cover the entire country, which has a population of approximately 1.1bn. In comparison, Sweden – which has a population of 9.9mn people – has 250-300 drug regulators with the same responsibility.

Disease Burden

non-communicable diseases – such as diabetes and cancer – have a slightly greater burden in India than non-communicable diseases – such as tuberculosis and HIV/AIDS.=Mhealth# Compliance and Adherence systems like Simpill to be deployed.
Hypertension is a serious issue on the sub-continent. Driven by changing lifestyles, studies indicate that prevalence of the disease has risen from under 5% in 1960s to 12-15% in the 1990s.= Mhealth# Remote monitoring of the Affected populace.
The WHO estimates that by 2020, a staggering 60% of the world’s cardiac patients will be found in India.In the past 50 years, rates of coronary disease among India’s city dwellers have increased from 4% to 11%.= Mhealth# Daily tips for self care, Drug reminders and Diet and exercise.
India is said to have over 2.5mn people living with HIV. The Joint UN Programme on HIV/AIDS
(UNAIDS) estimates that the number of AIDS cases topped 124,000 in 2006, with a third of patients
being under the age of 30. Overall, 0.36% of India’s population lives with HIV and accurate figures are
extremely difficult to gauge.= Mhealth# the number of cases has been falling in recent months, suggesting that the infection rate has effectively been decelerated by prevention campaigns and programs urging people to practice safe sex.
More than 2.5mn Indians are reported to be suffering from cancer.Oncologists are expecting a five-fold increase in cancer cases in the next 10 years.=Mhealth# Information, Awareness, Remote diagnosis using Telemedicine.

Clinical Trials Problems:
One drawback to conducting clinical trials in India is that the country does not allow phase I clinical trials on the basis of patient safety, and began allowing phase II trials only a couple of years ago. Additionally, India lacks adequate numbers of research personnel.

Pricing Problems:

Ayurvedic medicines, traditional Indian remedies based on natural and herbal ingredients, are also regulated by the Drugs & Cosmetics Act (DCA), but can be sold freely.There is no formal price control on ayurvedic medicines.
The NPPA is responsible for fixing and controlling the prices of 74 bulk drugs and formulations under the Essential Commodities Act, although only a few OTC ingredients (such as ephedrine) are price controlled.Overall, price control covers only around 40% of the total pharmaceutical market in India.

India will continue to struggle to provide adequate healthcare services to its rapidly growing population, which is also exhibiting signs of ageing. According to the statistics recently released by Population Statistics Bureau (PSB), India is predicted to overtake China by 2050 as the most populous country in the world, with just under 1.63bn people. Such demographic changes will significantly alter and increase India’s demand for pharmaceuticals and health services, the needs of which still remain unmet.

The Health Website

2010-10-21T23:45:00.000-07:00

Good Morning friends! Hope you are doing good.Today we will talk about a Health website. I keep getting these mails from Health care Enterprises and new entrepreneurs asking for some suggestions and help for their health website, and I really don't get time to revert to them. This post of mine will help them understand and pave their vision better.

Q1. How people are going to find you and notice you online?

Ans- Internet represents less than 10% of the total retail sales. Online Business is of importance to consumers just because of two things:
a. Speed
b. Quality of Information
People are loyal to discounts, not you. Bundle your packages and wow your visitors. Position yourself as an expert whether it is apparel, cosmetics, shoes or medicines. If one product you sell-> Keep your customers informed about its use, your degree of expertise in that, related offers -> if possible provide buy back and all.

Q2. How to beat the competitor?

Ans- The thing that will make you win on web is the convenience factor. Easier + faster+ relevant= Beat beat beat!!!!

Easier
1. Suggestions, Prompts, analysis, comparisons always sell. (Saves time= serve better)
2. User friendly websites, Less complicated with flow and navigation maps.
3. Most of the customers don't know what they want, therefore prompts and drop downs are better than a blank search box. Something what Google does.

Faster
1. Variety motivates, Specialty motivates along with a simple UI (User Interface) and a robust search engine- As people love to buy products that are personalized, unique and different ;same ways a website lures. So if you have a niche site, your participation is confirmed.
Convergence= Focus= Win!

Relevant
1. We cannot define our products and packages- Customers do that- Demand does that.
2. It got to be relevant= People pay extra money for convenience and security. Also ,if they are hurrying up to meet the deadline, they will happily pay for their peace of mind and will transact from home.

Big Point: Once glued, come and show policy- Remember the last time when you tried to change to a new web browser??? People don't do it often either.

Q4. How to add the entertainment factor to your website. How to help your customers stay glued?
Entertaining and answering every customer need is a herculean task. However, there are certain things you can do based on the following:

1. Emotion= FUN- There are these emotional customers who are looking for details. Tell you story, Tell them more. Company history, employees, assets, nobleness, charity and Business benefits if somebody ties up or collaborates with you. Put a name behind every review, every description, assign a particular Customer service agent name to each product- They should feel familiar, like they are taken care of and that it is not virtual= dangerous to shop online!

2. Discounts- So what's more exciting shopping for the most expensive watch or getting an ARMANI for half the price that too on installments/monthly EMIs. Bidding is fun coz it throws a challenge. When you buy that piece, you are thrilled. It makes you feel like a winner.

3. Forums- Heard of a concept called assisted shopping or s-commerce? People love praising certain products and show that their knowledge is impeccable. Some people love pulling down products and comment each other as well.

4. Creativity- Very recent concept, but Fun! Certain games like apps on facebook who loves you? what color is you? your makeover! The comic you!, your wedding look!, Games, puzzles are also fun. Especially if there is a competition or a prize.

In one sentence, whether it is a health care website, a retail one or Drugs website? It's got to be Customer Responsive. Marketing and sales gotta be a s good at the front end as is transaction processing at the back end.

:)

Mhealth Model- Dr SMS in India- The Success Story

2010-10-07T11:05:00.000-07:00

The... patient should be made to understand that he or she must take charge of his own life. Don't take your body to the doctor as if he were a repair shop. -Quentin Regestein

The World of “Speed- Living”! as simple, easy and compact as a mobile phone. Reminds me of Aircel’s popular advertisement “Pocket main Rocket hai”… I think”pocket main Rocket hai” is the right definition of Mhealth today! Many mobile projects struggle with scale and impact. While a mobile health project may run well with a small number of patients in one hospital, expanding the scope of a project until it is large enough to have real impact takes money, time, and widespread support of key stakeholders in a given community. And that is one of the biggest reasons why Mhealth is not keeping too well now-a-days and is suffering from “Pilotitis”.

Therefore, KSITM took this initiative to launch DR SMS in Kerala, aimed at improving health of the citizens of Kerala by improving access to health care resources by making available authentic information, providing timely information on medical and diagnostic facilities and providing informational alerts about emerging diseases. Kerala was also prompted to launch this m-Health project as it ranks as one of the leading States in India on mobile penetration. According to Telecom Regulatory Authority of India, in March 2008, Kerala has a tele-density of over 72 per cent as against the national tele-density of 32 per cent.

The project was piloted in Kozhikode (Calicut) in the district of Kozhikode in Kerala. The choice of Kozhikode was based on the fact that it is the third largest city in Kerala with a population of approximately 20 lakhs. Kozhikode was also chosen for the project piloting because it has the highest rates of mobile penetration in the State. Kozhikode also attracts huge migrant population/tourists, who are also one of the main targets of this project. The pilot project met with overwhelming success. The service was especially lapped by the large numbers of tourist population who did not know whom to contact in case of a medical emergency. During the pilot phase, an average of 200 daily transactions took place through the Dr. SMS facility.

The project has a credible and sound database on hospitals and emergency health centers drawn from a large data from the Health Infrastructure Survey, conducted by the National Commission on Macro economics and Health (NCMH), Ministry of Health and Family Welfare, Government of India. The system is supported by the National Informatics Centre and the State Information Technology Department. Encouraged by the success of the pilot project, the Government announced the launch of the project in all districts of Kerala.

What should be the Step 2 now?

I personally feel that Dr SMS can be very well linked with NRHM objectives for the State of Kerala. We actually have a lot to learn from a similar concept which Matt Berg described, during my visit to London. It’s called the ChildCount health monitoring system.

The project provides mobile phones to community health care workers who then use SMS to coordinate activities such as registering patients, transferring data to a central database, automatically alerting health workers to patients’ needs and facilitating communication among members of the health system. Roughly 100 community health workers at the Kenya site are equipped with mobile phones to monitor registered children for malnutrition and malaria.

The project’s five goals are to register every child under five in a given community into the ChildCount database, screen those children for signs of malnutrition every 90 days, monitor the children for the three major causes of death in children under five (malaria, diarrhea, and pneumonia), group all children into age groups in order to streamline immunizations, and record all local child births and deaths. The program has been meeting these goals with considerable success; for example, when the program incorporated a measles immunization awareness program, over 8000 children were vaccinated within seven days.

What will be the Business Model?

Though I am all set to pop a bill for this, I believe that NRHM should seek external funding as well. The ideology should be- “If the ultimate Goal is the same, Let us not work in silos, Let us work towards the common goal together”.Some of the Initiatives that could be of Interest to NRHM to collaborate with are:

Bill & Melinda Gates Foundation, Intel Digital Health Group,Robert Wood Johnson Foundation, McKesson Foundation, World Bank, UNICEF, UNFPA, European Commission, John Hopkins NCCC/GIAHC, U.S. Agency for International Development (USAID), Vodafone Americas Foundation, West Wireless Health Institute.

Reproductive & Child Health-II (RCH) program has already got funding from World Bank and the European Commission and We all know that the Rural Health Mission in Bihar recently got funding from Bill Gates Foundation.

According to the MoC, the Foundation will provide technical, management and program design support via NGOs in the areas of maternal, neonatal and child health; maternal and child nutrition; vaccine-preventable diseases, tuberculosis, pneumonia and Kala-azar, among others. While the MoC applies to all 38 districts in Bihar, the Foundation will initially start work in the nine districts of Patna, Banka, Khagaria, Begusarai, Gopalganj, Saharsa, Samastipur, and East and West Champaran. ..

To accelerate this momentum and fully unleash the potential of mHealth applications, dynamic multi-sector collaboration between groups as diverse as governments, multilateral organizations, and the private sector is needed.

We talk about 600 million subscribers in India- Are these subscribers or Connections?

2010-08-17T22:47:00.000-07:00

A recent report by India Mobile 2010, shuns TRAI for claiming a base of 621.28 million mobile subscribers at the end of March this year.India is without doubt the fastest growing telecom market in the world, but it had only 304 million subscribers at the end of May this year, according to a report by Juxt Consult. While Juxt survey measures and reports both the mobile users (subscribers) and mobile connections (subscriptions, ie who take new connections), TRAI data reports only the mobile connections, (which it mistakenly calls ‘subscribers’).

Apart from that, while TRAI data indicates a 75:25 split in urban and rural mobile connections, the split at both the subscriber level and the active connection level as found in the Juxt report is closer to 50:50. The report says that the mobile subscriber base in rural and urban India is 146 million and 158 million, respectively.

Also, according to the Planning Commission, 27.5 per cent of the population was living below the poverty line in 2004–2005, which means that only around 70 per cent of the Indian population can be the target subscribers.

There is little clarity on how the urban-rural split is recorded and reported by operators, and TRAI, and whether all SIMs in use in rural areas are recorded as rural, as many such connections may actually be getting bought in the urban areas.

Talk about a world of FREE SMS- (If you pay for an SMS, it got to be delivered. However there is no guarantee today, that is the reason why emergency or crisis management communication can't happen on SMS.- so why Operators are not giving SMS FREE- Is there something Handset providers can do- Yes yes Yes!.)

Wynncom has entered an exclusive agreement with a free SMS service application provider 160by2.com. The agreement will allow users to send free SMSs from their mobile phones through an embedded application.

Wynncom mobile phones will have a preinstalled application developed by 160by2.com, one of India’s largest free SMS service providers. This unique application enables mobile phone users to send free SMSs to any mobile in India and in the UAE, Kuwait, Saudi Arabia, Singapore, Malaysia and the Philippines.

This application will use a GPRS connection to send the SMS, and the charge for data use will be miniscule.

Sometimes, I wonder why Mobiles are the only effective source of communication Today? - Think of the engorging Deaf and Dumb population in India!

In Australia, more than 50 percent of the general population sends at least one text message a day.The result is a nearly universal, text-based communications medium that connects the deaf to the hearing world. By using text messaging, deaf mobile users can order a pizza or invite friends for a beer. It's great for younger people because their group of friends is extended to their peer group, and not just other deaf people.

I remember visiting a Deaf and Dumb village in Kashmir. People in Dadkai Gandoh village of Indian administered Kashmir's mountainous district Doda are becoming victims of an incurable genetic disease, which renders them deaf and dumb. At least 72 such cases have surfaced so far from the village and its adjoining areas. The figures are feared to rise in near future.

But here is a good news!Soon, deaf and dumb can talk on mobile using sign language.- Result: Better education facilities, Health related Information dissemination and much more...

Developed by engineers at the University of Washington (UW), MobileASL uses motion detection technology to identify American Sign Language (ASL) and transmit video images over cell networks in the US.

The tool, which can be integrated to any high-end mobile phone with a video camera, is undergoing field tests involving 11 participants and the researchers plan to launch a larger field study this winter.

Earlier, speaking in the valedictory function of E-India, Union Minister for Communications and Information Technology, Mr A Raja said M-health was the fastest growing part of e-health and its importance was increasing.

The rapidly increasing importance of mobile phones as a platform for healthcare delivery in recent years is mainly attributable to substantial price reductions and the resulting rapid expansion of mobile phones used around the world, he said.

Mobile Vas in India - Statistics and Trends

Almost 63 million urban Indians accessed Internet using their phone in February, 2009.
Checking emails and searching information using search engines are the two most popular reason cited by almost 3 in 4 urban Indians.
16 million urban Indians access Internet on their phone almost on a daily basis.

As per TRAI predictions, mobile VAS revenue growth contributing to telecommunication industry is expected to grow to 30% in next 5-7 years, which is way beyond the current contribution of 10-12%. Many experts are predicting mobile VAS in India to be 1 billion USD market by 2011. Let us wait to watch, what is there for Mobile VAS service providers in 2011.

Useful Links:
http://telecomyatra.afaqs.com/news/index.html?sid=1584_India+has+just+304+mn+mobile+subscribers

http://telecomyatra.afaqs.com/news/index.html?sid=1586_Wynn+Telecom+to+enable+free+SMS+on+its+upcoming+handsets

http://telecomyatra.afaqs.com/news/index.html?sid=1592_Soon+deaf+and+dumb+can+talk+on+mobile+using+sign+language

Public Partnership- Mobile Healthcare India

2010-06-21T10:34:00.001-07:00

Was busy the last weekend preparing for the GTF conference in Delhi.You can learn more about this by clicking on the emblem on the left . Government Transformation Forum is first of its kind forum aimed at enhancing collaboration and exchange of learning practices among the industry, academia, civil society organizations and the public sector in India. Through this forum, the organizers intend to keep the stakeholders abreast of the latest trends and cutting edge technologies so that the e‐Government programs are designed keeping in view the needs of the next generation. You can expect a lot of action here...

I was thinking while discussing the mobile health care concept with my peers, that if in case my Medical Insurance can't give me freedom from long waiting periods; my prescription delivered at home; Nurse and physiotherapy facility and continuous monitoring for my old parents and Real time Emergency Response in seconds, probably I will not opt for one.

But in India, is it too much to ask for??

Well, to cite a feasible example, Jon Pearce and his partners have created a technology called Zipnosis, which allows patients to get diagnosed and treated for minor health issues using a computer or mobile device. They call it “Health Care in Your Pocket.”

The process they’ve created is quite simple. The patient arrives at the site-->A series of questions are asked—>>>similar to what a patient might be asked in a normal office visit—>>that should take about five minutes to answer. This first step is referred to as “bullet-proof medical.” He means that the questions are designed to give a medical clinician the information they need to diagnose the problem—without the need for a physical examination.(Applicable for a few diseases only but can be lifestyle diseases like Diabetes, asthma, hypertension, arthritis to start of with.)

After the patient has submitted their answers, Zipnosis sends a text-based communication back to one of their on-call clinicians. The clinicians usually will have one of three general responses:

(1) suggesting an over-the-counter medication and get-well plan;

(2) prescription for an antibiotic; or

(3) a recommendation to see a physician for further examination.

Lastly, the patient receives a response from the clinician regarding their diagnosis and recommendation.

If a medication is prescribed, a map will be presented, indicating where the closest pharmacy is located, based on the GPS location of the patient.

This means that a patient could be almost anywhere when they receive their diagnosis. If I live at Karol bagh but when I am seeking help I might be driving close to Aurangzeb Road and thus would be looking at a pharmacy within 800 meters from there, once a prescription is received.

Now the Question is, who will enforce something like this in India...and through what?

Telecom Operators are "the king" in India. Telecom Regulatory Authority of India (Trai) is planning to introduce spectrum audit to ensure efficient use of spectrum by telecom operators. Now what is the meaning of Efficient? Government is the only entity that can enforce Health, Prevention, Reach and Outgrowth. 6.2 MHz spectrum is available in 2G in most of the cities while in metro cities 10 MHz is available. The word efficiency clearly indicates:

1. Smaller number of operators. (New operators are coming up and ready to give 3G Spectrum linked one time fee)(Bharti Airtel, Vodafone Essar and Bharat Sanchar Nigam (BSNL), stand to lose tens of thousands of crore if the government accepts suggestions Trai to charge 3G-linked one-time prices for spectrum already allocated to these firms many years ago.)

2. If we talk about taking mobile health to Rural India the government should implement this with Telecom operators by giving subsidies to private operators rather than a centrally owned government authority being given the responsibility to do that.

3. The Rural India- On a per circle basis, it is clear that India’s growth largely depends on rural demand and how fast mobile operators can connect the unconnected. Nevertheless, even though we believe there is clear evidence that 3G can help to bridge the so-called 'digital divide' in India, it will take time for mobile operators to develop users’ appetite for data services. A number of factors will influence the rate of adoption, but pricing is the most important.

Move ahead on MHealth

2010-06-06T10:31:00.000-07:00

I have many many people, many startups and several small and big firms working on mhealth today. UHC is coming into it, Vodafone, Ericcsson, Nokia and many others have already participated in the same. The upcoming news boards like mobihealthnews, telecareaware etc. are also up.WHO is into it, so is World bank, mhealth alliance is formed by UN and much much more. But why aren't we moving ahead on it ...what is required?

The first thing is strategising. We need to go step by step especialliy in developing countries, coz here its the Operator's market unlike other countries.

What I and Vikas were debating about was whether you do the technical work (software) on the ground or build solutions beforehand. As usual, it depends on the circumstances of a particular situation and project. My belief is that each country should have a platform available for launching national health services.

Governments should either enable the process by working hand-in-hand or fund and get out of the way of the private industry. Just like roads and electric grids, health platforms should be a matter of national importance and unless there is this realization, the fragmentation of technology will continue.

Thanks a lot for the consulting opportunities, I will get back to you one by one. Thanks for bearing with me. In case you are looking for face to face meetings, I shall be presenting at mhealth conference and Expo, 14th-15th september in UAE. for more see http://www.m-healthconference.com/

512 kbps of Mobile Healthcare

2010-05-22T23:01:00.000-07:00

The other day I was sitting with my Mentors and I realised that Doctors in India can do wonders if we provide them with 512 kbps bandwidth on mobiles. Apollo Telemedicine Network Foundation and Ericsson started a program sometime back in 2007 called "Gramjyoti" in rural India and that was considered to be a big foray of telemedicine in rural healthcare.Thousands of people within the Gramjyoti project area covering 18 villages and 15 towns were able to use broadband applications. Ericsson worked in partnership with Apollo Hospitals, Hand in Hand (a local NGO), Edurite, One97, CNN and Cartoon Network to deliver a range of services including telemedicine, e-education and e-governance.

Point to be noticed is the prolem area. Sometimes the main factor itself is not the sole criterion on which the success of a project depends and that is what we learnt. Those were the days of GSM technology and the conditions of roads in India was bad especially in the rural areas. Consider a van where people are coming to Be treated/Operated.This van was well equipped but a small ditch or bump on the road, and the wireless transmitter used to turn 360 degrees and we could see nothing...Trust me if we can get 512 kbps on mobile, It will be like a boon for us Indian doctors to serve those patients who live in far-flung areas and need medical attention.

"In India, there are 1 million people that die each year purely because they can't get access to basic healthcare," said Dan Warren, director of technology for the GSM Association, the umbrella organisation that hosts the MWC.

For people in Rural areas, prevention still starts with Good roads, Better electrical and water supply, Proper Sanitation and then we can talk about Health and wellness with them.Through video conferencing, doctors based in Chennai, 70 km away, held surgery with patients in village citizen centres and the Gramjyoti broadband van. The patients were supported by paramedics who could administer ECG tests, blood pressure and injections. Overall 200 patients were treated like this during the trial.Ninety percentwere givenmedicines on site, and 35% have been referred to consultants.We used the UETR and GPEH to track for any problems that arise during drive test activity.

Lesson/Tip for a Rural Healthcare Project (If one is planning to start one):If you want to roll out 3G in a cost effective way, you need to attack capex and opex costs. Seventy percent of these are in the towers.Gramjyoti project with the help of network operators showed that site sharing works.The site sharing experiment showed that what we did in 20 villages, we could do in 250,000 villages without any problems.This is roughly the number of GSM cells in India and each one could share a tower with a 3G cell without interference. Operators came, the regulator came and people fromthe government came to see the trial and they left convinced that site sharing works. With site sharing and refurbished 3G handsets,we can bring the same economics to 3G that have made 2G such a success. It’s a myth than 3G HSPA is only for urban environments.

There's a business case for it now; you have to have the experience of the Healthcare Providers + Telecom Providers and on the ground talking to the big corporates out there and creating real business models, and that's the only way to success.

mhealth in developing countries

2010-05-17T10:44:00.000-07:00

The potential of mobile telephony to bring health care to the majority
Acute and emerging epidemiological challenges are encouraging public sector to welcome and support the development of increasingly innovative health care initiatives. Given that nearly 70 out of every 100 people carry a mobile phone in the region, if the easy-to-use mobile platform can be applied to health care to contribute to increased equity, mobile care could also contribute to improved clinical outcomes and productivity, as well as to better public health monitoring and education.

Oh yeah! we know about the potentials but then where does mhealth exactly fit in? Is it for Prevention?- Disease management or Real time monitoring?..

Actually Mobile Health is gonna be everything- Mobile health is a recently coined term, largely defined as health practice supported by mobile devices. For purposes of this note, mobile health practice includes public health, clinical medicine, and self-monitoring supported by mobile phones and personal digital assistants (PDAs).Currently active mobile health applications include the use of PDAs in collecting community health data; using the mobile phone to deliver health care information to practitioners, patients, and nonpatients; and real-time monitoring for citizens, both patients and nonpatients.Mobile health services tend toward preventive care and support for wellness, essentially helping individuals take care of their health before they become patients.

Ok! So if we talk about India what will support its growth, PPP?

Acute and emerging epidemiological and demographic challenges to health care systems are pressing the public sector to welcome and support the development of increasingly innovative approaches and initiatives. Emerging fields in health care include biotechnology (gene therapy, etc.), nanotechnology (instrumental in drug delivery), and information and communication technologies (mobile health). Together these offer a basket of new tools to address health care issues.

Need of the Hour?
The potential benefit of the mobile phone as a tool in widening access and improving health care is clear. Increasing penetration, combined with a wider range of possibilities for communication and an easy-to-use platform, allows access to less technology-literate groups.
So as the increasing subscriber base is in rural India, there is pressure to bring on best value benefits to the rural Consumer. No wonder Nokia Life tools Agri services forecasting weather to farmers and fishermen is such a hit. The mobile market in rural India has significant potential with number of subscribers anticipated to grow at a CAGR of around 32% during 2009 to 2012. When we talk about bad terrains , climate and remotely located areas. More than Mobile commerce, More than Location based services- The prime and the most important are Occupation related VAS (that's why lifetools is a hit) and Healthcare Value add services.
I think that's the way to go ahead...Need and supply....

Health on Mobiles

2010-04-29T03:57:00.000-07:00

Mobiles have revolutionarised Healthcare, a big way, They are further going to make a mark in developing countries like India because of its reasonable penetration, Good subscriber base and ease to use.
The availability of low-cost mobile phones and the already broad coverage of GSM networks in India is a huge opportunity to provide services that would trigger development and improve people’s lives.

Today's Newspaper (Times of India) says- "3G Handsets to cost less thanRs. 5000 In a year"..Read more on Page 17 tuesday, September 15, 2009.

Yesterday, When a friend asked me - How secure will be the consultations provided by doctors over mobiles??, Say if somebody changes or tampers the prescription before it reaches the target consumer?, If there is some error in despatch , some inaccuracy etc., So till the time HIPAA compliance or HL7 server capacity is leveraged, Mobiles based Healthcare delivery will continue be a falcy. The Good News , Dr Neelesh shared with me on Health on Mobiles that there will be HIPAA compliant Doctor Diagnosis/consultations available now. The mVisum Medical Communication System is a communication tool that allows medical professionals to securely receive, review and respond to patient data recorded at the point of care.Information is transmitted via secure HIPAA compliant internet servers then transmitted through mobile technology to the required physicians’handheld smartphone.
Lets take an example , Have you heard of EKG, something like the picture below.We know this by ECG. A very common diagnostic procedure.
Using this service from mVisum, Of 600 EKGs read on a Blackberry mobile device, 599 were correct diagnoses.Great Accuracy. But is that 1% difficult to digest??

Lets move to privacy now, In order to take advantage of the technology, they use a GE Muse server and digital EKG. The mVisum software knows when an EKG is taken and grabs a copy (as does its internal EHR). If a call is placed regarding a patient, the cardiologist can scroll through the EKGs, locating the patient of interest and view the image off-site. Everything is server-based, so the EKG does not reside on the phone-when the physician logs out, there is no accessible data left on the phone. This is Great!

I was also impressed by 3Gdoctor.com's new concept. The Concept looks very interesting, But It costs a bomb, so not for rural market or to support connectivity in far flung areas. Folks in the UK have a new way to access medical assistance, i.e. via a 3G cell phone...it does not replace having a regular primary care MD, but it does cost...35 pounds per consultation...and accepts credit cards, pay pal, etc. It also offers the opportunity to create a personal health record here...no prescriptions given here. Once you have completed your Medical Questionnaire your answers will be sent for review by a registered Medical Doctor who is insured to practice by the Medical Defence Union or Medical Protection Society. Video conferences should be started within 1 hour of the request and are 24/7...365 days a year...and if you miss you call after 2- attempts, you will have a cancellation fee of 15 pounds. To Read more click here.

Successful examples like Aarogyasri and DrSMS in India suggest utilising mhealth for social causes, Health awareness and prevention.
Some better examples for developing nations like India come from Frogdesign and Frontline SMS.

FrontlineSMS:Medic

They Say -“In the developing world, lack of infrastructure prevents health workers from delivering efficient healthcare to rural areas. As health workers travel from clinics to reach isolated patients, they are often as disconnected from central clinics as the patients they are trying to serve. The mission of FrontlineSMS:Medic is to advance healthcare networks in the developing world by building and distributing innovative, appropriate mobile technologies. The centerpiece of our system is FrontlineSMS, a free, open-source software platform that enables large-scale, two-way text messaging using only a laptop, a GSM modem, and cell phones. We are also developing several applications for the FrontlineSMS platform that will enable better patient management, electronic medical records via the cell phone, cheap mobile diagnostics, and mapping of health services.”

Project Masiluleke

“Project Masiluleke (which means “lend a helping hand” in Zulu) is using mobile technology to tackle the worst HIV epidemic in the world in KwaZulu Natal, South Africa, where infection rates are over 40%. [frog design] is envisioning a solution that uses mobile technology in three crucial ways: 1) to encourage usage of low-cost diagnostic tools; 2) to walk patients through the testing process; and 3) to guide them into care should they need it, and encourage healthy preventative behaviors even if they don’t.”

Feedback and Suggestions Welcome!

1. How Should the Evolution of Mobile Healthcare Take Form? Simple or Advanced Services Development?

2. Where does mobile play a role - Limitations and Advantages, Extent of digitalisation, and support infrastructure required ?

3. Consumer Needs, Information Gaps and Role of the Ecosystem Player in the Healthcare Value Chain?

4. Challenges and things to watch out?

5. Exploration of Services and Evaluation of New Business Models?

Mobile Healthcare scenerio in India

2010-01-08T10:57:00.000-08:00

India is the second most populous country of the world and has changing socio-political-demographic and morbidity patterns that have been drawing global attention in recent years. Despite several growth-orientated policies adopted by the government, the widening economic, regional and gender disparities are posing challenges for the health sector. About 75% of health infrastructure, medical manpower and other health resources are concentrated in urban areas where only 27% of the Indian population live.

The new buzz is Mobile Health; in simple words it means access to valuable information and consultation for preventive and post treatment advice targeted at doctors and end users. The idea is to use telecom as a backbone tool to leverage the current brick and mortar model of Healthcare delivery across the country.

The scope of Telecom as well as technology to disseminate valuable and personalised Health information is now evolving. Better practices are expected to rely heavily on telecommunications services. Most of the high costs inherent in the current system are related to the proximity of the patient and provider, as well as to the archaic administrative systems used to manage records and exchange information. Telecommunications can bridge these proximity gaps as well as provide a normalized set of baseline data that can remain secure and yet be shared among healthcare workers.

While a major step was taken by Dr. Brilliant to eradicate even the smallest remnants of Small Pox from India, digital technology was used to predict and prevent this infectious disease depending on information that fed in from the grassroots. Teledensity in India is increasing at a phenominal rate and Soon Mobile handsets will emerge as a Mass targeted Medium, and hence various Health awareness and Information programs can be penetrated amongst the end users using the same.
Today, 90% of operator’s revenues come from Voice and Rentals. Of the balance 10%, about half comes from Person-to-Person (P2P) SMS. So, VAS accounts for only about 5% of revenue. Operators have primarily focused on voice. I see a new breed of companies emerging who will create direct-to-consumer services and focus exclusively on VAS. They will have multiple revenue streams - not just from subscribers, but also from advertisers and businesses. 3G will be a big enabler for richer services, and can actually drive higher ARPUs (Average Revenue Per User). Consumer will sit at the locus, and Healthcare services will become more consumer oriented, consumer driven and on demand.
The major need gap which can be addressed to, using Mobile based Information is Preventive Healthcare i.e. measures taken to identify and minimize risk factors for disease, improve the course of an existing disease and screening for early detection of disease. It is been said that by the end of 2009 3/4th of the Indian Population shall be covered by a mobile network, many of these new subscribers are from Rural India and hence the next possible market for derived revenue and penetration for Healthcare is the rural and semi urban population along with the urban saturated market which will possibly grow with VAS.An SMS on your mobile Phone is more personal and targeted, it forces you to take a moment to think and may be act.
The Consumer advantage scenario will take into account the seven major considerations of Cost, Quality & Relevance, Reach, Real time, on demand and Convenience.

Nominal subscription fee of say Rs. 30/month for Healthcare information and Tips on mobiles will be perceived as far more relevant when compared to spending the same on ring tones, Jokes or entertainment. The Challenge here lies in creating awareness as to how an early detection of disease will control your Health Insurance premium and lower your hospitalization costs. Also, a continuous follow up of an already detected disease using subscribed health information will reduce frequent doctor visits and in turn incurred cost.

The Quality of information dispensed should be from a reliable source, should be relevant and of local disposal. Partnership sources should include private and government participation using a strong and well branched out data collection network and a team of doctors.
People in rural areas usually have basic handsets, where literacy concerns are not paramount text messaging offer significant advantages in terms of convenience and flexibility. Information dispensed in local language with the ability to store and send data on ways to stay away from the possible ailments is the key.
As is the distribution and prevalence of certain ailments, so are the demand options, for e.g. Ulcerative Colitis is common in Punjab in north India, Cardiovascular diseases are more common in South India. Therefore, either data taken from the consumers can be utilized to develop an On Demand service or MOHFW or WHO Information base can be used to target risk factors in a particular community. An interesting publication in WHO Global Infobase indicates high prevalence of Multiple Coronary risk factors in Punjabi Bhatia community.
Convenience is probably the signature mega trend of the next era since the consumer desire for time saving plus the insistence on simplifying complexity coincides with technology developments able to deliver precisely the desired information in real time. Early detection of a disease always pushes early response and management. The information provided should enable the End User take informed decisions as a part of Primary Healthcare Module. In this model, Consumer convenience and rights to access the information is the major gap, which needs to be bridged.

The whole process of Mobile Healthcare not only requires knowledge of applicable requirements but also a thoughtful combination of technology, laws, policies, Insurance, procedures, appropriate contract provisions and regulations.

Maximizing the mobile and technology benefits in the coming era will offer effective Healthcare Management at the commencement of such a venture and beyond.

Mobile based Healthcare Models for Emerging Markets

2009-12-06T12:15:00.000-08:00

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 theyoucompany.com.The 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!!!

The Indian Wellness Industry

2009-10-27T22:26:00.000-07:00

The other day I heard somebody saying that the Wellness industry in India is growing by 35%, However this Industry has no set parametres or Guidlines, It is still unaffected by recession etc. But to me it seems its like playing darts in the dark, you might get it and you can very well miss it. Looking at the fair extension of wellness also, If you see, Alternative Therapies have been practised in India for quite long, its just today that it is considered to be a part of wellness.

Vikas and I was discussing yesterday and He shared some good facts. There are clear customer preferences in each region with regard to each segment - alternate therapies are the most popular choice of people in southern India, while customers in north are inclined towards beauty. The maximum number of fitness and slimming centres are in the west etc. But why is Wellness a hot topic today? I guess, the the increased level of activity is arising from the entry of several providers such as organised Indian and international players, expansion by existing companies, strategic alliances and interest among private equity investors and hospitality and realty industries. So what is the step ahead to tap this $2.2 billion market?

First Point, according to me should be lauching standards. The Standards for Health and Wellness accreditation will require consideration of a variety of criteria in Wellness service providers. These would cover aspects like technology, trained manpower, infrastructure, customer safety, processes and controls among many others, statutory & regulatory compliances. The standards would lay down stringent regulations for service providers to obtain mandatory full accreditation of the total services offered.

Secondly, "Well begun in Business is half done", As per test marketing, feedback and need gap, we need to clearly define our products as well as services. In my new role, I have learnt that there are several challenges faced by users of wellness industry in this early growth stage. These challenges mainly revolve around the quality of the offerings, substandard facilities, poor infrastructure and untrained staff. In their zeal to win clients, the providers frequently over-promise and under-deliver, which leads to unmet expectations of the users.

Thirdly, LBS and Regional services are the talk of the town today, A key challenge for wellness players in India is to be able to regionalise their offerings across India, on account of significantly varying consumer preferences. The one standard ‘menu’ on offer approach is sub-optimal considering the widely varying customer preferences across India.

The Fourth step should be synergising and marketing cohesively.The ability to build collaborative distribution models with companies in allied sectors is a challenge. Being able to create synergistic structures would help to control costs of reaching out.

The Fifth priority should be balancing Finance and capturing catchments.A carefully planned portfolio of “footfall generators” and “footfall preservers” services is difficult to achieve but is a must to balance the financial returns of any company. It is also important for follow up, feedback, upselling and cross-selling.

Would like to know your thoughts, Comments welcome...

Wireless Healthcare in India- probabilities and Innovation

2009-09-17T06:58:00.000-07:00

The goal of this Blog of mine is to gather an inter-disciplinary group to explore this hypothesis: that mobile-computing technology can enhance the health and well-being of Indians. For these Solutions and Services, I wish to define it under three sessions for e.g.

Daily medical suppport- How is it possible?

Wireless Healthcare- Major Challenges in Emerging markets

"Prevention"- Subscription based Awareness in underserved countries etc.

I would like to invite people working and involved in these areas to comment and bounce business ideas. In Indian Context, I would like to brainstorm about:

Services which meet the needs of healthcare trends in ageing, chronically ill markets

Public health sector innovation

WCDMA for mobile healthcare

Wimax for healthcare

Which technical platforms should be invested in now to ensure mobile healthcare services are effective and relevant in the 5-10 yr future?

The participants of this forum can also upload their videos, white papers and other relevant stuff -Just follow the steps below...

Mobile based Healthcare - Top Stories

2009-09-15T12:08:00.000-07:00

The availability of low-cost mobile phones and the already broad coverage of GSM networks in India is a huge opportunity to provide services that would trigger development and improve people’s lives.

Today's Newspaper (Times of India) says- "3G Handsets to cost less thanRs. 5000 In a year"..Read more on Page 17 tuesday, September 15, 2009.

Yesterday, When a friend asked me - How secure will be the consultations provided by doctors over mobiles??, Say if somebody changes or tampers the prescription before it reaches the target consumer?, If there is some error in despatch , some inaccuracy etc., So till the time HIPAA compliance or HL7 server capacity is leveraged, Mobiles based Healthcare delivery will continue be a falcy. The Good News , Dr Neelesh shared with me on Health on Mobiles that there will be HIPAA compliant Doctor Diagnosis/consultations available now. The mVisum Medical Communication System is a communication tool that allows medical professionals to securely receive, review and respond to patient data recorded at the point of care.Information is transmitted via secure HIPAA compliant internet servers then transmitted through mobile technology to the required physicians’handheld smartphone.
Lets take an example , Have you heard of EKG, something like the picture below.We know this by ECG. A very common diagnostic procedure.

Using this service from mVisum, Of 600 EKGs read on a Blackberry mobile device, 599 were correct diagnoses.Great Accuracy. But is that 1% difficult to digest??

Lets move to privacy now, In order to take advantage of the technology, they use a GE Muse server and digital EKG. The mVisum software knows when an EKG is taken and grabs a copy (as does its internal EHR). If a call is placed regarding a patient, the cardiologist can scroll through the EKGs, locating the patient of interest and view the image off-site. Everything is server-based, so the EKG does not reside on the phone-when the physician logs out, there is no accessible data left on the phone. This is Great!

I was also impressed by 3Gdoctor.com's new concept. The Concept looks very interesting, But It costs a bomb, so not for rural market or to support connectivity in far flung areas. Folks in the UK have a new way to access medical assistance, i.e. via a 3G cell phone...it does not replace having a regular primary care MD, but it does cost...35 pounds per consultation...and accepts credit cards, pay pal, etc. It also offers the opportunity to create a personal health record here...no prescriptions given here. Once you have completed your Medical Questionnaire your answers will be sent for review by a registered Medical Doctor who is insured to practice by the Medical Defence Union or Medical Protection Society. Video conferences should be started within 1 hour of the request and are 24/7...365 days a year...and if you miss you call after 2- attempts, you will have a cancellation fee of 15 pounds. To Read more click here.

Successful examples like Aarogyasri and DrSMS in India suggest utilising mhealth for social causes, Health awareness and prevention.

Some better examples for developing nations like India come from Frogdesign and Frontline SMS.

FrontlineSMS:Medic

They Say -“In the developing world, lack of infrastructure prevents health workers from delivering efficient healthcare to rural areas. As health workers travel from clinics to reach isolated patients, they are often as disconnected from central clinics as the patients they are trying to serve. The mission of FrontlineSMS:Medic is to advance healthcare networks in the developing world by building and distributing innovative, appropriate mobile technologies. The centerpiece of our system is FrontlineSMS, a free, open-source software platform that enables large-scale, two-way text messaging using only a laptop, a GSM modem, and cell phones. We are also developing several applications for the FrontlineSMS platform that will enable better patient management, electronic medical records via the cell phone, cheap mobile diagnostics, and mapping of health services.”

Project Masiluleke

“Project Masiluleke (which means “lend a helping hand” in Zulu) is using mobile technology to tackle the worst HIV epidemic in the world in KwaZulu Natal, South Africa, where infection rates are over 40%. [frog design] is envisioning a solution that uses mobile technology in three crucial ways: 1) to encourage usage of low-cost diagnostic tools; 2) to walk patients through the testing process; and 3) to guide them into care should they need it, and encourage healthy preventative behaviors even if they don’t.”

Feedback and Suggestions Welcome!

1. How Should the Evolution of Mobile Healthcare Take Form? Simple or Advanced Services Development?

2. Where does mobile play a role - Limitations and Advantages, Extent of digitalisation, and support infrastructure required ?

3. Consumer Needs, Information Gaps and Role of the Ecosystem Player in the Healthcare Value Chain?

4. Challenges and things to watch out?

5. Exploration of Services and Evaluation of New Business Models?

Eindia 2009 Conference

2009-09-04T08:04:00.001-07:00

ehealth 2009 was a very successful conference this year.The attendence was very impressive and it was great to see Public sector participation there.

In my session, i.e. Online and Mobile Applications in Healthcare –
exploring new service channels and business models, Dr Rathan Kelkar, Director, Kerala IT Mission, Govt. of Kerala shared some of the robust Government initiatives as per Kerala's IT mission.Dr. SMS is one such Initiative.

The sole idea of the project is to help people to use their mobile phones to receive information on health resources and to provide the user with a comprehensive list of medical facilities available in that locality, such as hospitals having expertise in various medical specialties (Cardiology, Opthalmology, ENT etc).

To avail the facility the user has to send an SMS to a pre-designated number, the contents of the SMS should be the Pin code of the locality for which he or she wants to know about. This pilot was tried in Kozhikode District and after its success there, KSITM has rolled out the project in six more districts this year.

This session was one of the most interesting because of the Global participation.The stress was on Emerging markets and I was extremely happy to see participation from Dr. Shabbir S. Abdul, Researcher, National Yang Ming University, Taiwan; Dinusha Vatsalan, School of Computing, University of Colombo, Sri Lanka
where e-health and m-health models in Healthcare are now taking shape.

Mr. Nivedan Sahani, VP Government and PSU Enterprise Services, Airtel- shared what Operators are doing in the m-governance and mobile applications arena to strengthen e-health in India. He explained the initiatives in terms of rural healthcare in India through Aanganbari Projects.The Health MATE product which Mr. Sahani showcased was developed under the Use Case scenerio that a Field agent records symptoms of patient in rural area, sends to city based doctor for his online prescription, delivers medicine to patient.

India is one of the fastest growing Mobile markets in the world.In September 2008, Informa Telecoms & Media conducted the annual Mobile Content & Services Industry Survey. Of the 307 telecom industry professionals who participated in the survey, 71% believed that social networking & community services will have a significant impact on driving P2P uptake of mobile content. Healthcare services can therefore be benefited using social networking to doctor to doctor, doctor to patient and patient to patient social networking.

When I was speaking about the Immediate Business models on the platform ehealth and mhealth in India, I talked about challenges, Infrastructure, Budgets and Feasibility.I talked about simple Business Models like Health Tips, Health awareness messages, Pill reminders, LBS and support with Healthcare facilities and personalised Healthcare.

SIMpill is a successful example of SMS, being used to help combat diseases.It is about making sure people take their medication. It was used during a 2007 trial in South Africa to ensure people took their medication for TB. In the pilot, 90% of patients complied with their TB medication compared to 22% to 60% take-up without it.

I talked about basic issues of Encouragement, Awareness and Assurance which are very critical and important in healthcare.India (as per Economic Times) will get back to 9% growth by September 2010- reiterating the Centre’s commitment to create more spending power in the hands of people especially growth of rural India. This will call for convenience and better health standards. Success will hence be particularly in the area of health awareness schemes and training health care professionals.

Mobile phones are generally affordable and available to the population at large, making them more accessible than computers and far more cost-effective than hospital beds.Therefore Mobiles in developing countries can boom the existing Telehealth and ehealth industry, by providing more reach, better impact and more involvement and awareness about such initiatives.

The Brainstorming went interesting when all revenue models started talking about the direct relationship between improved communication and access to health care, also Increasing numbers of subscribers and coverage reaching & superceding MDGs for connectivity.Where I was addressing Clear plans for sustainability,Mr. Nivedan Sahani rightly stressed on Training and capacity development.

Mr. KVRK Rao, VP Marketing, SG technologies, came across as a Knowledgeable Speaker talking about full network participation for Successful integration. He successfully cruised us through Creative combination of new and old technology in his new range of products.

The Session concluded on a clear picture regarding Value add for the consumer in terms of Enhanced quality of care, Enhanced disease surveillance and control as well as Increased productivity within health system and profitability for the provider so as to reduce feelings of isolation for health care workers as well as consumers as a part of the overall Healthcare services network in India.

Mobile based Healthcare in Emerging Markets

2009-08-10T02:05:00.000-07:00

Countries like Africa, India ,China where disease burden is high with infectious and communicable diseases and a number of lifestyle disorders adding up 1.2% annually to the ailing population, How can subscription based services using mobile phones penetration in these areas help the conditions improve? To start of with lets say we will start with pushing SMS to people who will subscribe for this at Rs. 30/month in India.

What all categories should be covered?
What should be the model which will define its success?
How far can we evolve this service?
I think of categories like providing Info about health awareness program, Diabetes, Hypertension, Pregnancy etc. What all do you think should be there?

Feedback welcome!!!!!!

Healthcare Collaterals- Mobiles based Healthcare

2009-07-31T12:42:00.001-07:00

Pharma Companies under Focus

How can Mobiles add value to the B2B order processing and Process Management?

Here you will have to go by the Healthcare Value chain. Mobility value add in Order processing i.e. B2B will be helpful only if:

It eases out product procurement and delivery

It helps stumbling blocks to improved value chain operations

For this one need to understand the strategies in three product areas i.e. pharmaceuticals, medical devices, and medical-surgical products and other such deliverables.Let's take the pharmacy market first!

There is already a scope for healthcare products/Devices and Pharma products as far as process management in the value chain are concerned.Introduction of M-commerce in health care value chain is also worth pondering over.

For eg. Mobiles can be useful in effectively managing a small scale industry supply chain.

Similarly, managing prescription order workflow in a pharmacy network can be done using mobile phones. A workflow may define a sequence of queues. To complete the distributed processing of the prescription order, the task object may be passed along the queues, where each queue corresponds to a portion of work in processing a prescription order. The original order data object may be referenced in the task object or passed along with the task object.

Value = a MOBILITY service provider in a B2B value model, the value that it will pass on to the entire workflow would primarily be:

Effective Communications
Process Productivity

The revenue for a service provider would be fee-for-service business model. For most of the Value chain, Big Pharma Distributors like ABC say for example operate on a buy/hold business model under which a company would purchase drugs from manufacturers in large quantities based on what their own pricing models predicted would happen to the value of the drugs. Then ABC would sell the drugs to its customers for a higher price than that paid for the drugs. This set up is also evolving today and shifting focus, which can readily be addressed by Mobile Phones.

Wholesalers are shifting rapidly to a new, fee-for-service pricing strategy- in which suppliers pay directly for wholesaling services rather than having those services bundied and paid for indirectly through gross margin and unseen discounts.

Free for Service Model using Mobiles:

ABC says “ABC has traditionally benefited from profits earned through buy-side opportunities from manufacturers .We have invested our profits in serving customers by dramatically increasing service levels over time. However, the manufacturers' model is changing, shifting to just-in-time inventory models that reduce our buy-side opportunities.”

ABC= “To support our investments in quality, technology and the future, we are making changes in how we do business. And while our goal is to insulate customers from changing economics whenever possible, we must make sure all our customers pay in a fair way for the value they receive." "We are moving toward a model in which manufacturers compensate us for distribution services on a fee-for-service basis."

Solutions/Services on Mobiles will help:

NEW Profits and Services
1. creating and managing service fee programs per contract
2. calculating, and managing fees as they accrue
3. setting up payment packages
4. accurately calculating payments based on incoming sales data
5. publishing this data to distributor’s (ABC) Pricing module on
6. a transaction-by-transaction basis

Traditional Profit margins:

The price wholesalers charged for servicing manufacturers dwindled down to a small, set discount

In today’s increasingly complicated supply chain, Mobile based (Solutions+ communications) contracts are a powerful tool for maintaining wholesaler relationships. Mobile based transactions as well as services will soon be used as a part of VAS to acquire data, manage inventory, and gain greater visibility into who’s buying once products. Because, although most of the companies want this feedback and snail-trail , they do not have the infrastructure to manage payments for these vital relationships.

Will come up with more…

Copyright @ Ruchi Bhatt ,Canadian Guild 2008

Mobile based Healthcare model

2009-07-26T04:10:00.000-07:00

Mobile based Model- The Process and the Differentiation

Value Chain

Healthcare Social Linkups

In September 2008, Informa Telecoms & Media conducted the annual Mobile Content & Services Industry Survey. Of the 307 telecom industry professionals who participated in the survey, 71% believed that social networking & community services will have a significant impact on driving P2P uptake of mobile content. Healthcare services can therefore be benefited using social networking to doctor to doctor, doctor to patient and patient to patient social networking.

Will this work?

Mobile operators and service providers are increasingly integrating social networking and community features in their value added services. For example, if we look at some of the popular mobile music services such as MusicStation, Cyloop Mobile, Shazam, Bebo Mobile and Vodafone Music Reporter; they all include community features. Prima-facie looks like it will work for Healthcare based Information as well, Reason being:

“Word of Mouth” (as in endorsement of a particular treatment, mode of treatment, prevention or home based healthcare) spread is high in healthcare related business. Also, there is a preponderance of data that confirms that word of mouth remains the most trusted form of advertising across the globe. According to Allbusiness.com, Vision of People Picking Providers Based on Price and Quality Information Far from Reality (So here comparisons database don’t work), Word of mouth is the most effective marketing for medical practices. Specialists generate new patients mostly from physician referrals.
Spending Power (See todays news Economic Times- INDIA will get back to 9% growth by September 2010- reiterating the Centre’s commitment to create more spending power in the hands of people especially growth of rural India. This will call for convenience and better health standards. Success will hence be particularly in the area of health awareness schemes and training health care professionals. Mobile phones are generally affordable and available to the population at large, making them more accessible than computers and far more cost-effective than hospital beds.
Encouragement and Assurance Say a doctor recommends an insulin pump for a newly diagnosed diabetic, here the patient has no idea what that is, so it can be scary for him. In that case, going to a handy mobile community and being in contact with others who have the same thing happening to them can be reassuring.( SMS to encourage medication- SIMpill is another example of SMS, being used to help combat diseases. This time it is about making sure people take their medication. It was used during a 2007 trial in South Africa to ensure people took their medication for TB. In the pilot, 90% of patients complied with their TB medication compared to 22% to 60% take-up without it.)
Support Groups - According to the Jupiter Research report, 17 percent of "online health connectors" said they used the Internet "to get emotional support" for a health condition. Mobile based social networking would help connect patients to each other through disease-specific online communities, virtual support groups, real-time Web chats, and other features whereby patients share experiences and advice, and even rate their doctors.

Value Added Services in Healthcare

Customized knowledge services company Boston Analytics forecasts a 50 percent compounded annual growth rate (CAGR) in India's Mobile Value Added Services (MVAS) industry that will lead to a US$348.8 million market by 2009.Timely convergence of a saturated mobile voice market, little government involvement, an emerging ecosystem and rich consumer demand will lead to rapid development and adoption of Healthcare VAS content within the country. Last year, the Government of India, through its enterprise -- Bharat Sanchar Nigam Ltd (BSNL) -- soft-launched third generation or 3G services in Delhi.

Competitive Landscape of VAS

Sources/References:

Computer weekly

Consultant Live

All Business

Cellular News

IMRB, Boston analytics

Health On Mobiles

2009-06-24T01:02:00.000-07:00

Shift from Communicable to Chronic Disease
Over the next 10 years the cost of diabetes, heart disease, and stroke will take a tremendous toll on the national incomes of developing world countries.

Mobile based Healthcare can be further enhanced to address these challenges using tools currently available. For example, just as SMS alerts are useful in raising public health awareness of communicable diseases, these same types of alerts can be used to ensure patient adherence with treatment of chronic diseases such as diabetes. SMS alerts can be sent out to address chronic diseases and mental health issues in urban areas such as smoking cessation and nutrition reminders.

Enhancing Mobile based Healthcare
Addressing future health needs will be facilitated by the development of mobile technologies and network expansion. The key technology trends in mobile technology continue to be the same trends that have characterized technological progress for the past 40 years: miniaturization, greater speed, and cost reduction. These advances are reflected in mobile telephony by some of the advancement issues shown in Table above.

Noteworthy Points:

Greater range of services becomes possible with more uniform, faster, and more affordable broadband access;

greater access and coverage expands the ‘subscriber’ base, building volume, creating incentives for players, and helping push sustainable mHealth applications beyond simple one-way data services.

Health experts note that within the next 15 years, policymakers and health providers
in the developing world will be forced to turn their focus to prevention and early detection rather than late-stage treatment of non-communicable diseases, such as diabetes and cancer, as well as to the health needs of an aging population.These changes are being caused by trends such as migration from rural to urban areas, economic growth, and changing dietary habits.

As developing countries like India, tackle and make significant improvements in the spread of communicable disease, average income levels increase along with average life expectancy. Even a slight increase in income contributes to changing dietary habits and Lifestyles.

Late detection of these diseases leads to lower survival rates and reduced life expectancy, and has negative consequences for social and economic development. Developing countries are therefore being confronted with a double burden of treating and containing the spread of communicable diseases while combating a wide range of unfamiliar health challenges.

Read More here...

Customer Relationship Strategies in Health Industry - Role of CRM

2009-05-13T11:30:00.000-07:00

Improve physician segmentation and targeting

With the proliferation of multiple channels there is the need to be able to gather information from multiple sources to better target physicians and maximize sales impact. Only a CRM lets you respond quickly to changing market conditions by providing analytics that are built into the sales force automation and marketing applications, to better target physicians and maximize sales impact. You can use the applications to realign your sales force quickly, validate an alignment before deploying it in production, and model several alignment strategies. Concurrently, you can maintain historical views of alignments and territories to comply with federal regulations. To help unify your sales efforts, the application supports cross-functional processes such as customer targeting, samples and territory and objectives management. The application can be used both online and offline, the sales representatives can easily create target lists to plan routes and calls, add appointments to their calendars, invite medical education event attendees, and more, thus improving their overall sales effectiveness.

Healthcare practitioners and managers increasingly find themselves in clinical situations where they have to think fast and process myriad diagnostic test results, medications and past treatment responses in order to make decisions. Effective problem solving in the clinical environment or classroom simulated lab depends on a healthcare professional's immediate access to fresh information. Unable to consult a library for information, the healthcare practitioner must learn to effectively manage knowledge while thinking on their toes.

CRM and Knowledge management

CRM also supports Knowledge Management (KM) and in turn KM holds the key to this dilemma in the healthcare environment. KM places value on the tacit knowledge that individuals hold within an institution and often makes use of IT to free up the collective wisdom of individuals within an organization. Healthcare Knowledge Management: Issues, Advances and Successes will explore the nature of KM within contemporary healthcare institutions and associated organizations. It will provide readers with an understanding of approaches to the critical nature and use of knowledge by investigating healthcare-based KM systems. Designed to demystify the KM process and demonstrate its applicability in healthcare, this text offers contemporary and clinically-relevant lessons for future organizational implementations.

CRM and Integrated Delivery Systems

Hospitals and integrated delivery systems (IDS) are constantly seeking ways to form the perfect triad: (1) enhance revenues, (2) reduce costs, and (3) provide state-of-the-art patient care. One of the methods used to bring in additional dollars is promoting a multifaceted range of hospital services, such as lab, imaging, rehabilitation, home health care, cardiology, etc. Hospitals exploit a number of marketing strategies such as advertising, news bulletins, field representatives, and health fairs.

The first thing that people need to understand about “brokering strengths” is that one cannot do it de novo. You must have an existing relationship with the customer. In the case of a community-based hospital setting, it is usually not an issue because there are existing rapports with the local providers that may use the hospital for one or several components. Unlike the black-and-white capabilities of advertising and newsletters, the marketing person puts a human touch behind the interaction. He or she needs to function as more than just a vendor of services. He or she must make available several components in such a way that these capabilities contribute to an expansion of the doctor’s success. The term used to define this marketing wherewithal is “cross-selling.”

CRM and Cross selling

Hospital cross-selling is a potentially powerful weapon—and it has become a necessary one due to the competitive pressures from commercial companies and the necessity of growing hospital revenues. Administrators task many of their departments to significantly grow revenues each fiscal year, and the field person plays a large role in that initiative. So Hospitals can cross-sell to their laboratory chains, Wellness Centers and others.

The lab generates around 70 percent of clinical determinations in a patient’s chart. This decision making, however, increases to 80percent to 90 percent if one combines diagnostic imaging. Consequently, from a volume and profitability point of view, it is understandable why hospitals want to market both entities. But it doesn’t rest with lab and imaging. The attraction of selling “one-stop shopping” is mighty marketing fodder. There is often an entire suite of services that the hospital wants to market to area providers.

CRM as Expanding the Relationship

Most industry analyses show that it costs about six times more to acquire a new customer than to retain a current one. On the other side of the coin, it is widely accepted that the cost of losing a customer must include all of the hidden costs of lifetime potential spending, not to mention bad press. Therefore, from a business standpoint, it makes sense not only to do what is necessary to retain current customers but also to expand relationships with those customers. In addition, many astute business leaders strongly believe that if a customer relationship is not advancing, then it soon may be retreating. The field representative plays a significant role in building and growing the bonds between doctor’s offices and the hospital. He or she should aim to intensify the affiliation after the initial sale is over. Cross-selling strategies embody a terrific opportunity to realize both organic growth and help in advancing the rapport.

CRM and Up selling

CRM is not only about Marketing new products or selling via channels, it’s also about:

Selling the right products to the right members at the right time.
Personalizing member communications.
Measuring cross-selling and up-selling in relation to the totality of the member experience.
Increasing member lifetime value and profit per member.

Customer Analytics via CRM assessment is very critical in retaining customers in healthcare. As the role of today's contact centers continues to evolve, the need for successful cross-sell and upsell programs, strategies, tactics and agent sales performance becomes increasingly important. To improve results, contact center agents need to grow beyond service thinking and become sales successes using customized CRM.

Customer Response Management and Intelligent Marketing

2009-04-15T08:47:00.000-07:00

Better managed Portals: Remember when simply establishing an online presence was a big deal?

The healthcare industry is reacting to:

Empowered consumers who are seeking information on the Internet in record numbers
Dissatisfied consumers who are willing to spend their own money to get the care they want
Consumers who want to manage their own care and have greater access to their physicians.

CRM enabled Health Portal allows you to respond to all of these trends. As an integral part of a comprehensive CRM solution, the health portal is a password-secure, health management tool. Because one web model no longer fits all consumers, the CRM has to be custom made, personal and flexible.

Patients can keep all of their health and insurance information in one place, make appointments and requests via e-mail with their physician's office, receive information on subjects they choose, receive reminders about medication schedules, classes or exercise timetables and other health calendar entries, participate in support groups, and keep health journals.

You build trust, strengthen relationships, and learn more about what your patients want and need so you can constantly adjust and fine-tune your programs.

Better Pharmacies:

Increase productivity and cut costs - View your contact and health information on one screen. Track all your patient correspondence. Slash data entry time when you import price spreadsheets directly into your system. Instantly manage your margin.

Easy e-commerce – Customized CRM provides your customers with an easy-to-use online shopping cart that makes buying effortless – and keeps you in control.
Simplify your supply chain - With CRM technology and marketplace experience, you can easily fill from anywhere in the world.

Get prescription approvals - quickly & easily CRM receives prescriptions in electronic format then “attaches” them to your customer files. When you use CRM, doctors login and approve prescriptions over the web. Approval is instant, and the system provides a complete audit trail.

Your Customers will love you for letting them track their order – and you’ll save money - Your customers can log into the CRM system and see the status of their order from your web site - greatly reducing expensive call center volume.

Your data is safer than ever before - CRM servers are double redundant and feature up to seven layers of encryption.

Better Organized Labs:

CRM models for Labs and medical devices industry is almost the same.

CRM describes how pharmacies can use IT to better:-

1. identify up-sell and cross-sell opportunities-
2. identify partnership and collaborative agreements for new product development-
3. identify creation of profit from interaction with key opinion leaders and influencers-
4. realize increased collaboration with distributors to promote channel efficiencies-
5. create more highly trained, motivated and pro-active sales forces-
apply customer segmentation strategies to positively impact the bottom line and- manage employee knowledge to drive innovation .

CRM- The strategic Importance:

Nearly 42 percent of the respondents indicated that CRM was a valuable tool for their customers, 29 percent thought CRM was valuable, but difficult to sell and install, and 16 percent said that CRM is something they need to carry just to be competitive.Seventeen percent of the partners said that the average deal size was $250,000 or above, while 32 percent indicated it was between $10,000 and $49,000.

Those figures include hardware, software and service sales.Fifteen percent of the partners responding claimed that between 75 percent and 100 percent of their total revenues come from CRM service and sales, 19 percent generate between 25 percent and 75 percent of total revenue from CRM, and 25 percent make 10 to 25 percent of revenue from CRM.

The research showed that Microsoft, with its MS CRM, which came out nearly a year ago, has made--and will make--the most impact in the CRM space. Siebel was voted second, and Best Software was a close third.

Will come up with more..
Any queries or suggestions pls feel free to write to me..

Healthline, WebMD and a Dream to match magnitude

2009-03-16T12:15:00.000-07:00

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. Drkoop.com 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. Drkoop.com 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 Drkoop.com 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.

Consequence:Success!

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, Drkoop.com 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!, drkoop.com forgot to let consumers know that they were getting paid for each successful clinical trial referral. (In fairness, drkoop.com 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 drkoop.com 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..

Why to promote Ehealth?

2009-03-11T11:43:00.000-07:00

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.

E-health for blind guys

2009-02-24T04:37:00.000-08:00

I wanted to have some more inputs about any kind of handicap be it mobility, blindness, handicapped or deafness to e-health. Some people may be surprised to find out that the blind and visually impaired are about as likely to be on the internet as a sighted person. It can seem like a daunting task to learn to use a computer system, but the fact is, there are plenty of easy ways for the visually impaired to get online.

A common method for computer access for the blind and visually impaired is a screen reader. There are many screen reader programs available; the most common is the JAWS screen reader. A screen reader takes the output from Microsoft Windows and converts it to speech. The screen reader will tell you that you are currently in the Internet Explorer browser, and it will read to you the contents of the web pages. With time, and practice, a blind or visually impaired user can become very proficient at using a computer system.

Screen Readers offer a great degree of flexibility; you have full control over your computer. However, the screen readers are often difficult and time consuming to learn. Each program generally has different button combinations to access different menus and systems. These button combinations must be memorized. There are, literally, hundreds of possible key combinations which provide a great deal of control, but can be very daunting to learn.

How It Works

For example, a visually impaired individual wants to find out what image is showing. The image shows a photo of Mount Fuji taken during sunset. Existing screen reading software may not obtain the same information as shown in the image, or a description of the photo is simply missing. Whenever visually impaired users face such difficulties, they can report that incident by using the collaboration tool developed by IBM Research and ask for adding an improved alternative text to describe the image.

The request then is automatically sent to a server hosting the Social Accessibility Project Website where visually impaired users and any Internet users who wish to take part in help improving Web accessibility will register themselves to use the collaboration tool. Internet users who are registered to the Social Accessibility Project can see this request on the project Website, and may decide to respond to this request by using the collaboration tool by clicking "start fixing it" button, and type a short description, such as "Photo caption: Mount Fuji during a gorgeous sunset." The short description will automatically be transformed to an external metadata. The next time any visually impaired person tries to revisit the Web page showing the photo image, screen reading software will read the alternative text from the metadata to give better explanation of what the photo shows.

Metadata consists of useful information such as description of the content and the physical location of the particular content. By having external metadata to reside at the Web server, Web content will remain unchanged while making the Web more accessible.

To further enhance the usability of Web content, the Social Accessibility Project Website offers an incentive mechanism where screen reading software users can rate the quality of external metadata provided by Internet users along with a comment to show their appreciation. Also, active users are listed at the project's top page to recognize their active participation on the project.

In addition, screen reading software users can place a landmark whenever they find an important position on a Web page, and other users can benefit from those landmarks to help reach important information easier and faster.

One such good initiative is taken in Bhutan ..Read this link below:
http://www.kuenselonline.com/modules.php?name=News&file=article&sid=8415

Another method for computer access is to use an assistive technology device that simplifies the Windows operating system down to a few common workflows. There are a few devices on the market which do this. The SpeakEasy Media System is one such device. It is a system that comes with hardware and a preconfigured e-mail address. The system provides simple, menu driven access to e-mail, typed documents, news articles, podcast audio shows, encyclopedia entries, dictionary entries, and more. The SpeakEasy does not provide as much control over the system as a screen reader, however it is an excellent option for easy access to the most common functions that the blind and visually impaired will use.

Lastly, there are also machines specifically designed for reading typed documents. These reading machines will take a typed document and convert it into speech. They do not provide any access to the internet, nor do they support any function beyond simply reading a document. However, they are very simple to operate. There are a number of standalone reading machines on the market, one such machine is the Simon reading machine.

The options discussed provide a good cross section of the available access methods to computers for the blind and visually impaired. Screen Readers provide the most functionality, but are also the most difficult to use. Reading machines are simple to use, but lack most functionality. The media system provides most functionality of a screen reader, and also provides an ease of use experience similar to a reading machine.

But the question that still persists is how a blind person can read a patient information leaflet. Same explanation is given below:
http://www.ehiprimarycare.com/news/item.cfm?ID=1534

So suggest me some more ideas for the possible outcomes like:

Outcomes:

• Improved health condition of the visually challenged people participating in the pilot project as direct beneficiaries.

• Development of critical awareness and understanding on issues of e- Health for visually challenged people among health professionals, policy makers, development agencies and the blind population at large.

• Financial and social sustainability of the pilots launched as part of the research.

• Adoption of visually impaired people friendly e-health amenable solutions within the national health system.

Scommerce and How much it matters in Healthcare

2009-02-09T10:14:00.000-08:00

First of all I would like to thank all of you for this overwhelming response..

So lets take our discussion further, Yesterday I was talking to a few people on the possible alliances between scommerce and health as for them all this was new.

Lets first of all have a look at stats:

10% of Retail shopping including health and cosmetic products happens online, out of which the conversion of the best websites is almost 4%.(that too not in first 3 yrs.) I firmly believe in this survey which happened among approximately 2,000 online shoppers, that a majority (53 percent) went directly to retailer and manufacturer sites to research and purchase products, rather than using shopping comparison sites or social and/or community networking sites.

So 100 - 53= 47% left.

Of this 47% around 35% wanted to be physically present in the store while they buy and were certainly not online shoppers.

While social and community sites and content offer some value, they are only driving a small portion of online shoppers (12 percent) to buy more than planned."

So are we fighting for this 12%?

The answer is NO.

Reason 1: Despite their negligible impact on sales, social and community networking sites do play a role in how consumers perceive a company's brand, products and/or services. = A brick model to support this would work wonders.The big opportunity in the social arena is really in branding and advertising and awareness building= after this effort Sales happen through the pull model only.

Reason 2: Believe it or not, Scommerce is SEO as well. Scommerce is also used as a way to build inbound links and generate user content, all of which are tools to improve a website's search results on a given search engine such as Google.

However, social and community networking sites play a pretty minor role in driving online sales, it is equally true that Google still played a relatively major role, especially when compared to shopping comparison sites, social and community networking sites and third-party blogs.
Indeed, Google now drives 15 percent of traffic to retailers' Web sites, compared to just 3 percent for shopping comparison sites.= So the model should revolve around this approach.

Will come up with more.