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ITU Workshop on “ E-health services in low-resource settings: Requirements and ITU role ” (Tokyo, Japan, 4-5 February 2013). Challenges in developing Countries & E-Health. Rajendra Pratap Gupta, Member , World Economic Forum ’ s Global Agenda Council – Digital Health 2012-14 - PowerPoint PPT Presentation
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Tokyo, Japan, 4-5 February 2013
Challenges in developing Countries & E-Health
Rajendra Pratap Gupta,Member , World Economic Forum’s
Global Agenda Council – Digital Health 2012-14
ITU Workshop on “E-health services in low-resource settings:
Requirements and ITU role”
(Tokyo, Japan, 4-5 February 2013)
Tokyo, Japan, 4-5 February 2013 2
eHealth was born out of the challenges of - constrained financial resources,
Clinical resources, infrastructure, increasing need of healthcare in rural / remote settings and advancements in
ICTRajendra Pratap Gupta
Tokyo, Japan, 4-5 February 2013 3
eHealth is no more an innovation now. It is a basic necessity of every
healthcare system Rajendra Pratap Gupta
Tokyo, Japan, 4-5 February 2013 4
eHealth – Push & Pull
MCH – IMR – MMR
Rural Health
Health Screenings
Secondary prevention amongst affluent class – NCDs
Second opinion or referrals & tele-radiology
Geriatric Care
Medical tourism
Tokyo, Japan, 4-5 February 2013 5
Priorities for the Developing World
MDGs 4 & 5 – MCH
Healthcare delivery in rural areas
NCDs
Training of *HCWs
* HCW – Healthcare Workers
Tokyo, Japan, 4-5 February 2013 6
MDGs 4 & 5
In India , MMR is 212 / 100,000 live births . 1 death every 10 minutes.
Target is to get MMR down to 109 / 100,000 live births by 2015
IMR is 48 / 1000 live births & needs to be brought to 42 / 1000 by 2015
Jeevandainee Project - Maharashtra
Tokyo, Japan, 4-5 February 2013 7
Sample report – High risk patients
Tokyo, Japan, 4-5 February 2013 8
Tracking high risk pregnant women
Tokyo, Japan, 4-5 February 2013 9
Tokyo, Japan, 4-5 February 2013 10
Outcome
Cost of intervention per village < $ 100
In a year and half of being in operation;
Maternal mortality dropped from 91 /100,000 to 51 / 100,000
A drop of 43.95 % in MMR
Tokyo, Japan, 4-5 February 2013 11
Healthcare Delivery in Rural areas
70 %( about 830 million ) of India’s population lives in rural areas
India has about 6,40,000 villages
Absenteeism of doctors is 40 % in rural settings
eHealth delivering in low resource settings
Tokyo, Japan, 4-5 February 2013 12
• Service is operational in several regions in India– More than 677 village centers
in UP, Bihar, Tamil Nadu, AP, Maharashtra, Tripura, MP & Karnataka.
• More than 200,000 consultations, Rs. 20-200 fee, sustainable village centers
• Covering 40 Mn population. To increase to 70 Mn by end of 2013.
• 30-40% traffic of patients who have earlier visited for a different ailment
Equipment•Stethoscope
•Temperature
•Blood Pressure
•ECG
•SPO2 (opt)
Rural Health Centre
Tokyo, Japan, 4-5 February 2013 13
Tokyo, Japan, 4-5 February 2013 14
NCDs
53 % of all deaths in India due to NCDs ( WHO ). This is set to increase by 18 % in the next 10 years ( WHO).
* Raised blood pressure prevalence is 32.5 % ( approx. 396 million )
* Raised blood glucose prevalence is 10 % ( Approx. 122 million )
*estimates as per WHO. http://www.who.int/nmh/countries/ind_en.pdf
Tokyo, Japan, 4-5 February 2013 15
NCDs
Government has already started a mass screening program
Crossed 14 million screenings
India needs a mass secondary prevention program for NCDs, using mHealth / eHealth.
eHealth has the solution for RPM*
Tokyo, Japan, 4-5 February 2013 16
• Biometric Screening–SpO2
–Blood Pressure–Blood Sugar–Spirometry–Total Cholesterol–ECG–Triglyceride–Body Composition–HBA1C–Ultra-sound–X-Ray– Doctor consultation
* Remote Patient Monitoring
Tokyo, Japan, 4-5 February 2013 17
Training of *HCWs
India has approx. 866000 *ASHAs
No. of ASHAs to increase in future
A new 3 year course for HCWs (Rural)
Training , capacity building & re-training - a big challenge !
* HCW – Healthcare Workers. ASHA- Accredited Social Health Activist
mHealth – addressing the challenge
Tokyo, Japan, 4-5 February 2013 1818
• 360 degree approach to communication
• Launched 4 months ago
• Covers 29 million population / 8 districts
• Trained 40,000 workers
• 1 million minutes of talk time used by Health workers
Tokyo, Japan, 4-5 February 2013 19
Challenges for eHealth
Lack of data in support of eHealth
Successful & scalable eHealth projects
Technical competence amongst policy makers to understand eHealth
Tokyo, Japan, 4-5 February 2013 20
Challenges for eHealth
VOI ( Value On Investment ) should be considered for eHealth and not just financial ROI ( Return On Investment ).
BOO ( Build , Own & Operate model ) or BOOT ( Build , Own , Operate & Transfer model ) under PPP ( Private Public Partnership model ).
Conclusions and Recommendations
Tokyo, Japan, 4-5 February 2013 21
When it comes to eHealth , we have achieved ‘technical maturity’ , but the lack of
‘organizational maturity’ is proving to be a big bottleneck in unlocking the potential of eHealth
Rajendra Pratap Gupta