The time has come for India to leverage its software skills in the healthcare sector, and systematise patient records and medical history
SNEHAMOY MUKHERJEE
In this digital age, I am amazed to see that doctors still prefer hand written prescriptions! There can be just two reasons why this still continues; they either do not have robust and trustworthy softwares in place, to help write out prescriptions and give a signed printout to their patients or, the softwares do exist, but they are reluctant to adopt them.
Either ways, I believe that the government and medical industry regulators should make it mandatory for doctors to write their prescriptions into a Patient Information System (PIS), to help them keep track of the patients they have seen and the medicines they have administered. In India, where we write software for the rest of the world, what remains a cause of great worry is the absence of world-class PIS, made in India. On further investigation, I was made aware of the fact that many of the Hospital Information Systems (HIS) that are implemented in Indian hospitals do have modules that can be customised to store the history of patients, but the struggle that many of them have is to enforce this and create a process by which it can be utilised to its full potential. The common reason for the lack of such enforcement seems to be that most doctors and nurses are still content carrying physical folders around, with hand-written instructions from the doctors. Maybe it is time to arm them with ipads!
While it may be easier to enforce the practice of maintaining a digital history of patients who are hospitalised, the bigger issue would be to implement it outside hospitals also, like the outpatient departments. As a patient, I feel that it is my birth-right to know my entire medical history, including the multitude of tests that I have undergone so far and ensure that they are recorded for posterity, so that I do not need to rummage through vast reams of files and yellowed prescription sheets for all ailments that I have been treated for.
Now, some may argue that as a patient you may be visiting multiple doctors for the same or different ailments, and it may not be possible for all information to be tied back together to create your own medical profile. This is where I would like to draw your attention to an earlier article where I had written about the need for creating an online medical history database for which the commercial model, sponsored by major pharmaceutical companies who will find great value in that data, will itself pay for the cost of maintaining the database. So, for the sake of this article, we will assume that we have Google Health (a service which was not adapted by the world and led to them taking a decision to retire that service). Arguments about the privacy of such a database have already been addressed in that article and we will assume that this Medical History Database or Databases ( there can be multiple vendors providing this service, similar to mail services provided by multiple companies) will ensure patient privacy and anonymity before sharing their data for medical research, to help figure out different aspects of treatments like, what dosages have worked in what kind of ailments, for patients with what age, weight, height etc.
The only way that the online medical history will become a reality is, when it is enforced by the government. Else, it will remain a failed experiment, a great idea that never took off, because the governments of the world refused to act on it.
Manifold advantages
The advantages of having such a database is manifold as your doctor can easily look into your ailment history, see what medications have worked in the past and what medications haven’t and then prescribe the appropriate medicines. It will also help bring alleged medical malpractices to the fore as it will discourage doctors from prescribing unwanted medicines, performing non-critical surgeries and prescribing unwanted tests, as it leaves an audit trail of their treatments. The database can be mined to provide more innovative, but maybe controversial statistics like the success and failure rate of doctors with respect to their treatments, surgeries etc. and also feedback from patients. This system will reward the truly hardworking and well-meaning doctors, and penalise the small percentage of the outliers, who tarnish the image of the medical community. Imagine, people looking at the ranking of doctors and looking at patient feedback and queuing up to consult the truly great doctors in their locality. It will also have real feedback, as compared to a few word of mouth referrals on the truly good hospitals and nursing homes in their neighbourhood. The advantages that I mentioned above are more personalised and short term in nature. The biggest beneficiary of this database would be our mankind in the longer term, as this database will enable a thorough investigation of drugs and their effects/symptoms and enable the pharmaceutical companies, in conjunction with the medical research community, come up with better cures and better treatments. It may be possible to discover cures for many diseases that do not have a cure yet, by looking at the analysis of treatments in such cases.
Pilot phase
This needs to be rolled out first in metros where there can be no excuses about the non-availability of computers or broadband connection. Any aberrations need to be strictly dealt with so that only genuine cases where patients vouch for the unavailability of resources (like electricity outages while entering data, printer issues, network issues etc, are recorded by the patient themselves) are entertained.
The only way that the online medical history will become a reality is, when it is enforced by the government. Else, it will remain a failed experiment, a great idea that never took off, because the governments of the world refused to act on it.
Our government is concerned about enforcing the digital era in cable television, but seems to completely neglect a more pressing need to enforce digitalisation in all patient treatments made by doctors. It is a burning need of the hour. Maybe, this would be one area where India can show the way ahead to the world!
Snehamoy Mukherjee is a part of the Strategic Leadership Team at Axtria, a New Jersey based Analytics firm, where he is responsible for business development, solution development, delivery leadership and strategy formulation. Prior to this, he used to head the analytics practice at Technopak Advisors and has over a decade of experience in the analytics industry having worked in multiple domains like retail consulting, FMCG/CPG, insurance and market research.
