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Mobile Health Around the Globe: Ruchi Dass and mHealth India Plans 2012 Part II-Exclusive Interview With Dr Ruchi Dass

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Posted May 29, 2012

Keywords: Dr Ruchi Dass, India, Mobile Health Around the Globe, Mobile Health

Dr. Ruchi Dass

EXCLUSIVE POST - This is part II of our Mobile Health Around the Globe post this week. Part I is Dr Ruchi Dass's post on mHealthIndia Plans 2012 from her website HealthCare India.

I had the extreme pleasure of interviewing Dr Dass the other day to go into a little more detail on her post and her ideas on the mHealth situation in India. We had a very enjoyable Skype call and I asked Dr Dass several questions which she answered graciously and eloquently. Please view the following video to see this exclusive interview:

To read other posts in this exclusive ongoing series, please visit the Mobile Health Around the Globe main page.

And if you have a Mobile Health Around the Globe story to tell, please email me at joan@socialmediatoday.com

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Joan Justice

Joan Justice is currently the Senior Curator for HealthWorksCollective. She holds both a nursing and a graduate business degree, and has worked in domestic and international marketing management for several major healthcare corporations. She lives in Charlottesville, Virginia.

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July 5, 2012

Claire Right says:

8 per cent of households are pushed below the poverty line each year due to health expenditure. Income Tax exemption under section 80D of the Income Tax Act is not provided for preventive health checkups in India so far. A preventive health care voucher system, like social health insurance scheme (as conceived in the National Health Policy 2002), funded by the Government, with service delivery through the private sector, could also be tried for the general public.

With schemes like Aarogyasari, RSBY (Rashtriya Seva Bima Yojana) and other rural health insurance options, now acute care is slowly becoming manageable. However, chronic care is still a farfetched dream. NPCDCS program under State Health initiative is bringing stakeholders together to screen patients with these diseases on time and provide a guided disease management approach. Pilots have already started in several states in India on Diabetes and will slowly help manage these conditions better leading to fewer hospitalisations and increased adherence amongst patients. mHealth can be best leveraged here as emntioned by Dr Dass in this interview. Its about the right positioning.

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May 31, 2012

Gerald A Theis says:

I believe due to the above limitations in Internet connectivity an interim mobile health solution is a valid reliable PHR on a digital device. Doctors would have access to review data entry and upload diagnostic files remotely so the citizen can download their PHR on their device then share "off line" on any computer. Gerald Theis Innovator

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May 31, 2012

Ruchi Dass says:

Jerry,

Great to hear from you. Though PHR is better than nothing, it has its own set of problems as well.

Advantages

you can limit who can access your PHR online and can limit how much of your personal information people can access

many different types of people can access them (i.e. your physicians, pharmacists, pharmacies, insurance companies, etc.)

many different forms as website ones are stored on a secure, reliable server created by one of your personal health care providers

Also, when a new doctor asks a patient for his medication history but he can’t remember it, he can go access the patient’s PHR online with his password and find it during an

Disadvantages

there is still no federal law right now stopping people from sharing or selling personal medical records to any marketing agencies or other 3rd parties without the patient’s consent

Doctors don't rely on PHR fully.

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May 30, 2012

Anil Satram says:

I agree cent percent Clair - what is important to recognise is that internet and mobility has opened the door for all over the top (OTT) solutions and products each trying to outsmart the other and I'm an advocate of stadardisation of information held electronically or exchanged between systems be it communication industry, electronice devices, mobile devices or healthcare. There is myriad of possiblities and opportunities that are shaping up with the advent of mHealth, Cloud Computing, Remote Health monitoring etc..that only would see the real benefits and connected care system where there is interoperability and stardisation of information and information exchange in place.

We have industry consortium such as TM Forum for communications industry that provide platfrom for various communication provides, System Integrators, OEMs etc. to collborate on in creation of process frameworks, solutions and integration frameworks that brings in interoperability among diverce systems/entities in telecom ecsystem. Likewise, the it is primetime, "next thing is now" that Healthcare domain need to realise and collaborate on an international level and work towards influencing creation of standard for health information and health information exchange. USA has lept ahead in making some headway in this already and perhaps rest of the world should follow the steps and bring about an internation healthcare industry forum that will guide and create frameworks for interoperability.

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May 31, 2012

Ruchi Dass says:

Anil:

Thanks for sharing Info on the TM Forum. Today, electronic records and standardisation are widely perceived to be the outstanding theoretical problems of our profession. In the case of the former, the "practicality" of trying to find a solution is well understood. Perhaps the latter does not receive the same attention because it is felt that we have descriptive solutions already, that the only question is whether we need to make them a bit better, and that it can wait upon more "urgent" priorities.

It is already clear that, whatever successful strategy is developed for dealing with electronic records, possession of an adequate documentation strategy is a key to that solution. The two great problems (electronic records and standardisation) are not, in fact, two problems at all - they are twin aspects of the same problem. Electronic records cannot be dealt with effectively apart from an adequate documentation and standardisation strategy.

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June 1, 2012

Anil Satram says:

Thanks Dr. Daas, you have said it – in deed electronic records and standardization are aspects of the same problem. At the base of it, there should be a strong case, intent and desire among various players in the ecosystem to share medical records and information for providing a holistic and affordable healthcare for very individual – rich or poor, urban or rural, nationally or internationally.

In way, communication industry has been fortunate I would imagine. The players in the communication ecosystem have had realized the importance to interwork between disparate systems, different parts of the world and between nations and along the evolution of communication technologies, various parties in the ecosystem have realized each would have to implement their systems of information such a way that it could share a common standard for interfacing with third party systems – they saw necessity to conform to an industry standard for communicating between disparate systems. For instance, let’s imagine, how the ubiquitous Internet has enabled us exchanging message in this forum each using disparate communication peripherals, say one uses iPod while the other uses laptop. These disparate peripherals conform to a standard Internet communication protocol i.e. TCP/IP. Both systems would have their own custom implementation of the TCP/IP protocol while conforming to the core principles that allows interoperability and interworking. I’m sorry there was a digression but nevertheless intentional.

So, the point I wanted to make is that such strong case, necessity and intent has not yet been realized at least to the fullest sense in healthcare industry - perhaps the players in the value chain don’t see values in information/ records sharing outweighs perceived threats. In an ecosystem, inherently there is an interdependency for mutual existence that is only possible by conformance – standardization.

Henceforth, soon the healthcare industry realizes the need to exchange and share information between care parties and foresee the benefits it can bring to patient centric ecosystem – there will be a desire and impetus locally and internationally towards (1) standardization of electronic care record format and structure and (2) standardization of storage of electronic records and policing record sharing between care organizations. Drawing analogy from the above example from communication industry, each care provider could implement the above standards differently while keeping the essential components that allows interoperability and interworking between different care parities locally and internationally at the same time does not restrain from providing additional documentation. For instance, the record format should account for a flexibility for doctors/care providers to document custom/patient/disease specific information over and above what the standard electronic record format.

21st century technology has potential, that would enable both (1) and (2) and promises a patient centric land that can *only* be possible when care providers and organizations, technology vendors and other parties realize that sharing of health information is the enabler and not a blocker or threat… we are getting there... as I can see, with industry pundits and evangelists like yourself and many more, it is coming. What lies ahead is “now” – does mankind see (really I meant...) healthcare is “priority one” in life?

Thank you for your perspective and looking forward to your next article or blog.

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May 29, 2012

Julian Beck says:

Dr Ruchi Dass- "Economies of Indian states can grow 1.08 per cent faster with every 10 per cent increase in Internet and broadband connections, says a study released by Indian Council for Research on International Economic Relations (ICRIER)."

I am surprised and pleasantly surprised. Wondering what wireless technologies can do if this is the growth potential for internet in India.

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May 30, 2012

Ruchi Dass says:

Dear Julian,

Yes. It is true. Let us take the example of Canada. The mobile industry provides economic value to the wider economy in Canada well beyond the revenues which flow to the network operators and service providers, and excluding the value generated to the government through taxes and spectrum licence fees. The CWTA believes that the Canadian wireless industry has made significant contributions to the public benefit through licence fees - the AWS and PCS auctions have generated $4.26 billion and $1.481 billion respectively.

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May 29, 2012

Julian Beck says:

Rural India is expected to account for 40% of the 250 million new wireless users as per a recent study conducted by FICCI and Ernst and Young. If these subscribers had access to broadband and high-speed Internet, every citizen would truly be able to participate in - and benefit from - the global information revolution and contribute to a balanced growth of the nation.The winds of change are blowing in that direction - the Indian government has recently announced its 3G policy which will make available 3G, HSPA and WiMAX technologies that are expected to bridge the last mile and drive mobile broadband in rural areas. Moreover, the Telecom Regulatory Authority of India's (TRAI) recent Internet telephony decision, permitting ISPs to terminate local, STD and ISD calls from computers to mobiles and landlines or vice versa, is likely to reduce both local and long distance call rates and boost rural connectivity in a relatively price-sensitive market like India. It is great to know that there are plans for an overall strategy for telemedicine in india ynderway now.

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May 30, 2012

Ruchi Dass says:

Thanks for sharing these statistics. Healthcare is potentially one of the most important areas where broadband can make an impact. It has been estimated that at least USD 5 trillion is spent worldwide on providing healthcare and savings of between 10% and 20% could be achieved through the use of telemedicine delivered by broadband. A World Health Organization report revealed an estimated shortage of almost 4.3 million medical staff worldwide, with the situation being most severe in the poorest countries. Medical advice, monitoring, diagnosis and training delivered through broadband can help a great deal to overcome these gaps. Training of professionals in all sectors can be delivered through broadband video and other applications.

ICT have clearly made an impact on health care. It has improved dissemination of public health information; enabled remote consultation, diagnosis and treatment through telemedicine; facilitated collaboration and cooperation among health workers, including sharing of learning and training approaches; supported more effective health research and the dissemination and access to research findings; strengthened the ability to monitor the incidence of public health threats and respond in a more timely and effective manner; and improved the efficiency of administrative systems in health care facilities. This translates into savings in lives and resources, and direct improvements in people’s health.

The spectrum for 3G and BWA technologies for provision of high speed data services has been allocated recently. It is expected that wireless broadband will be available to subscribers from early 2011. There were 687.71 million wireless subscribers at the end of September 2010. Out of 687.71 million wireless subscribers, about 274 million wireless data subscribers (i.e 39.8%) are able to use Internet services from their mobile device. The mobile Internet user base has tripled from 2007 to 2009. We also have 1.5 million high speed data card subscribers. The high growth of data subscribers, capable of using Internet through mobile devices, makes available a ready population which could adopt broadband.

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May 29, 2012

Clare Michael Dom says:

The ICT is without a doubt the superhighway on which economies surge ahead, and apart from the apparent benefits to the economy and a modern workforce, there is also immense opportunity for agriculture as well as other traditional industries. Good interview.

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May 30, 2012

Ruchi Dass says:

The bandwidth requirement in rural areas is high due to usage of multimedia particularly where literacy is low. Most of the applications presently available on Internet are in English. As English literacy in rural areas is low, communication through video will be a popular application. e-education and e-health will pickup and are expected to have high video content. Initially broadband may be used through community centers. The proliferation of broadband connectionswill increase with the knowledge and awareness. Considering the bandwidth requirements as discussed for various applications, on an average a minimum of 2 Mbps per household will be necessary to support the broadband requirements till 2014.

The number of broadband users will rise to 5 billion by 2016 from 900 million now, according to some estimates. Evolving 3G and LTE are already the basis for rapid data uptake in mobile networks. A wealth of applications and devices like smartphones and dongles are operating at speeds of 21 Mbps, which may go up to 100 Mbps once 4G gains traction.

But without an efficient mobile backhaul strategy, a 3G or 4G operator will find it impossible to offer uninterrupted user experience to smartphone/ tablet users wanting high speed internet data downloads on the go. Hence this need to be planned and discussed.

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