[Editorial Analysis] Digitize healthcare slowly

Mains Paper 2: Health
Prelims level: Digital Health ID Project
Mains level: Issues related to Health Sector

Context:

• Recently the Indian PM has launched the Digital Health ID Project (DHID) which generated debate on issues related to the use of technology in the broken healthcare system.

Digital Health ID Project (DHID):

Objective:

• To improve the quality, access and affordability of health services by making the service delivery quicker, less expensive and more robust.

Advantages of DHID for India:

• The use of tech for record maintenance is not just inevitable but necessary.

• With DHID the burden of storing and carrying health records to the doctor is minimized.

• Moreover, the doctor has instant access to the patient’s case history enabling more accurate diagnosis and treatment.

• Further, DHID enables portability across geography and healthcare providers which helps in reducing re-testing every time a patient consult a new doctor.

• It will hugely impact the quality of care and enhances patient satisfaction and confidence.

• Digitization of medical records overcomes the problems related to space and retrieving databases.

• Well organized repositories enable easy access to records that can stimulate much-needed research on medical devices and drugs.

• It can have a transformative impact in promoting ecosystems that functions as paperless facilities.

• The direct electronic linkages between the patient registration process, doctor, laboratory and pharmacy enable the use of relevant information before the patient’s arrival, thereby reduce delays and enhances efficiencies.

Challenges/Concerns with respect to DHID:

• Although technology smoothens the process and enhances the patient experience, there is a cost attached to it.

• In the immediate short run, DHID will increase the admin cost by 20% due to the capital investment in hardware and software development and personnel.

• Studies showed that small and medium hospitals are reluctant to adopt EMRs, because of the upfront investments that are required.

• Ultimately, any scaling up of this reform would require extensive subsidies and techno-logistical support to govt and private hospitals.

• In India, the challenges for Digitization is much higher because :

• The majority of the facilities do not have the required physical infrastructure.

• Cards getting corrupted,

• Servers being down,

• Computers crashing/hanging

• Frequent power outages in India.

• For many years, the inability to synchronize biometric data with ID cards has resulted in large-scale exclusions of the poor from the welfare projects.

• Repeating the same mistakes in the health sector will cause immense hardships to the most marginalized sections of Indian society.

• Though teleconsulting has certainly helped patients access medical advice for managing minor ailments and getting drugs delivered home.

• But in handling chronic diseases that necessitate continuity of care, teleconsultations have been problematic and cannot be substituted for actual physical examination.

• The serious shortcoming of using teleconsultation is the high attrition rate of doctors.

• Technology can be of little use in absence of doctors and basic infra.

• The most important is the possibility of privacy being violated increases with the centralization of all information.

• There is also the high possibility of hacking and confidentiality breach.

Way forward:

• There is a need to conduct a pilot study to assess the use of technology for streaming patient flows and medical records and thereby increase efficiencies across different facilities.

• There is an urgent need to build robust firewalls and trust.

• Increasing the doctor: patient ratio by encouraging more and more doctors into public hospitals.

• Increasing and upgrading the infrastructures of the hospitals.

Concludsion:

• The only way to ensure that a good policy does not die along the way due to poor implementation is by going slow and steady by making DHID sustainable and acceptable with the aim to achieve this aspiration sooner.

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Prelims Questions:

Q.1) With reference to the AMRUT 2.0, consider the following statements:

1. It aims to provide 100% coverage of water supply to all households in around 4,700 urban local bodies by providing about 2.68 crore tap connections and 100% coverage of sewerage and septage in 500 AMRUT cities.

2. It will adopt the principles of circular economy and promote conservation and rejuvenation of surface and groundwater bodies.

Which of the statements given above is/are correct?
(a) 1 only
(b) 2 only
(c) Both 1 and 2
(d) Neither 1 nor 2

Answer: C

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