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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

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challenges in developing countries e health

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

[email protected]

slide2
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 ICT

Rajendra Pratap Gupta

slide3
eHealth is no more an innovation now. It is a basic necessity of every healthcare system

Rajendra Pratap Gupta

ehealth push pull
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

priorities for the developing world
Priorities for the Developing World
  • MDGs 4 & 5 – MCH
  • Healthcare delivery in rural areas
  • NCDs
  • Training of *HCWs

* HCW – Healthcare Workers

mdgs 4 5
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
outcome
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
healthcare delivery in rural areas
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
eHealth delivering in low resource settings

Equipment

  • Stethoscope
  • Temperature
  • Blood Pressure
  • ECG
  • SPO2 (opt)
  • 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
slide14
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

slide15
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
eHealth has the solution for RPM*
  • Biometric Screening
    • SpO2
    • Blood Pressure
    • Blood Sugar
    • Spirometry
    • Total Cholesterol
    • ECG
    • Triglyceride
    • Body Composition
    • HBA1C
    • Ultra-sound
    • X-Ray
    • Doctor consultation
    • * Remote Patient Monitoring
training of hcws
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
mHealth – addressing the challenge
  • 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

18

challenges for ehealth
Challenges for eHealth
  • Lack of data in support of eHealth
  • Successful & scalable eHealth projects
  • Technical competence amongst policy makers to understand eHealth
challenges for ehealth1
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
Conclusions and Recommendations

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

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