Health care Delivery system in India
India is a vast country of 1. 4 billion population
• It consists of 29 states and 6 Union Territories governed by a federal system
• Health is a state subject which follows a three tier system – primary health centre catering a group of villages, Secondary level health centre located at district level and medical college hospitals constitute the tertiary level located in the big cities.
Telemedicine in India:
Potential of ICT to improve health care
65% of 1100 million will be literate by 2015
60% of rural India has access to TV coverage.
650,000 existing PCOs ® internet kiosks,.
400,000 villages already have telephone connections.
Internet users in India 2m Dec 2001, 8.5m 2003, will grow to more than 10 million by 2010.
Need for Telemedicine
• Non availability of facilities / skills / technology locally(rural /remote area)
• Urgency of treatment
• Inadequate opportunities for CME
Challenges and Barriers
• Reliability of connectivity
• Need for speed- (Bandwidth)
• Legal / Ethical issues
• Data Security/Patient confidentiality
• Learning Curve
• Resistance to change
According to industry analysts, any hospital with a minimum capacity of 100 beds is a potential IT buyer. It is estimated that there are over 1,000 hospitals in that category in the country. National Association of Software manufacturers are services
Companies (NASSCOM) believes that healthcare organizations in India will spend around INR 100 million on IT in the current year.
The major component of this will be hospital management systems and networking hardware required for processes like telemedicine. Even with such a small scale of operations, some significant changes are being made nationwide that will strengthen telemedicine initiatives and the healthcare industry as a whole. The most important initiative being, the standardization of exchange of health information between different entities within the healthcare sector. The Ministry of Health & Family Welfare and the Ministry of Communication and Information Technology are jointly creating a national health information infrastructure, for easy capture and dissemination of health information. To support this infrastructure, necessary steps are also being taken in creating a legally safe environment that will protect the privacy and confidentiality of health information .
Steps are also being taken to educate various stakeholders of the healthcare industry about the need for complying with health information standards. The above-mentioned initiatives of the government are indirectly going to bolster the growth of cross border e-health services.
Healthcare is becoming more and more regulated in developed countries such as the USA. Healthcare payers and providers are willing to outsource work easily to countries/companies that comply with health information standards and have a robust legal framework for privacy and security of health information. In principle, telemedicine has bridged the urban rural divide by taking healthcare to interiors of India. There are more than 150 telemedicine initiatives today most of it are supported by Indian Space Research Organisation and IT Ministry. On an average close to 6 (range of 2-10) telemedicine encounters take place per day in each of these centers.
These figures are very low considering the dearth of healthcare services in the same areas of India. However, a start has been made. These figures are only going to increase as the technology costs are falling regularly, e.g. telecommunication costs have reduced by 3 times since the last two years.
e-health services are being adopted by healthcare provider organizations in India gradually. The growth of e-health services has given rise to the need for a new breed of healthcare professionals, healthcare administrators and healthcare technologists. This industry needs people who can understand any two of healthcare, business and technology. Historically the healthcare industry has been the last adopter of technology, the same has been the case with healthcare education. Even till today, many of the medical, dental, nursing, pharmacology and other healthcare degrees do not have courses on information technology.
The industry has grown to such a size that people from non-healthcare backgrounds are being recruited and trained. Interestingly, a lot of youngsters with traditional healthcare degrees such as MBBS and BDS are exploring career options in e health. As technology is pervading more into our education system, learning is becoming “anywhere and anytime”. E-learning enables students to study and appear for exams at their convenience from any place they want to, as long as they have a good internet connection. Some forward thinking companies such as Medvarsity have started offering healthcare courses to healthcare students and practitioners.
It is helping medical students to prepare for higher studies through online courses. It also has courses directed to both students and practitioners. e.g.- courses in subjects such as emergency medicine, health insurance, etc. E-Health service companies can get business more easily if their employees’ qualifications are recognized by their clients. Since majority of revenue comes from American companies, many companies are encouraging their employees to enroll for online healthcare courses recognized by American educational institutions and associations. In the coming years India is going to have more e health activities considering the present trend.