Health on the Line

July, 2011
By Anumita Raj

Like much of India's highly touted "potential", the healthcare system is hampered by the stunning disparity in wealth that is evident in the country. It doesn't matter that wealthy foreigners from other parts of the world now fly to India to be treated to some of the best possible medical care and some of the world's most highly trained physicians. The fact of the matter is that hundreds of millions of people in India still go without the most basic healthcare because the system is either too far removed from them or too expensive for them. 

This is not to say that there isn't hope for the future. Thousands across the country, in government, the private sector and in non-governmental organizations are working almost daily to find solutions that will change the status quo. The expanding reach of technology in India is providing new avenues for these dedicated healthcare workers to explore. In the past few years, information and communication technology (ICT) has been of particular interest to researchers who work in healthcare. As the penetration of ICT increases in the coming years, this intersection of ICT and healthcare could yield greater successes, specifically having a significant impact on the lives of the poor. 

The Centre for Development of Advanced Computing(C-DAC) is the research and development wing of the Ministry of Communications & Information Technology (MCIT). C-DAC is responsible for creating Sanjeevani, which is a project that combines the use of cell phones and computers to enable services such as Tele-consultations, Tele-education and Tele-diagnosis. Tele-consultations allow for patient histories to be placed online so they can be accessed by doctors in different parts of the country with ease. Tele-consultation will allow patients to have continuity of care regardless of where they are. At the same time, poor patients may be able to consult doctors who live in other parts of the country, by virtue of having their patients histories, tests and scans already online, enabling the other facility offered by Sanjeevani, Tele-diagnosis. 

Tele-diagnosis allows specialist to consult with local physicians via video-chat and calls. The Tele-diagnosis facility could prove to especially useful to poor people in rural areas. Most community healthcare centres and government hospitals in these areas do not have specialists available on call, such as oncologists, paediatricians and so on. Through this programme, it is possible that more diseases will be caught in early stages for people who usually have limited access to healthcare, and most often cannot afford to travel to nearby towns and cities to be examined by specialists. 

Another example can be found in Chennai's Sankara Nethralaya hospital. The ophthalmic hospital, which is a not-for-profit, has mobile van units that operate out of remote rural areas. Technicians offer basic eye-checks for the rural poor, and then the results are transmitted through a messaging service and very small aperture terminals (VSATs) to an eye specialist in Chennai. Roughly 60-120 patients are examined per day through the mobile vans. The vans are even equipped with video-conferencing facilities to enable the doctor to speak directly with the patients and technicians. 

HealthNet Global (HNIG) is a private healthcare information technology solutions provider that is collaborating with a cell service provider Aircel to introduce an application into the market that will enable 3G medical consultations using smart phones. There is also an increasing use of free numbers that one can call from a cell phone or pay phone that enable you to do anything from calling for an ambulance to availing of medical advice from a phone bank that has a medical expert on call. 

As of February 2011, there were 825 million mobile phone subscriptions in India. As of 2010, there were approximately 80 million internet users in the country. Given this, it is natural that both public and private actors are looking to use the increasing penetration of ICT as a means to benefit essential services such as healthcare and education. The penetration of mobile phones, computers and internet access will only increase in the next few decades, meaning that there is still enormous potential for healthcare services to be offered using ICT technology, both for profit by private organizations, and for free by NGOs and government organizations. 

However, at present, most ventures are fragmented, and disparate from one another. For example, there are several free numbers that a person can call in an emergency but they differ from city to city, and even from service provider to service provider. This heavily diminishes their success. If a project like Sanjeevani is successful, it is possible that more ventures could become streamlined. At the same time, the level of awareness amongst the general population about these various projects is low, meaning that the likelihood of them seeking out such an ICT-based healthcare solution is still quite unlikely. Unless more awareness is generated, such projects may be hindered even before they are fully functional.

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