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The Growing Impact of Digital Health Innovation

Mar 22 | 1:30 PM

Digital health technology and innovation are pivotal in delivering value-based care across the healthcare spectrum in India. Adaptive intelligent solutions can lower the barriers between hospitals and patients, boost access to care, and enhance overall patient satisfaction, particularity in tier II and III cities in India. As the pace of digital innovation in healthcare accelerates, it holds great promise to transform the delivery of health services in our country. Join us live on Medflix to discuss this fascinating topic with Dr. Eisha Anand, Senior Advisor of Trade - Healthcare & Life Sciences for the British High Commission in India!

[Music] good evening everyone i'm dr vedica and i welcome you all on behalf of netflix for today's question on the growing impact of digital health innovations and for this topic we have with us uh dr isha anna she is a senior advisor trade healthcare and life sciences at the department of international or trade are based out of british high commission delhi in india i mean i'll just start your presentation ma'am so we have the session now rolling thank you uh well uh thank you everyone for coming for today's session it's a it's a very big topic the growing impact of digital health innovation and i'll try and make it as relevant uh as possible in this one hour so that all of you can gain something out of the session uh what is digital health and why do we really need digital health i think this is one big question and if i have to just very quickly in very simple words explain it is nothing but using a digital technology to improve health care we use it technology using a computer using a mobile phone using internet using um using devices that are connected to internet which can capture data all of these tools that can help you either deliver health care needs to your patients can help you diagnose early can help you prevent diseases anything and everything that is digital and it can help you treat your patients will come under the bigger umbrella of digital health now the question is why digital health uh this is a little busy slide but i'd just like to point out that if you remember you know a couple of decades ago or 15 years ago it was a very very simple um it was a very simple way of delivering health care you know there was a primary physician or a family physician we could go to i remember as a child going to my family physician for anything and everything and if something was very serious we would just go to a secondary or a tertiary center which is in most cases the hospital or wherever you're staying but what changed over the years in the last two decades was that a lot of new concepts kept coming in so we had a concept of wellness so you know a lot of uh sick management or sick care converted into health care in the in the truest meaning we had telemedicine coming in we had family clinics home care coming in uh specialized clinics you know these ivf centers or opthal hospitals coming in geriatric care coming in preventive uh healthcare became very very important so a lot of these factors have now sort of changed the way the healthcare has been delivered across globally but just to take a quick look on you know what this industry looks like and some numbers to throw uh the healthcare industry in india is expected to grow up to a 372 billion dollar by end of this year the hospital industry that stood at 4 trillion in 2017 is going to reach 8.6 trillion in 2023. these are all good news uh the cost of treatment we all know in india is much lesser as compared to the us the clinical outcomes of leading hospitals are as compared to you know as good as the international standards again there's a shift from hospitals to home everybody wants to do everything at home and because of all these reasons i think digital health has reached every single touch point of a patient's journey uh in when he or she wants to avail health care service and because of all this uh there's an increased focus from the government of india uh to focus on digital health and we'll talk about in a minute uh as to you know uh what is the government doing about it another perspective that i want to bring uh here is from a patient's point of view if you see we're at a we're at a junction uh in india where uh the the baseline of our population the maximum number 60 65 percent of the people are in the age group of 20 to 60. uh we're a very young nation and we're all informed and educated now what happens when you know when you're in a place where your maximum uh population is educated and informed you know they want everything quickly there is uh increased penetration of mobile health internet so this all of this um you know is making the way the healthcare is delivered in a certain different ways so let me give you an example imagine there's a 20 22 year old uh boy who's uh responsible for the health of his parents staying in a safety or one tier two city uh let's take an example kanpur uh and he wants to have uh have a consult with an oncologist now when he goes online he searches best oncologist in india and then he realizes there are a lot of them in all the cities and says okay let me see best on colleges in delhi and let me see best hospital for oncology in delhi and that's how he will somewhere stumble up to a doctor who he can quickly book an appointment with he can decide whether he wants to take his parent in person or can wants to do a tele medicine wants to do a video consult can decide whether i want to travel or not how much cost i want to incur for this consult you know it's instant gratification less time could probably have a consult done tomorrow morning or in the evening um it also generates very meaningful data for both the patient and the doctor so when you're doing concert or you've done some tests and you have reports online it it there is a there's an actual data that gets generated that can be looked up and then there are easy follow-ups so all in all if you see everything is becoming very very digital and healthcare has not uh you know you cannot stop healthcare from being delivered digitally and then came kovit which was the final nail in the coffin uh we know what happened the healthcare infrastructure of a country and in fact the entire globe collapsed routine and planned surgeries were stopped patients postponed their care care needs especially the non-chronic diseases or cancer you know patients could not reach out to the doctors everyone was calling their doctors for concerts when they were covered positive or they had any symptoms so that was the actual test where we realized that a simple phone call a video call or a whatsapp message could actually deliver healthcare and and what we saw in these two years is unparalleled to the kind of growth that has happened in this industry i mean it took probably almost 20 years for the healthcare to reach from a proper family care a family physician and hospital set up to an entirely large digital healthcare ecosystem but the last two years you know the healthcare the delivery partners va patients doctors everybody just so quickly adapted to the new technology and the new ways of seeking health care that we've not seen that kind of a growth anywhere and the government realized this and that's why if you see uh they've added digital health care as a major component in the in this year's financial budget and if i just may point out that there are uh you know they aim to open 23 telemedicine centers of excellence uh for mental health um and they will uh and you know nimhans was going to be one of the major centers to be coordinating all of this along with uh iit uh bangalore who will then look after the technology side of the thing so i mean things are happening at a much larger you know government level and it's that it's the right time for every one of us to be aware of what's happening now just a quick look at what happens in what happened in the last two years in terms of telemedicine when uh if you look at you know the number of users for telehealth or telemedicine pre-covet were only 11 which increased to 76 percent uh in these last two years there were 50 million indians who accessed tele consultations 80 consults were first time consult users which means that new patients who got adapted to this technology was 80 percent and we all know that there were no inpatient uh in-person appointments happening so we could actually see a 50 to 175 times of uh telehealth visits uh as compared to pre-covert levels and even doctors were very comfortable with this they you know 57 percent of providers said the telehealth was actually very easy and very uh doable thing in the near future so how big is really digital health in india uh some some more numbers for you uh just for an understanding that the mobile health market which is when you use a mobile phone to deliver healthcare services is growing at twenty point two percent rate uh india which was at a sixteen point four million uh usd market size in mobile health in 2019 is going to be 44.1 million in 2024. these are big numbers i mean look at the amount of um growth this sector is going to bring in the telemedicine market is expected to grow by 31 percent and it's in fact said that terry medicine could actually replace 50 percent of in-person consultations in india uh and and i'll in in the end of my presentation i'll come to it how can you uh you know imbibe telemedicine as a regular feature into your practice so again looking at and coming to the government as to what the government of india is doing uh or playing as a you know playing an important role in promoting digital health uh do you all remember this this this was in 2018 it had rounds of uh whatsapp messages saying do not consult over phone do not consult over mobile do not consult over whatsapp uh do you all remember do you want to give a thumbs up or yeah yeah so so this was a ruling that came in 2018 after a medical negligence case was put across in the high court bombay high court and they said that you should not be doing telemedicine concerts you should not be seeing your patients over phone and this was also the time when i was working with one of the major hospital chains to set up their telemedicine centers across india and while we were we were successfully able to do 26 centers in tier 2 tier 3 cities this role came in and suddenly you know it wiped off all our efforts but but if you know if you want to know what happened during covet and and what response government did in fact government started to think about all of this base uh way earlier this is the in this is a journey of india in digital healthcare so in march 2017 way before this particular case came into um you know the limelight india decided the government of india decided that let's have a national health policy this will uh envisage or create a digital health technology ecosystem which will aim at developing an integrated health information system in july 2018 there was a creation of national health stack which were basically the building blocks of how this whole infrastructure will look like we were talking about india as a country not a state not a hospital not two hospitals all hospitals all private practitioners everything so it needed a a very strong building blocks on which uh you know the entire digital health ecosystem will be built in july 2019 they the government released the national digital health blueprint again it was a document which said how will we implement digital health services uh and how do we support this uh digital health ecosystem march 20 telemedicine practice guidelines came into you now while while we've all done whatsapp walls and uh chats and you know i'm not i'm not currently practicing but uh even i was consulting during covert uh and uh government of india has taken a stance that if if we are looking at telemedicine practices there has to be some guidelines that we follow there has to be there has to be set rules and regulations that doctors should follow in in order to maintain um the true sanctity of a consult to be able to say no where you they think that this concert cannot be done over telemedicine and there are many instances we know about it so telemedicine guidelines generally talk about the flow chart of how a consultation can be done it it says that the doctor has to use it his or his or her own judgment to say whether uh this is the case that can be dealt through telemedicine or it can't there are certain set of medicines that can be prescribed over telemedicine there's uh the certain set of medicines that can be prescribed over phone certain set of medicines that can be provided if you're doing a video consult and some of the uh there's a schedule which says you cannot prescribe these medicines um these are this is also it also says uh when can you convert a phone call to a teleconsult or to a video consult or to a physical consult how to identify a patient how to take consent how to take history taking what you do in emergency cases etc so i think it's worth looking at telemedicine practice guidelines if you're following telemedicine or you're practicing telemedicine in your clinics or your hospitals uh do have a look this is available if you just google telemedicine practice guidelines by government of india you will get the entire list it's a it's a slightly larger document about 20-25 pages uh but it's worth reading it and then in august 20 uh they decided that we need to have all of this done in a mission mode so the national digital health mission actually came into being which is now being used and which is now being uh accelerated to you know create this whole ecosystem and there are a lot of things that even we as practitioners are supposed to be doing but um what is aishwarya bharat digital mission uh it's it's a national health digital mission that was that got combined with the ayushman bharat scheme basically government of india wants to provide health care for all and they decided let's take digital health as one of the mediums to doing so and therefore came in ayushman bharat digital mission it's it's fairly simple uh i can give you a vision statement which is about five lines but in in very simple terms uh they want to develop a backbone necessary to support integrated digital health infrastructure of the country they want to provide if efficient ways of providing healthcare accessible to all they want it to be inclusive which means even patients who are you know in remote areas rural areas they can um you know they can be a part of it or if they're practitioners who are working in two tier three cities they can be a part of this whole ecosystem it should be affordable it should be timely and it should be safely delivered and i have a whole vision for you but i think in the interest of not boring all of you i'll skip that now what does it mean for the patient and for the doctor so the aishman bharata digital mission essentially means in short that i as a patient am going to be responsible for my health records wherever i go whoever i meet in terms of taking a consult or taking any health care services be it a hospital be it a private practitioner be it a you know laboratory or be at an imaging center i will have full control of my digital records i can go to a family physician and share those records after consent obviously or i can go to a bigger hospital and take these records with me on my phone and i can choose to share information that i like to share with the practitioner so basically they uh patient will be in very much control of uh what they want to share in terms of their health information with practitioners uh here are some of the things that the government of india is establishing there's going to be an abha number which is essentially your unique id that every patient will have through which they can access their health records there's going to be an abha app which will enable sharing of these this information with different practitioners or clinics or hospitals etc there's going to be health facility registry which means any clinical practice private or government or individual clinics will have to be registered on this registry it is going to be an india wide registry which says these are all the hospitals clinics labs imaging centers available in in the country similarly there's going to be a healthcare professional registry it has already started they're inviting doctors to register on this including ayush practitioners so they are looking to say let's have all healthcare practitioners on one platform we should have a registry of how many doctors we have how many nurses we have how many midwives we have so uh very soon it's it's voluntary at the moment but very soon we'll all have to register ourselves uh on this health care registry and there's a unified health interfair uh inter interface which means that there are guidelines that how will this information be shared with different uh players so if you're a private uh clinic uh you run a private clinic versus if you run a hospital there's going to be a simple api which is uh which is basically how you code an app that can that will allow you to share this information they are building up this there are already some companies that they've identified who are building this infrastructure uh for the government and for private players to be available so please expect in next uh you know six months to one year that you will have uh you the all these will be a requirement to be able to practice in india now how impactful is digital health and who are the enablers and here i'm going to take an example of the journey of a patient i'll try and explain you what all tools does a patient have today in digital health that they can use and how does it what impact does it create for them so if as a patient i want to book an appointment i can just go on google and get an appointment done so you would be yeah i think you'd already uh know some of these names and please uh click the thumbs up button if you have practice one credit health is another where you can get enlisted you as a doctor you get visibility but patients more importantly get to uh book their appointments online then very good so a lot of you have already you already know about these apps then telemedicines there are again more platforms uh apart from tractor and clarity health their docs app liberate apollo hospitals like medanta who have their own websites or applications apps and a lot of hospitals are building their apps and some of them have already done that max is another example focus is coming up with one where uh you can all do telemedicine consult uh then there are investigations or aggregators we say uh these are platforms where you where a patient can just go say i want a blood test okay book a blood test somebody will come and pick a sample from your home or i want uh i want some medicines to be delivered home or um uh you know i'm seeking for some medical device to be delivered at home so all of these things are now on a click available on a click of a button to the patient then there are e pharmacies like i said tata 1mg net meds flipkart is coming into it big time click on care is coming amazon is venturing into it they've already started their function in the u.s then this surgery surgery surgery matlab pristine care is the newest you know addition to the family where they say that we hand hold a patient right from you know when the need of a surgery arises or when they've decided to have a surgery up till the end of the surgery and post care then there are home care models or health care at home ico at home nightingale call call health they're all providing health care at home which means they set up an entire institution at home for patients who are who can't go to the hospital or do not want to go to the hospital or are in a rehab mode there are also some transition care centers coming in and healthcare at home has started with uh with them with suvitas which are basically when you want to get away from a hospital quickly but you want to be you don't you can't be at home so there's a transition care center where you get rehab where you get speech therapy physiotherapy etc available to the patient you can stay there get those uh done at a much lesser cost as a hospital as compared to a hospital and and they use all the medical devices use are again digital health devices because they are either artificial intelligence integrated or machine learning etc uh and then there's another uh interesting area of lifestyle and or non uh communicable disease management diabetes management apps you see fitness apps you see healthy fire me you see very variables and you know other apps that can help you collect data so the latest is that manipal is collaborating with fitbit and and one more company to monitor the patient's condition after they've had a surgery so the fitbit band or the um these the health uh you know the fitness band that you wear on your wrist will actually monitor all your parameters or your basic parameters and they will use those parameters to monitor a patient's uh recovery post surgery and all of this has a huge impact on patients everything is on a click it's delivered at home it is convenient efficient on time there's a lot of transparency now because you you know you're you're in control of what you want to do and how you want to do and there's a value in value for money that a patient sees uh you know when he or she takes these services and then what's the impact to providers of using digital health so right from how a patient gets registered into your facility right from a patient coming in and saying i want a health care service collecting information basic information about their age name gender and other things to booking an appointment be it an in person or a tele concert scans on the go uh today i see in the hospitals that i visit i see that there are doctors who have mobile phones on in their hands and they can you know see every patient's history in that they can see their labs etc similarly patients have all their labs available on the uh portals for of different uh laboratories lal path lab srl we all know all these big hospitals they all have now apps where we can a patient can download their reports so ehis and emr have actually become very very uh hands-on uh during this time nurses are collecting uh histories for patients uh on apps on on tablets etc and there is something called a cdss which is a clinical decision support system now in no way we are saying that digital health is going to replace doctors that cannot be done at any point in time because you need human intelligence you need uh you need the clinical acumen that a doctor goes through in his in his or her education and training and experience but these cdss tools are very very hands-on when you talk about rule substitution when you talk about in a country like india where you have less doctors and even less in areas who also require health care for example the rural areas or tier 2 tier 3 cities where quality of healthcare is is extremely not accessible or not easily accessible that's where cdss come in comes into place these are artificial intelligence driven tools that help doctors to um to help diagnose to help an entire disease management protocol that can help them understand uh or ask the right kind of question not to miss the kind of questions that they would want to ask another another area where cdss systems are used in the government of india is uh piloting it in fact we were doing it with uh nithyayo is where we gave the maternal and child standard treatment guidelines converted into a digital platform to ashas and a m workers um in a city called you know in a district called baharich in lucknow in up and uh ushers and a m then went with a tab in their hand asked the relevant questions they were prompted for interventions typically if your hemoglobin is low and your you know you you need uh your diagnosis anemic and you need medicines in in a normal case you have to be referred to a medical officer who would prescribe etc but these standard treatment digital guidelines enabled asha workers to tell the uh patients that you're anemic and this is the medicine that you have to take similarly for diabetes once they were able to do a hpa1c for these patients they could easily diagnose that this is a gestational diabetes coming in and you need to be referred and the medical officer sitting at a district level would have all the information all the history all the relevant uh lab reports for the patient on the go and that decreases the time that a doctor takes to see a patient and they can see far more patients uh you know considering that this is one doctor versus thousand odd patients that come to that district hospitals then there are ai enabled diagnostic tools for early diagnosis uh some of the examples that i can give you are ai based smart peak flow meters these are small devices the which gets attached to your mobile phone you you puff into it and it can actually detect your lung capacity it can tell you if the patient is going to have an asthmatic exacerbation or if you're not taking your inhalers properly similarly there are digital otoscopes that are there there's early detection of cancer some of the cancers like lung cancers through ai tools which are built into your ct scans etc or digital pathology or digital autoscopes these are these are very uh new age technologies that are coming in to help doctors uh diagnosed early to diagnose without uh invasive methods then very simple we were you you know all of those who are working in a hospital would have done this e summaries e discharge summaries uh e follow-ups etc everything is on a prescription everything is online you send the patient uh you have a record of it you can review it when the patient comes for follow-up it becomes extremely easy remote monitoring is the other thing that's coming in we see uh we're seeing a trend where hospitals are now looking at uh remote monitoring which means uh instead of a nurse coming in every few hours to take uh vitals of a patient here the patient gets attached to some of these um sticky things on the body which can actually track your uh you know typical five vital parameters that they look that you look for in a hospital i know one of the big hospital chains is going to be using this um this tool for early detection of deterioration of patients in icus and ers so this can actually through an algorithm that has been built into it can actually say that yes your patient is deteriorating now you need to act right now and then managing ncd's we spoke about how healthy family has come in uh how abbott has come in with a patch that can actually monitor your diabetes throughout your day what you eat or what you what's your physical activity etc minute by minute it can actually monitor how your insulin levels in the body are functioning then there's obviously use of drones and for transporting supplies samples and even organs during the organ transplant etc so all of these things are are coming in practice and these are highly this all of this brings in high efficiency for hospitals or for providers it frees up doctors time like i said we don't have enough doctors in our country it allows doctors to see more patients it allows the whole healthcare ecosystem to um to generate more capacity for new patients to come in patient satisfaction is another thing patients feel more empowered they feel more informed health education is a big part of digital health where you you can do counseling mental health counseling nutrition counseling these are areas that are going to be picking up very fast and and very relevantly in the coming few years it empowers the healthcare practitioners it provides accurate data accuracy in diagnosis evidence-based medicine is is now coming into play this is the impact that digital health is now creating uh you know for providers now coming to the question that uh one of our audience members asked how can you add digital health elements to your practice or how can you how can you inculcate some of these things into your practice so like i said the easiest thing to do is a telemedicine consult you should always keep that option open or this will help you reach out to areas where healthcare is not delivered adequately or quality healthcare is not available it could be your hometown it could be you know places which are far away from your city where you're practicing uh that's one way you can get attached to some of these uh uh you can get attached to some of these uh platforms like practically health etc you can get on these platforms where you get more visibility and they offer an entire emr system for your private practice as well uh i'd also say i'll also take a name of a company called medo which is also digitizing clinical practices uh so they provide you with um in you know apart from just creating a good look and feel of your clinic they will provide you with emr system they will provide you with lab tests a person who will come and collect samples etc and have multiple appointments uh digital uh health records and all of these into place then you can the easiest thing to do is create a digital uh standardized history form so while your patients are waiting in your uh in your opd you can hand them this form to fill up a nurse can either uh transcribe it into a digital form or this can be a you know this can just be a simple google sheet that you create and you send a you can send a link to your patients and they can fill up this form what this does is get you accurate history accurate information about the patient uh first-hand information it also helps you put a record into place uh again there's a whole ecosystem if you want to get into an e-record or have an emr system into place you get appointment scheduler you get a history taking or you know clinical notes management you get uh you know you can send patients information about health any camps you're doing any vaccinations that are coming up etc doc on is is one of the examples um which a lot of practitioners are using here in delhi ncr or token is very hands-on very digital in fact you can do an entire prescription on your tablet you can just click things your you know your favorite medicines or your favorite uh you can create your favorite lists of different things tests medicines etc and you can just on a click of it complete this becomes a part of how you practice it becomes a it becomes very much a part of your entire ecosystem uh xevi is coming up with a cdss system uh with a clinical decision support tool which is i think going to be extremely extremely important especially for new budding uh doctors um then digital pen is another thing where you can digitize you write on a normal sheet of paper with that pen but it actually transcribe everything onto you know digital it makes everything digital uh that's another which is being used a lot of practitioners are using this you can also add in some variables uh if you have that kind of a clientele or if your patients are very tech savvy where you can use those data sets that come from these variables uh that your patients are using and you can use them for uh monitoring various conditions there are uh you know for even for sleep study there's devices as small as this that have come up which you can just this patient can just put on their throat and after a night's sleep you will get all the data on a on a mobile app so there are a lot of new innovations that are coming in in this area and some of them are doable in a clinic some of them are not some of them are more hospital focused but there are definitely elements that you can add to you know be a part of this healthcare digital digital healthcare ecosystem uh yeah man we can take your questions now uh so in telemedicine is there a legal or illegal buy code or telemedicine is there an idea sorry is there anything legal aspect involved yes so the guidelines that i spoke to you about uh they rest most of the things on a clinician's ability to judge they say there's a whole flow chart uh it was too big to put it in a presentation but again if you go on to the telemedicine guidelines you will see the flowchart at the end of that document it talks about where what are the points that a doctor has to take a decision whether they want to do a teleconsult or they want to convert it into a physical concert so just very quick high points uh emergency care you know you're not supposed to in an emergency when a patient is having a heart attack or when a patient is critically injured you're not supposed to do a consult and explain what to do you're supposed to say go to a hospital or you're supposed to say this is the first state please run to the hospital uh in terms of medicines that you apply there's a whole list of medicines that you can uh prescribe when you're doing a phone consult or a video consult and those are different so there are more medicines that you can do in a video video concert than on a phone console versus a physical concert and there's a prohibited list of medicines so please look at that uh it's these guidelines have come into play you are also expected to do a course uh within a stipulated time of i think three years as you start your practice but in the absence of a course you have to definitely abide to these guidelines uh so please have a look at these guidelines these will they will uh help you understand better as to what you can do they're not very uh stringent it's not that it's too difficult that you have to stop doing telemedicine but it's always good to know right uh thank you mom uh it was very well explained another question that we have from dr jayadeep is how you mentioned about few platforms and few practices of telemedicine or information system but dr jayadeep is asking how can we inculcate all of this in our practice in our own setup so like i said um there are companies who do it for you so for example meadow health is one if you're in a clinical if you have your own clinic uh you know you can reach out to them and they provide you this then practo also has their own software called quickwell uh which is an integrated appointments and clinical management system you can uh avail that there's a subscription fee for that i think so uh and there are a lot more companies doc one is another it's a very very user friendly uh you know system of which right from how you take your appointments to how you manage your patients uh send them alerts tell them you're not in the clinic today or your clinic will remain closed you know even that details of messaging can be done through uh through that app and you have your own patient record your patients can see a prescription online so they they build an entire ecosystem for you to uh you know inculcate digital health practices in your system right perfect so i can see a lot of amazing comments from this wonderful talk thanks a lot uh very well experienced so uh currently is there any cdss is what doctor ship kovar is asking me um i what i know of is al xevier is coming up with their uh seriousness system they already have one in the maternal and child health care and they're developing one for non non-communicable diseases and there's going to be uh cds in emr available is slightly tricky uh people have i haven't known often one of such but uh i think elsiever is working on one of that technologies uh so dr sindhuja is asking uh some patients use adverse drug effect apps can we encourage this uh we have i mean is there anything wrong like adverse drug reaction in case of adverse drug reaction is there anything to report or so uh adverse drug reactions usually you know when when you get an emr and when you have a medication system inbuilt into that emr it prompts you if this patient if these medicines can have adverse reaction or you know if given together or or you can report adverse drug reactions now uh in a hospital it is a very common practice where uh you have to report any adverse drug reactions and then there's a there's a whole committee that's set up and then you do a rca to understand why and how and what and how can you mitigate this uh but in a clinical practice uh i don't know i i don't know what kind of patients you're talking about that they are using these apps on their own uh but you know if you have an emr system in place it does give you prompts that you could have an uh you know it was drug reaction or when you're driving certain medications all right i hope that answers your question so you're saying to diagnose it or to uh just tell you what the current uh practice is i mean when you are giving any drug uh not to report or anything yes so while you are prescribing there are these intelligent emr systems which can prompt you if there is going to be an adverse drug reaction if you draw you know if you describe certain set of medications together right uh so dr deep that is asking is there any survey or data uh which claims that telemedicine helps in decreasing load and burden on essential services like ambulatory services so um a lot of hospitals have done these experiments and seen increase in uh you know opts especially the medical opis so general practitioners or internal medicine or ent or ent has a part of surgical also but we've seen that it reduces load i will have to find if there's a documented uh report but i'm sure there are because this is a very uh established practice that is done in hospitals especially in endocrine endocrine sees a lot of patients and you know we've done those kind of things and hospitals will be experimented on how you can do uh your tele consults for your follow-up patients so there so okay i was trying to i was also trying to come up on how you can include telemedicine and uh some of the things that you all can do is uh depending on what your practice is if your practice entails that you have to get some tests done for example endocrinology you know you would want to see patients uh blood glucose levels or thyroid levels etc you can do your first consult on a telemedicine or a video consult you can ask the patient for a detailed history followed by or tests and the patient can come in for a physical consult to you uh you know with the test reports that saves time cost for the patient and for uh you know time for you in certain other cases certain other practices like the dining halls or obviously surgical practices and in some of the cases and you'll have to be very you know practical about how you handle certain diagnosis that you can have your first consult as a physical consult and you can do follow ups uh you know three monthly six monthly follow-ups or you know weekly follow-ups over your concert especially when you just require to get a test done and review certain parameters etc you can do those on telecom consultation or video consultation i'm sure you guys would be doing this already but this is a more this is a very effective way of managing a combination of physical and uh virtual concerts very insightful now thank you thank you so dr sunil is asking uh which kind of digital health technology can be promoted in public health facilities so so depending on what the problem what is the problem that you're solving in public health public health is a huge area and uh there are multiple areas that have been worked on maternal and child health is one uh especially you know areas where the government is focusing their efforts those are the areas that are you know seeing more digital health technology at options so like i said that uh we did this whole pilot for six months uh during covert where a m and asha workers were given in standard treatment guidelines for mother and child health uh into uh you know to imbibe into their uh daily door-to-door activities that's one uh i know of uh ai based uh anthropology data sets collected so uh just to just to actually see if a child is underweight a newborn is uh you know underweight or what are the anthropological parameters uh to monitor infant mortality etc they're using ai so they actually by a click of a picture they take they they're able to uh calculate circle head circumference and entire body weight body structure height etc so there are multiple such uh you know technologies that are coming in and it will it will change and depend on different areas that you are trying to focus uh another for you know tb and for lung cancer for uh respiratory diseases there are ai modules that have come in which through either an x-ray or a ct they can tell you what are the you know what are the uh abnormalities seen in the in the scan this not only helps uh free up radiologists time because we all know in our practice sixty percent of x-rays are normal so it completely evades those normal cases saying that these are normals put in in put the abnormal cases in front of the doctor uh citing that these are the areas that you should look at or you should definitely consider while reporting so it also tells about the kind of cancer it tells you you know the kind of differential diagnosis you should look at so all of these things are coming into practice similarly in histopathology digital digital pathology is coming up in a big way where uh especially for lung cancers for liver cancers ai modules are being developed where uh you know just at the when you look at the slide it can actually tell you this whole picture looks like a particular cancer or this looks like a you know abnormality of some sorts so uh rosh and you know these big companies they are developing and working on research and development for identifying more and more such algorithms in oncology right so dr sunil i hope this answers your question uh perfectly it was very elaborate explanation thanks thanks a lot uh i can see all the questions answered uh again amazing comments and it was really good session i will definitely have some other uh on digital health definitely really soon with mark but uh for now we can definitely wrap up it was amazing sessions

BEING ATTENDED BY

Dr. Murtuza Zozwala & 529 others

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dr. Eisha Anand

Dr. Eisha Anand

Senior Advisor Trade, Healthcare and Lifesciences for North India | British High Commission In India, Delhi.

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dr. Eisha Anand

Dr. Eisha Anand

Senior Advisor Trade, Healthcare and Lifescie...

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