Digital technology with clinical expertise, a game changer for primary health care sector in India


-By Manasije Mishra, Managing Director, Indian Health Organisation & Aetna India

Indian healthcare is characterized by a lack of access to robust primary care system, increasing medical expenses and a poor doctor to patient ratio. In urban India, there is a focus on tertiary care with significant investments in high-quality corporate hospitals. We in India, tend to ignore symptoms, take self-medication or take advice from friends, family and unqualified people around us. When matters become serious, we tend to go directly to a specialist or super specialist doctor. This often leads to poor clinical outcomes and higher costs. This is unlike in more advanced countries, where a primary care doctor, who knows the patients’ medical and family history, coordinates preventive care, acts as a guide and gatekeeper in providing early diagnosis and treatment. The neglect of primary care in India is one of the reasons of the increasing disease burden and medical costs. E-healthcare has the potential to make quality healthcare accessible and improve the quality of primary health care.

The government has recognized this and included e-healthcare in the new National Health Policy 2017. The focus is on greater inclusion of digital mechanisms to widen the reach for health care. There is no doubt that given the rapid deployment and uptake of mobile internet penetration across our country, the opportunity for delivering primary health care through technology already exists.

India needs a robust digital health care ecosystem which will enable families to access fully integrated primary care services. Other than making services accessible, key aspects that can sharpen India’s existing digital primary care industry are as follows:

•Teleconsultation is a specialized science, it requires well qualified and experienced doctors who are extensively trained for teleconsultation. Expert training that enables them to take a deep dive into patient’s background, understanding the social, medical and family history, listen and understand the presenting symptoms and get cues from their voice and breathing rate

• Evidence-based medicine is crucial for remote diagnosis. A chronic headache could be due to multiple medical problems like a migraine, stress, eye problem, ongoing medication, neurological problem, sleep deficiency, brain tumor and more. It is highly essential to rule out such health issues and narrow down to the actual cause of a problem instead of treating the symptoms. To do this, doctors providing remote consultation should be equipped with established clinical protocols that will allow them to probe with relevant questions and ask patient’s to do certain maneuvers to identify the root cause of the problem.

• Digital revolution has made day-to-day routine comfortable by providing services conveniently. However, for health care services, we need a system that provides quality care with complete ownership of treatment. Half of the battle is won if a patient is heard properly with sufficient time. Remote consultation doesn’t allow patient and doctor to be physically present, and therefore what’s required is a detailed conversation for proper diagnosis and treatment. A robust process with proactive follow-up services and handholding is essential to monitor the progress of the treatment and make the corrective action as and when required. This will help patients get appropriate advice and act as a moral support across the treatment process.

•Along with the expertise in remote or digital consultation, a comprehensive ecosystem that empowers families to access all required medical services is needed. In cases where references or additional services are required, the primary care doctors should be able to guide the patient to the right specialist, helping them save time and money. The ecosystem should include hospital, clinics, diagnostic centers, and pharmacies will help facilitate any physical examinations, diagnostic tests, home care treatment, hospitalization or even medicine delivery at home.

Aetna, a global health care giant, has chosen India to pilot a digital primary health care service called vHealth by Aetna which has the capability to provide best in class quality medical services and encompass all the key aspects of catering quality care. In collaboration with Medgate AG, a Swiss market leader in telemedicine, vHealth is aiming to create a unique ecosystem with trained doctors to follow scientific clinical protocols to treat and guide patients. The vHealth service will allow people to access unlimited remote consultations on video or telephone with vHealth doctors and discounted access to a network of over 16,500 medical practitioners located in 38 cities in India.

There is a pronounced need for a model that provides a complete ecosystem of medical services without compromising on quality outcomes and yet be affordable for Indian population. Above aspects, if taken care of, will help digital consultation gain faith and adaptability in India.