Tuesday, April 09, 2013

Opinion: My Health Records? Directly Post On FB, Cloud

While the West may be paranoid about privacy of personal health data, in India, it appears, people hardly have privacy as their primary concern. Call it a cultural thing or an evolutionary response to the pitiable public health we have. People are not only willing to share their health records over social media but are more than happy to submit their genetic information to a doctor or healthcare professionals to ensure they have all the information available to treat.

In a 10-country survey of consumers’ attitudes toward technology in healthcare that Cisco released this week, Indians turned out to be the most advanced. Of those surveyed, 62 percent of Indians showed a willingness to share a range of information regarding their health as compared to a 42 percent global response rate. When it comes to trust in devices, 87 percent of Indians were up for it, as compared to 70 percent globally.

The data gets more impressive when you look for consumer trust in the ‘cloud’: 94 percent in India said they were comfortable having their health records in the cloud (hosted by healthcare or other service providers), assuming adequate security, whereas only 74 percent respondents in other countries expressed confidence. Mobile health is no different: 60 percent acceptance in India versus 40 percent elsewhere.

Even health care decision makers in India are ahead of their counterparts in other regions, though in many cases they are behind the consumers in India. For instance, while 60 percent of the consumers surveyed said they have no issues sharing personal data if that improves the quality of future care, only 45 percent of healthcare decision-makers believe that such data should be shared.

The survey includes responses from 1,547 consumers and 403 healthcare decision-makers in four age groups from 18 to 67 years. So that means about 200 people from each country were surveyed. Not a sample size that can be called truly representative of India (or any country for that matter), especially if we account for the vast population in rural areas that have hardly any access to technology.

Vishal Gupta, Vice-President and General Manager, Global Health Solutions, at Cisco argues that these studies give “directional shifts”. Additionally, in India, Cisco has collected data from 29,000 consultations in Karnataka and Madhya Pradesh across seven district hospitals and 20 primary health centres in the last 18 months. That data, he says, shows people are accepting virtual diagnoses and consultations with much ease.

Why is Cisco doing surveys on healthcare attitudes?

Cisco has quite a lot riding on the acceptance of virtual healthcare and customer service. It has been developing technologies and solutions, both high-end and low-end, for health care. But most of them remain in pilot stages. So the networking giant did this survey to show that virtual healthcare is no longer a myth. While the survey has brought out some interesting findings, they are hardly surprising. In a country which has glaring shortages in healthcare professionals – according to WHO India should have 23 health workers per 10,000 population but what we have is merely 12.9 – technology is the only means of bridging this gap.

But here’s the challenge: initial support or incentive for adoption of such technologies – be it electronic medical records or e-prescription or virtual diagnosis – often comes either from the government or the payers. The governments either fund it or lay standards, say, for electronic medical records (EMRs), to make them mandatory. All such initiatives here seem far in the realm of just planning; rather in the 12th Plan document. If the Universal Health Coverage that the Prime Minister talked about early last year had moved towards reality, which it hasn’t, as this earlier story in Forbes India shows, EMRs would be the starting point.

As technology providers like Cisco see it, basic healthcare could be delivered via kiosks-like ATMs. Practically speaking, it is doable. After all, the banking and financial services sector in this country has seen tremendous growth because of such innovation. But the catch is there is no single body like, say, the RBI, Sebi, or Irda, which transformed financial services, in healthcare to bring sweeping changes.

Rajendra Pratap Gupta, Chairman of the India chapter of non-profit Healthcare Information and Management Systems Society (Asia Pacific), believes insurance companies will drive IT deployment in India. In three years, he says, India will see patient groups demanding such technologies, just as they influence policy and other decisions in the developed countries.

My hope too is the patient demand. Unless consumers start demanding it and differentiating care providers on this basis, change will be very slow to come.

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