How has mHealth evolved in India? Where do we rank in comparison with developed and other developing countries?
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Gajanan Nagarsekar
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It is definitely the need of the hour, and India with such a large population, would be able to achieve a significant leap in patient care using mHealth technology. mHealth leverages on the number of mobile phone users – so we definitely have a plus there. I have observed during my visits to various hospitals in the country that there is either a decision pending or work in progress with respect to either having all patient records digitised i.e. on a mobile or tablet based app or work in progress where different modalities such as MRI, CT, cardiac care are being integrated into one application. On the government front there is a lot of room for improvement as the environment and size of health services covered by the government are very diverse and huge. We are just at the beginning phase of mHealth in India.
The developed world is advanced in not only implementation but also adoption and training,, we have a lot of room for improvement in both the private and government sectors for the same. Speaking about ECGs, transmission of ECG by the paramedic to the emergency room and getting a response from a doctor is something that is being done since the 90s in the developed world. They also administer drugs for cardiac first aid. At present, the cost of equipment and service is huge in the developed world for treating cardiac emergencies.
Whereas in India with devices such as ours i.e. mobmon 12.0 we are able to treat a cardiac emergency in seconds and this will help save a lot of lives. But of course, as mentioned above, adoption and training is key to tele-medicine’s success in India. The cost at which we will be able to achieve this diagnosis and treatment is going to set an example for the rest of the world. A good example of the same is STEMI India’s programme, presently piloted in Tamil Nadu. Check it out at www.stemiindia.com
What are the reigning trends in it? What would be its future?
Some common trends in mHealth are adoption of HIS, EMR, EHR and LIMS.
HIS – An app that offers information about the patient’s history and the present. This is the superset.
EMR – It can cover a single modality or multiple modalities
EHR – It would be an EMR with analytics and also integrate data from LIMS and EMR.
LIMS – It would be nice if I can receive my pathology i.e. blood sugar test results on my smartphone. Then, I or the doctor could decide whether there is a need to visit a clinic or a hospital.
The future is bright for each of these as it would be difficult for a single company to have a domain expertise in all modalities, for example with HIS you will see tie-ups of software and medical device companies working together. Web-based data access is a growing trend and I would like to see it grow with more doctors accepting technology.
What are Kallows’ offerings for the sector?
Kallows is a medical devices company and has ECG machines which use an android app to record, store and manage ECGs. The application on its own can be used to record all patient vitals so it can be extended to record pathology tests results and vitals of the patient, either for the doctor or the patient.
We have different scenarios and delivery channels for the ECG service. To list a few:
- Resting ECG: Routine, prescribed or emergency – now one machine like mobmon 12.0 can conduct all these three tasks in a single machine, But the delivery of these three tasks is very different. E.g. Routine ECGs can be conducted by your GP or by diagnostic lab, Prescribed ECGs are mostly done on recommendation by doctors, so they are either at the physician’s or cardiologist’s clinic or hospital and the ECG in a cardiac emergency scenario happens only in the Emergency/Casualty ward of a hospital.
So having a Smartphone capture an ECG and transmit it during routine or emergency is a key step – it is like a car which can be driven and flown if required. - Cardiac monitoring: Post angioplasty or bypass – Patients, mostly aged, require a hand holding in the early days post-surgery. If their ECGs can be reviewed by their cardiologist or physician on a daily or weekly basis it would bring a significant change in the patient’s confidence. It will also add to the convenience of the family members and friends, who would then not only be assured but will applaud the tech. Our mobmon 3.0 product has done patient monitoring during Goa and Mumbai marathons in 2013 and 2014 respectively under supervision from Dr Aashish Contractor, Medical Director for both the marathons. Most of the products on the Internet with respect to this area of patient care are either 3-lead or single lead ECGs.
- Sports monitoring: It is similar to cardiac monitoring but less hand holding is required and the features would include a lot of health and wellness related information and analytics.
How are they different from those offered by others in this sphere?
Differentiating our products with other ECG companies, we would say Kallows India designs, manufactures and patents all its products. More importantly, features such as Live-Transfer, File-transfer, reporting of ECG on smartphone, 1000+ ECGs recording and storage on a single charge are the biggest differentiators, and even legacy companies do not have such hi-tech features for their ECG machine. Most important is the cost at which it is offered. The fidelity of the ECG is way above expectations while reviewing on the phone or web.
What are your expectations from Medicall this year?
We are in the process of setting up dealers and distributors in the country and Medicall is one of the strong platforms to network. We aim to create awareness about our hi-tech products which can save lives in seconds. For e.g. live-transfer feature; sending ECGs for reviewing and reporting through smartphones etc. Moreover, they are also priced comparably to the basic ECG machines in the market.