Prayers for Japan and Learnings for everyone on the benefits of National Health IT Policies

The past few days have involved almost all of us praying for Japan which was ravaged by a severe earthquake and tsunami. Japan's most powerful earthquake in 140 years struck the north-east coast on March 11^th 2011, triggering a massive tsunami leaving behind many homeless and stranded. (Information and Situation Report from WHO)

As we continue praying for hope in Japan, we are also learning all we can about how disasters can impact the way we live and seek to improve. Sadly, Japan now faces severe logistical problems and with the latest news on the mishap at a nuclear reactor, the situation only seems to be getting worse. While Japanese officials have more pressing issues on their hands, a problem that will arise as time progresses will be that those left alive may find themselves without their medical records. Natural disasters wipe out everything — including paper medical records as well as computer and communication networks.You can setup the network again, but you can't bring back the paper.

In this time of national crisis, it would have certainly been helpful for Japan to have a robust Healthcare IT network in place. A collaborative one where it is easy to share data, which is securely backed up redundantly in multiple locations that would leverage geographical diversity as a means of countering nature’s unpredictability: Geographical Division Multiplexing if you please;

While Japan does have a Healthcare IT strategy setup, with benefits and stimulus funds, it is relatively new and yet to mature. Health data digitization and Electronic Record Keeping is still in its infancy. Japan does not boast of large scale Electronic Medical Record coverage.

Wouldn’t any country ride out disasters better with health data sharing in place? This should be taken as a wakeup call as well as a learning lesson by all nations which haven’t yet devoted time and money to setting up Nationwide Health IT Infrastructures.

India for one must be looking at learning from this.  Having a Nationwide Health IT Strategy should be treated as important as a Tsunami Alerting System (TAS).  Purists will argue that a Nationwide Health IT System is not intended for alerting and helping contain situations like the TAS. And they are not completely wrong. 

In many cases it has been observed that long term benefits are eventually forgotten. Instead, this concept of “Long Term benefits” must be replaced with Pre-planned Goals which must be “Sought” on maturity of a model.  Now, any system can provide a set of benefits directly on implementation, and an additional set when it has matured.

Similarly, the use case of using a Nationwide Health IT System for predicting and alerting requires a certain amount of usage at first.  A sophisticated and mature Nationwide Healthcare Network built using technology can identify the emergence of possible pandemics. Trends in symptoms can help identify risk areas, and collaborative diagnosis can help is sharing treatment plans and improving them.

One must understand that if maturity of a network is required for additional goals and since that takes time, one must seek to implement early. 

Links of Interest

WHO Page on Environmental Health in Emergencies

WHO page on Myths and Realities in Disaster Situations

NDNC just got a bit "Smarter"

The National Do Not Call (NDNC) registry is a short sighted solution to the nation's tele-marketing woes. Its strange that in a country built on a pedantic education system, the real life solutions which are implemented never seem to identify educating masses as a possible option. 

Note: to those who implemented the NDNC: your intentions were great; However, its important to look at the impact on Indian business of all types... The fact is that Mass SMS solutions are used not just for Tele Marketing. Since a Bulk SMS plan (primarily for telemarketers) is sold for 5-6 paise per SMS vs a Bulk Priority SMS plan for 50 paise or more per SMS (For Priority SMS which routes around the NDNC), Most Indian firms(primarily SME's) were happily using the former for all their SMS needs: even for critical alerts...Customers usually would demand that decision due to the knowledge that a lower price is possible and most firms would jump at this opportunity to inflate margins; Rashmi Bansal and many others celebrate this spirit and call it "Jugaad"...

Well the NDNC was appreciated at first, but as it went along, it started having detractors. The ones who were affected: All the way from Solution providers, eventually to the ones who wouldn't receive Password change alerts, Medical Appointment Alerts, and so on and so forth became critics of the NDNC. A most interesting and worth mentioning example here is of a "Software Security" Institute which would send the password for newly registered  users via an SMS and since half the nation had parked their numbers into the NDNC these guys would wait endlessly for the SMS ... I found it really silly on the part of this Institute: apparently teaching cutting edge IT Security,  they could'nt take the basic effort to update their systems: Instead they put up disclaimers stating that this is not their fault but that of the govt. :).

But what else does one expect. In India, entrepreneurs and  businessmen are driven by profit rather than anything else. Most Indian Business firms start talking RoI on day 1. The usual plan is to create quick and dirty solutions, as long as they work... and move to quick and dirty solution No. 2. Well getting back to the point, a number of cool firms locked in SMS solutions for their effectiveness and also for the coolness factor involved. The day NDNC came in, these guys were on plan 5 and plan 1 got hit. Most didn't care sadly.

Thankfully, the NDNC solution has been modified and made a bit more flexible and smarter. Now it allows mobile subscribers to register into the NDNC; but also specify their options on industry types do they find worth their time.

One simply has to dial 1909 from the mobile or send an SMS as following:

START [OPTION] and send it to 1909.

There are a number of options to choose from. For example, if you’d like to block all calls and messages, your option code is ‘0’ (ZERO). In this case, you should send an SMS as START 0 to 1909. Other options are:

1. To block all calls and SMS except from Banking/ Insurance/ Financial products/ Credit cards category
2. To block all calls and SMS except from Real estate category
3. Block all calls and SMS except from Education category. Similarly,
4. Allow only health related calls or SMS
5. Allow only consumer goods including automobiles related calls or SMS
6. Allow calls or SMS only from Communication/ broadcast/ Entertainment/ IT related fields
7. Allow calls or SMS only from tourism and Leisure segments.

As an example, to allow calls and SMS's from the Health care Sector and to block everything else

Compose an SMS "START 4" and send to 1909

On an other front, I am happy that more people can benefit from Plus91 's SMS Based Appointment AlertsPrescription Reminders. Further now more patients can take advantage of our Information Therapy Initiatives such as My Fertile Time. 

Facebook for Medical Practices and Doctors

Facebook has seen unprecedented growth in the last 4 years. From a small community site, specific to colleges, it has overtaken Google to become the favored haunt of the webophile. One of the reasons for this has been the number of applications that are built on Facebook, but a bigger reason is that because "Everyone is On Facebook". Lets face it, if you want to know what someone did last Sunday, or last month, Facebook is a bigger help than any friend that you have.  Coming to the point, the last year has seen a serious growth in the number of doctors creating Facebook profiles.

Now I've spent a considerable amount of time helping doctors embrace technology for different reasons. Some want technology to help manage their clinic, some to help manage patients also, some simply want to use it to connect to friends and family far away while some other want to use it to see if it can help them learn more. Facebook is a brilliant technology for just keeping in touch, and to make regular announcements. Not too regular mind you.

The presentation below delves into the Why's and How To's of setting up a Facebook Page for a Medical Practice. It also provides some examples and contains a video showcasing samples of very effective techniques.

Facebook Pages For Doctors and Medical Practices

View more presentations from nrip.

Note:
As with all professions, Medical Professionals have started slowly empowering themselves using the benefits of technology. Over the years, I have analysed how each medium would benefit a doctor given his specific needs, and of course had to reason on factors such as the learning curve, investments on time  and mindsets.   Social Media is one such medium. This article is part of a series of 4 where I delve into how Doctors can use different Social Media avenues for different purposes.

You may wish to check out Websites for Doctors to start off with creating a digital Identity for yourself. By my calculation, its the largest provider of Medical Websites in Asia