Information technology is now spreading to all sectors of the economy from job creation to education to manufacturing to travel and tourism. Health care of the people is one area where IT is being used in the west to provide better and timely care and also to reduce the cost of care to the patients by avoiding unnecessary hospital visits. Many US based IT companies have developed sophisticated IT and telemedicine for the alzheimer patients like the GPS devices attached to their ankles to track their movements when they are alone. Some of these companies claim that these IT enabled medical technologies have turned the traditional hospital care into proactive patient-centric health care by improving health outcomes and quality of care of the patients.
Patient information can be accessed anytime and anywhere and some image automation software companies like Global Media Group allows clinicians to store and forward digital medical images of eyes, throat and skin. Even committing suicide by swallowing poison or accidental poison effects on family members can be traced quickly by nurses and care givers by poison exposures on phones!
But even in the US, which is a pioneer in the use of IT in health care, problems are many and it still has a long way to go. For the first time in the US, Medicare will soon track the spending on millions of individual beneficiaries to reward hospitals that hold down costs and penalise those whose patients prove most expensive.
Medicare spending
The US health department plans to establish Medicare spending per beneficiary as a new measure of hospital performance just like the mortality rate of heart attack patients and the infection rate of surgery patients. Under the new health law, Medicare will cut payments to hospitals if they do not replace paper files with electronics health records and it will further reduce payments to hospitals with high rates of preventable errors, injuries, infections etc.
The strategy of health care in the US is to improve the quality and efficiency of people’s health by linking payments to the performance of health care providers and is best described by the economists as value based purchasing and will distribute Medicare funds to the hospitals based on this principle.
But there are also serious doubts about the efficacy of the system. If the big financial giants could fudge data and cause global financial crisis, there are doubts whether the IT approach can really bring in good health at low cost in the US. Many of these health tech companies are not sure of the measures to be adopted if these high tech instruments fail to perform or perform wrongly and what should be done and who is responsible for these faults? If the health data is wrongly used or hacked by someone how will the health insurance companies decide on insurance claims and make settlements?
In India many super speciality hospitals in the big cities have developed medical records and IT enabled patient’s record keeping. But when we go to the district hospitals and primary health centres in many states the situation is in a mess. Even the basic birth and death registers are still not updated from time to time.
In many of the villages the birth registration of new borns are never done because of social and cultural factors like women delivering her first child in her mother’s house/village than in her husband’s house/village. The first birth, according to our Indian rural tradition, is supposed to be precious and has to be in her mother's care and house.
The naming of the new born is also done in her mother's house and all this takes as many as six to seven months. Due to these intervals the birth registration is postponed. If the registration is made compulsory in hospitals at the time of birth, the children’s progress can be tracked later tracked to their school enrollment, schooling record, drop out if any, till they attain the age of 18.
India should expedite the use of information technology as it can be a great instrument for tracking our human resources’ wellbeing. UID is just one IT instrument that the Government of India is promoting. But the real need is to build the IT enabled information system right from the gram panchayats level so that information is available at the click of a mouse.
