Providing quality healthcare in India is a formidable task. While the majority of people live in rural India, the majority of physicians live in urban centers— the ratio of doctors per thousand people in urban India is said to be seven times more than that of rural India.
In addition there are several factors that make delivery of healthcare in rural India particularly challenging :
• Government health centers are understaffed and ill-equipped— there is less than one doctor per 10,000 people in rural India
• Health staff are undertrained and lack the knowledge for diagnosing certain medical conditions and undertaking specialized treatment
• In most cases, patients who can afford it, are forced to travel to towns and cities, often with their relatives, for diagnosis and treatment, all of which translate into high cost and loss of daily income—of every Rupee spent, 70% is overhead and only 30% is used for medical care
• All diagnosis and prescription documents are in English, which is not the working language of rural people
One way of bringing quality primary care to people in rural India is to empower the intermediaries (healthcare or outreach workers from each village) already active in those regions. To this end Accenture has been working with multiple stakeholders to equip field workers with Decision Support System (DSS) enabled tablets or smart phones that incorporate the latest World Health Organization (WHO) guidelines, clinical protocols and best practices. Each tablet has inbuilt mechanisms for supporting consultation with doctors, remote diagnostics and context-sensitive treatment and location-aware data capture. The result is the iDoc@Village.
The system fulfills two important requirements. First, the powerful knowledge-based mobile devices— capable of processing complex business rules—allow the rural intermediaries to provide the human touch necessary for overcoming the local language, literacy and trust barriers. Secondly, the system allows less than fully trained medical doctors to deliver quality healthcare.
DSS for clinical diagnostics has been around for some time. What is relatively new, however, is the usage of such a system (for outreach workers) on a handheld mobile device that can operate even without network connectivity.
What is iDoc@Village?
iDoc@Village is a flexible and extensible system which can operate in three modes.
In this mode, the system does not require network connectivity. Using a mobile DSS, the solution allows outreach workers to make on-the-spot diagnosis and recommend remedial actions. Where patients have a low cost cell phone supporting basic text SMS, iDoc can also be configured to send alerts and reminders of treatment to patients in their preferred language.
This mode allows the outreach workers to go beyond asking questions from patients. They can use medical devices to collect physiological data on parameters such as, blood pressure, oxygen content in blood, blood sugar, ECG data, weight and other health parameters.
Furthermore, outreach workers can also use cameras to take photos physical symptoms such as rash, skin color, abrasions and others for a more detailed analysis and comprehensive treatment. In the event of network connectivity the workers can also leverage comprehensive backend diagnostics systems if required.
This mode requires network connectivity for enabling realtime video consultation between a patient and doctor present in an urban hospital. Features embedded in the iDoc system that allow outreach workers to identify and contact the most appropriate specialist, based on criteria such as region, language, specific problem at hand and availability/presence of the specialist.
iDoc@Village is an example of the innovative IT strategies required to empower people living in areas where infrastructure development has a long way to go.
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