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The second decade of the 21st century, will probably be best known, for the radical transformation of healthcare, using Information and Communication Technology (ICT), particularly in emerging economies. WHO defines e-Health as “… the cost-effective and secure use of Information and Communications technologies in support of health and health-related fields, including healthcare services, health surveillance, health literature, and health education, knowledge and research …” (Resolution 58/28 of the World Health Assembly, Geneva, 2005).
E-Health alone can bridge the health divide between the haves and the have nots. Today, we are on the threshold of a revolution—a revolution called “Information Medicine”. This will soon become personalised and participative. ICT applications in healthcare will probably be as important as advances in diagnosis and treatment. In spite of the obvious benefits, the use of IT in the healthcare industry is far less than its use in banking, commerce, travel, automobile or almost any other industry. While the financial service industry spends 10–12% of its budget on IT, the healthcare industry spends only 2–3%. Recognising the change in technological innovations, more hospitals are now adopting ICT to improve the quality of healthcare delivery. ICT bridges distances and provides access to clinical knowledge leading to better quality healthcare. Disseminating information and knowledge management with ICT will empower all stakeholders. This will improve outcomes quicker and more cost effectively, than only developing better drugs, better surgical procedures or improved diagnostics. In the future integrated health records of patients, smart cards, radiofrequency identification tags to track patients, medication management, etc will form the core of the healthcare system. Introducing new technology in an existing healthcare system is one of the foremost challenges of Digitising. “Digitising” a medium-sized hospital involves integrating 300-plus applications supporting thousands of processes. There are literally thousands of processes at play simultaneously in a hospital at any given time. Process redesign to increase efficiency and efficacy is mandatory in the fast-changing healthcare environment. Hospitals are people-intensive enterprises and capacity of the people to embrace change is a major challenge. The functional requirements for adequate automation support of clinical healthcare activities far exceed those of any other industry. For instance, most industries do not need to maintain 24/7, 365-days-a-year service with absolutely no tolerance of downtime. Ultimately, healthcare is delivered by people for people. The capacity for staff to accept and embrace change will make or break solutions because people are the implementing the solutions. Large investments in money and time are required.
Clinical applications of e-Health include Electronic Health Records, TeleConsultations, Clinical Decision Making Support Systems, Vital Signs Monitoring Services, TeleHomeCare, Ambulatory e-Health—smart clothing, e-Wear, e-Clothing, ePre-scribing, e-Nursing, e-dissemination of personalised healthcare and professional Continuing Education using e-Learning tools: Health Information Systems, LifeTime Health Records/EMR, Pharmacy Information Systems, Electronic Claims Systems, Laboratory Information Systems, Interfacing with Diagnostic Equipments, ICT in Health Administration, and Identification and Tracking Solutions.
Healthcare in the second decade of the 21st century will essentially be DIY—Do It Yourself. Patients will no longer be passengers in a vehicle driven by doctors. They will increasingly be responsible for their own health. Real time access to electronic information on new technologies and treatments will make them empowered patients. They will not just be checking their BP and blood sugar but critically reviewing different treatment options! Medicine of the future will be wireless. Implanted devices will be able to communicate directly with the monitoring systems located hundreds of thousands of miles away. Blue tooth-enabled devices will communicate with insulin pumps implanted in the body and insulin will be automatically released when required even without the knowledge of the subject. Today telemedicine is slowly making inroads into healthcare. Tomorrow it will be mHealth (the broad term deployed in the use of the ubiquitous ever increasing all pervading mobile phone in providing healthcare).
The first generation of e-Medicine enthusiasts should not forget that technology should be used as a support to treat patients, not viewed as a goal in itself. The challenge today is not confined to overcoming technological barriers, insurmountable though they may appear. It is true that available technology still has considerable scope for improvement. Rather the challenge is why, where and how, to implement which technology and at what cost. A needs assessment is critical. The take off problems, facing e-Medicine is legion. It is our dream and hope that within the next decade e-Medicine will be an integral part of the Indian healthcare system. What is required is not implementing better technology and getting funds but changing the mindset of the people involved. E-medicine in India should only be a mouse click away!