DIGITAL HEALTH ECOSYSTEM - ACCESS HEALTH DIGITAL VISION
Over the years economists and leaderships around the world have learnt that economic growth that is gained through the hard work of a creative, healthy and productive working population; is easily lost through healthcare costs arising from disease burdens that come with ageing or other public health challenges; which could be endemic communicable, lifestyle related or pandemics as in the recent experience.
This challenge becomes even more acute in the case of developing economies and economies with very young populations which will see longer life expectancies and higher healthcare burdens in the future.
The Sustainable Development Goals (SDG) framework elicited by the world community is an attempt to ensure that economic growth translates into real change in the lives of large populations around the world, lifting up their quality and experience of life.
Universal Healthcare is adopted as the third SDG in this framework but on closer examination has profound interconnections with all the other goals in the framework, and therefore is perhaps the most important one. In fact, it is so important that it is no longer possible to leave people to fend for themselves and pay-out-of-pocket for their healthcare costs. This report describes India’s policy initiatives for Universal Healthcare, along with a detailed discussion of, and solutions for, the hurdles that India faces in it’s drive towards implementation of Universal Healthcare.
Providing Universal healthcare in a way that is sustainable for economies requires a preventive, predictive and proactive approach to healthcare that is wellness centric and is both equitable and accessible to citizens. There are a number of paradigms that need to be understood to effectively deliver on these approaches.
Firstly, it requires Healthcare to be seen as an ‘Eco-System’ or a collective environment, rather than disjointed entities / industries making overlapping or selective efforts that fail to address the issues holistically. Healthcare is not a single industry or a set of unconnected industries. Some of the issues arising from isolated efforts are discussed as ‘Fuzzy boundaries’ in the report.
Secondly, having realized that healthcare is an inter-dependent ecosystem, even more so when an entity other than the beneficiary or patient is paying for the services rendered; it becomes critical that all members (stakeholders) of the ecosystem work together in close cohesion with minimum administrative glitches and ensure economy of effort and resources used. The Size, Scale and Speed that is required to make this work, makes it essential for information to flow amongst the stakeholders in a seamless and meaningful way that is universal and helps decision making easy, rapid, transparent and non-discriminatory to the extent possible. For this to happen, Interoperability becomes critical and lack of Interoperability - fatal
The centrality and criticality of effective Interoperability calls for universally accepted structures, rules, processes and data standards. This is the core of the work that Access Health Digital has been doing over the recent years. Access Health Digital (AHD) has expertise across Medicine, Technology, Public Heath, Governance and Policy, Healthcare Systems, Adoption, Capacity Building and Implementation; with at least 3 if not more cross functional disciplines available within each individual team member’s multi-decadal span of experience and qualifications. AHD has Conceptualized, Designed the Building Blocks, Minimum Viable Product Designs and other Digital Health Assets for healthcare delivery information systems. The central purpose of this document, and the efforts behind the working group initiative, is to serve the nation by releasing this body of work into opensource for Public Good and secure majority agreement with stakeholders on these. This helps create an inclusive approach to the ecosystems instead of one that threatens or challenges the smaller stakeholders with financial ruin. The exclusiveness that is possible in other sectors of business is not viable in healthcare, as it would trigger a systemic collapse. Healthcare services are greatly personalized in nature since medicine is an extremely nuanced and evolved discipline, where a clinician often needs to factor in a lot of subjective information to make the best decision for the patient.
Essentially the Healthcare Space has three broad principal stakeholder groups namely:
- Payers – These are entities that pay for healthcare services given to a patient. These could include the patient and his family, governments schemes, insurance providers – private and public. As discussed above, Universal Healthcare is striving to ensure that this burden is minimized for the patient.
- Providers – These are entities, public or private, that provide care – ranging from the individual medical practitioner in a remote area, to the sophisticated urban hospitals; ancillary services eg. Labs and Diagnostics, telemedicine, medicines and so on. This is a vast area running into millions of entities.
- Patients or Beneficiaries are those receiving healthcare services.