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HealthFore Advanced Concepts in eHealth & eHealth Solutions Partners:

30th April 2013

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mHealth Program

Ghana

• Population 24.4 mn

• Enhanced focus on healthcare since 1997 with the goal to increase the % of population utilizing qualified health personnel from 30% to 50%

• Physical Infrastructure

– Healthcare Expenditure is 8.3 % of GDP

– Spending by private sector is 48% and public sector is 52%

– 0.9 beds/1,000 population against a world average of 2.61 and WHO norm of 3.9 beds/ 1,000 population

– One third of the population lives 5 kms away from the nearest health facility

• Health Insurance

– A high 80% of patients visiting private hospital have coverage

– Claims processing is very lengthy

• Medical Personnel

– 0.1 Physicians per 1,000 against a world average of 1.5

– 1.0 Nurses per 1,000 against world average of 3.3

• Unequal Distribution – the urban versus rural divide

– In rural Ghana, consulting a doctor takes an average of 4 hrs. and costs 8 times more then elf-medication

India • Population 1,241 mn

• Physical Infrastructure

– Healthcare expenditure 5.1% of GDP

– Spend by private sector is 80% and public sector is 20%

– 0.86 beds/1,000 population

– 1 mn deaths/ yr due to inadequate healthcare facilities

• Health Insurance

– 80% expenditure borne by the patients

– Private Health insurance a mere 3%; State bears 12%

• Medical Personnel

– 1.2 Physician per 1,000 population

– 0.9 Nurses per 1,000 population

• Unequal Distribution – the urban versus rural divide

– Over 700 mn people have no access to specialists care

– 80% of the specialists live and work in urban areas

Healthcare Sector: Challenges

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Common Problems & Growing

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Population Growth

Ageing Population

Ris

ing

He

alth

care

Sp

en

d

Patient

Centric

Integrated Care

Connected Healthcare

Standards &

Interoperability

265

40 23 10

848

194 68 30

0

200

400

600

800

1000

2005

2011

NCD (# in ‘000s)

Challenges: Priorities are Changing

Improve Patient Care/Safety/Satisfaction

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Gain Operational Efficiencies

Meet Regulatory Obligations

Challenge: IT is more Complex

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More Integrated Operations

More Networks

More Devices

More Virtualization on Demand

Patient Centric Healthcare

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Connected

Coordination

Collaborative

C A R E

eHealth Solutions

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eGov Phase II Healthcare Drivers

• Mobile Phone penetration in Ghana is > 100% (number of mobile phones is more than the population because multi-SIM’ing is common)

• 62% of the disease burden in Ghana is still communicable diseases, maternal and prenatal conditions and nutrition deficiencies; 31% is NCD and 7% injuries related

Sub-Sharan Africa accounts for 11% of the world’s population yet bears 24% of the global disease burden and commands < 1% of global health expenditure

Opportunities that can be addressed by ICT

1. Enhance CHPS (Community-based Health Planning & Services) initiative through mobile health (mHealth) services

2. Strengthen healthcare Communication system through ICT to enable faster flow of information, better governance and effective decision making

3. Reduce load on institution care through effective disease prevention and control at community level

4. Improve access to quality maternal, neonatal and child care to reduce IMR/ MMR

Examples & Case Studies

Mother & Child Tracking System

(MCTS)

Outreach Disease Surveillance

Program (ODSP)

MediPhone

Healthline24x7

Tele-Radiology

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Mediphone is a 24X7 “Doctor on Phone” service for 186 mn Airtel subscribers, backed by internationally renowned clinical decision support system from Medibank, Australia

MediPhone empowers people to get medical advice over the phone, at the time of their choice irrespective of location. Running since Nov 2011, the service offers:

• Medical advice including self-care, doctor’s consultation and/or medication

• Accredited medical professionals & doctors to ensure right diagnosis

• Prescription by SMS/ email

• Psychological and Diet Counseling

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Doctor On Phone

Provider Comparison and Evaluation

Health Alerts

Medicine Information

Disease Information

Specialist selection system

Appoint Scheduling

Health Update

First of its kind round the clock, technology enabled, independent healthcare information services platform, positioned to transform healthcare by addressing the basic issues of: • 60,000+ registered home users

• 24x7 Operations across 13 cities • 150,000 registered healthcare providers

0% 4%

8%

73%

15%

Emergency

Information on diseases

Information on Medicine

Search Select

Symptom to Specialist

MCTS Agents, Paramedics and Doctors calling the beneficiaries

High Risk Pregnancies

Low Risk Pregnancies

Monthly call for high risk

cases. Total 9 calls.

Mother & Child Beneficiaries receive calls and reminders as per predefined schedule

Proposed MCTS Call Center- Approach

9 AM – 6 PM Operations

Advanced reminder for due MCH services

Improved Compliance

Reduced Maternal & Infant Mortality

Saves Lives!!

MCTS Database of phone number & other mandatory details for work plan

Information extract of Pregnant women and children

MCTS Portal

HealthFore CRM

Children

Call at every ANC visit,

before & after delivery.

Total of 5 calls.

2 calls for OPV/DPT and 1

call for Measles.

Total of 3 calls

Healthcare professionals/ Hospitals/ CHC etc.

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Screening conducted at PHCs

Patient Details capture – EMR ID generation

Samples processed at Gujarat Laboratories (Partner)

Cards and Reports Issued to PHC

Reporting Dashboards

Spot Test Issue of Appropriate Card

Outreach Disease Surveillance Sickle Cell Screening

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INTERNET

Billing Diagnostic Test Performed by Technician

SRL Radiologist 1

SRL Radiologist …

SRL Radiologist 2

Guwahati Central Data Center

Technician Teleradiology Image server

Patient

Tele-Radiology

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Objective: Use ICT to overcome lack of staff and expertise in providing Radiology services Scope: Tele-radiology services in 11 district hospitals, with centralized reporting

Across 11 Regional Diagnostic Centers covering 14.9 mn citizens in State of Assam

Healthfore Positioning Extending the Point of Care

© Religare Technologies Ltd.

Tele-Health

Institutional Care

• Patient Care & Advice

• Wellness

MediPhone

• Health Information

Healthline 24x 7

• MCTS

• Tele-Radiology

• Disease Surveillance

Other Solutions

• HIS

• RIS

• PACS

• ERP

• Kiosk

Magnum \ infinity

EMR EHR HIE PHR

Integrated, Patient Centric Continuum Healthcare Solutions

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• Healthcare segment is complex business and an important part of every country’s economy

• Medical industry has seen path breaking innovations both in the area of medical procedures as well as medical equipment

• Common Problems and Challenges loom in healthcare across the world primarily to do with lack of accessibility, affordability and awareness

• ICT and mHealth integrated with traditional care methods are the only way to bridge the growing healthcare divide

• Standardization and Inter-operability, security and privacy are going to play a critical role in adoption of patient-centric integrated healthcare

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To Summarize

Thank You

Pankaj Vaish (m) +91 965 443 5656 pankaj.vaish@healthfore.com

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