Benefits and Roadblocks

Despite the rewards most of these AI applications are seen outside India. A discussion paper floated by Indian government’s Niti Aayog places healthcare among one of the focus areas for AI intervention. For India, according to the Niti Aayog, an incremental USD 957 billion could be added to the GDP by 2035 by adopting AI in sectors such as healthcare and education, boosting India’s annual growth by 1.3 percentage points by 2035. Of all countries, India, with its dismal and egregious healthcare system and infrastructure, certainly can benefit from this technological disruption. AI has tremendous potential to bridge resource gaps in Indian healthcare framework, enhance the accessibility of quality care and ultimately reduce the burgeoning costs.

But still we hardly witness any major implementations of AI in India. Why is that and what are the key deterrents to the growth of AI in healthcare in India? Is it due to scarcity of funding, dearth of skills in AI, reluctance by doctors to adopt AI, lack of clear guidelines for AI adoption or the existing archaic regulatory infrastructure in India?

Inside View

Dr. Vikram Venkateswaran (Director, Deloitte and Founder of Healthcare in India) and Dr. Sumeet Kad recently engaged in an intriguing discussion on the role of AI in healthcare and what are the challenges holding back the adoption of AI in healthcare in India. Please click in the video below to watch and also share your comments (YouTube link: https://bit.ly/2AFXsmD)

The post Future of AI in Healthcare in India: Opportunities and Challenges appeared first on New Age Healthcare.

On Feb 17, 31st case of coronavirus surfaced in Daegu, South Korea. On outlining the tracks of this ‘Patient 31’, public health official ascertained that in the last ten days the patient had attended two worship services with over 1000 people. Within a week, a 30-fold increase occurred in the nation’s number of cases. Since then, extensive use of analytics and data science has been central to South Korea’s approach in successfully ‘flattening the curve’. South Korean government has been tracking on quarantined people through a mobile app which also aids patients’ communication with the local health authorities to report symptoms.

The utilisation of data analytics to understand the causes of the pandemic is reflective of the substantial transformation in the potential of organisations and governments to collect massive amount of data and use AI algorithms to harness them. In this battle, firms have been collecting and processing real-time data at an unprecedented pace and scale. Countries such as India, Singapore, China, Korea, Spain and Israel have successfully developed and deployed indigenous mobile apps to provide instant notifications if an exposure to a covid infected person has occurred. Government health officials and epidemiologists then uses such data sets to track down and screen the exposed individuals and create hot-spot zones where stern isolation is implemented.

Artificial Intelligence for Monitoring and Drug Development

Baidu, a Chinese tech giant, uses infrared sensor and Artificial Intelligence powered facial recognition technology to predict people’s temperature at various airports and railway stations. Drones powered with AI-based thermal screening are deployed in public places by various nations to detect fever. AI and cloud computing are being used extensively to identify potential drugs and augment the research for coronavirus vaccine development. IBM has offered its AI-powered virtual agent, Watson Assistant for Citizens, which helps governments deliver accurate information to their citizens. Microsoft had released chatbots that can help people self-identify the best action plan based on their symptoms. Tech  majors – Apple and Google – recently announced a collaboration for developing a decentralised contact tracing tool. Machine-learning tools have analysed millions of social media posts in China to help predict the spread.

The aforementioned examples clearly indicate that the striking advances in data analytics and AI-based algorithms have provided a strong fillip to global efforts in identifying communities at risk and arresting the contagion spread. BlueDot, a Canadian AI-based infectious disease surveillance system, spotted the coronavirus nine days before WHO released an alert for the virus’ emergence. Scientists at Carnegie Melon University have developed an AI based tool that can determine a covid infected case by analyzing the sound of a person’s breath and cough.

Active monitoring and contact tracing, and analyzing real-time data is pivotal to assuage the stark implications stemming of the pandemic. Countries such as Singapore, India, Taiwan, China, South Korea, Spain, Norway, Belgium etc. have successfully deployed these data-driven predictive mechanisms. Today, smart phones are laced with high-end technology which can easily enable in mapping the travel patterns of people, thereby offering real-time date to telecom providers and tech firms. Data from CCTV footage and ATM transaction records have been used for contact tracing in Singapore and South Korea. A portable surveillance device powered by machine learning, FluSense, can detect coughing in real time at public places, and then analyse the data to monitor trends.

Pressure on Privacy Protection

This massive tracking of consumer behaviour and data has invited severe rebuke from privacy law activists across the globe terming it as ‘privacy-infringement’. Doubters of AI and data science technology complain that this is a blatant attack on the civic liberties brought upon populations in the name of disease-surveillance. There is a growing fear of how this data will be used once the crisis is over and whether such data sets are truly anonymous. However, we should look at the data privacy guidelines from a different lens to facilitate the suppression of this pandemic as precious lives are being lost on daily basis.

Governments and regulators need to provide assurance that data-use and analysis will not endanger privacy rights. Greater transparency is required amongst governments, telecom providers and tech firms that such data sharing will not result in any future regulatory action. The data by telecom providers need to be in an anonymised and aggregated format. More ‘privacy-friendly’ alternatives should be wrought and use of tracking apps should be done on voluntarily basis and non-intrusive.

Such arduous situation necessitates a fine balance between governments, regulators, telecoms, and tech firms. We need to wisely analyse the trade-off between saving lives and civil liberties during this public health emergency. Ample evidence of AI and data science being effective tools against coronavirus should enable consumers to understand that some leeway could be given to the individual privacy laws. We all need to think and act unitedly to mitigate the impact and the methodical use of technological solutions can prove to be a formidable and potent warrior.

The post AI and Data Analytics to Combat Health Pandemic appeared first on New Age Healthcare.

Digital adoption is being driven by the advantages offered to the people of connectivity, increased accessibility to unlimited stores of information, products and services and personalized experience according to one’s preferences.

As a result of this increasing adoption of the internet and digital technologies, even the business models are rapidly changing to cater to the needs of the consumer of today. The following are four tools that make digital all powerful [1]: Social Media, Analytics, Cloud Computing and Mobile Applications.

Consumers now expect companies to leverage the power of digital for personalized and enhanced customer experience, quality product offerings and competitive market prices.

The use of Digital technology has deeply been ingrained in almost all major industries and has successfully proved to be a significant improvement.

With digital technology making its presence felt in most major industries and becoming indispensable for their functioning, the healthcare industry finds itself at crossroads in terms of deciding the extent to which it should jump on the digital bandwagon. It is a challenging dilemma as it is and will continue to change how care is delivered to patients while constantly pushing the borders of the extent of services that can be delivered via digital methods.

A patient survey predicts that more than 75% of all patients are expected to use digital services in the future[2]. Technology is the best way yet to realistically provide affordable, accessible and quality healthcare to all patients and to achieve the vision of a connected healthcare ecosystem. Medical devices in hospitals, new age mobile care applications, wearable monitoring technologies are all modern digital innovations have and are continuously disrupting the existing healthcare system.

Some Digital healthcare initiatives which are noteworthy and are rapidly making inroads in our healthcare system are as follows:

1. EMR
2. Telemedicine
3. Big Data Analytics
4. Robot Assisted Surgery
5. Wearable Health Monitoring Devices
6. e-Pharmacies
7. m-Health
8. e-Learning and training
9. CDSS-Clinical decision support systems
10. Wearable medical devices

On the clinical side,  these “Internet of Medical Things” can be used to monitor the patient’s vitals continuously irrespective of the patient’s location and raise necessary alarms with subsequent following of protocols of emergency care rendered. In the ICU and wards, comprehensive dashboards can very concisely and accurately display all the significant patient information, triage and prioritize patients on their need for care and predict episodes like sepsis, stroke etc based on their accumulated as well as programmed knowledge[3]. This can help change the reactive approach of healthcare delivery currently practiced to that of proactive. This will lead to better patient outcomes, improve the quality of care given to patients and efficiently utilize the time of our bottleneck resource- the healthcare providers.

The importance of responsible and ethical AI has been highlighted by experts[4]. There is certainly a potential for digital technologies to transform healthcare in India. Having said that, the ethical, legal, and cultural factors need to be considered by developers, practitioners, and policy makers when designing, using, and regulating e-health platforms. How can the systems ensure consent? How will questions of liability be addressed? How does it fit into existing ethical frameworks in India? How can the security, privacy and accuracy of digital solutions be ensured – particularly in the health sector as individual lives can be at stake and highly sensitive data is being handled?

Let us discuss the above questions- the potential ethical, legal, and cultural concerns around digital in healthcare in some detail:

With the advent of Digital in healthcare, the age old system of paper-based storage of information is becoming obsolete. The Right to Privacy is held by the Supreme Court as a fundamental right[5]. The Srikrishna Committee constituted for recommendations on data privacy and its management made a draft bill called as the Personal Data Protection Bill, 2018. It is the first step towards India’s Data privacy journey

The current Privacy Policy is laid down under the following Acts:

1. Section 43A of the Information Technology Act, 2000
2. Regulation 4 of the Information Technology (Reasonable Security Practices and Procedures and Sensitive Personal Information) Rules, 2011 (the “SPI Rules”)
3. Regulation 3(1) of the Information Technology (Intermediaries Guidelines) Rules, 2011

Hackers can exploit solutions like the Electronic Health Records to collect private and sensitive personal information . Machine learning algorithms can also be misused to develop autonomous techniques that jeopardize the security and safety of such vital information. AI systems can challenge privacy through real time collection and use of a multitude of personal data points that may or may not be disclosed to an individual in the form of a notice with consent taken.

In 2016, the hacking of a Mumbai-based diagnostic laboratory database led to the leaking of medical records (including HIV reports) of over 35,000 patients. This database held the records of patients across India, and many may be unaware that their details have been exposed. The database had been the victim of multiple hacks in the previous few months, sometimes up to thrice a week [6]. However, no action had been taken by the laboratory to secure the data.

This highlights the need for higher privacy and security standards regulating sensitive personal information in India and the need for requirements such as breach notification

The type of information collected from the user can constitute Personal Data and Sensitive Personal Data or Information (as defined later) relating to an individual. The collection, storage, handling, usage, analysis and transfer of Sensitive Personal Data or Information (SPDI) currently falls under the Information Technology Act 2000 under the Data Protection Rules. Servers, cloud based storage systems are amenable to hacking from where sensitive information of patients can be leaked or fall into the wrong hands

The following constitute Personal Data:

1. contact data (such as your email address and phone number);
2. demographic data (such as your gender, your date of birth and your pin code);
3. data regarding your usage of the services and history of the appointments made by or with you through the use of Services;
4. insurance data (such as your insurance carrier and insurance plan);
5. other information that you voluntarily choose to provide to us (such as information shared by you through emails or letters)

The following constitute SPDI[7]:

1. passwords;
2. financial information such as bank accounts, credit and debit card details or other payment instrument details;
3. physical, physiological and mental health condition;
4. sexual orientation;
5. medical records and history;
6. biometric information;
7. information received by body corporate under lawful contract or otherwise;
8. visitor details as provided at the time of registration or thereafter; and
9. call data records.

The company is free to use, collect and disclose information that is freely available in the public domain without consent.

The e-health platforms have a responsibility of protecting patient privacy and anonymity. Usually a user is asked to agree to a barrage of terms and conditions before being allowed to use the services. The information that is collected by the e-health platforms are:

1. Personal information and or SPDI
2. information received by body corporate under lawful contract or otherwise;
3. visitor details as provided at the time of registration or thereafter; and
4. call data records of consultations

This collected information by the e-Health platforms can be used by them for the following purposes:

1. for the purpose of providing the Services,
2. for commercial purposes and in an aggregated or non-personally identifiable form for research, statistical analysis and business intelligence purposes
3. for sale or transfer of such research, statistical or intelligence data in an aggregated or non-personally identifiable form to third parties and affiliates
4. debugging customer support related issues
5. Publishing such information on the Website.
6. Contacting End-Users for offering new products or services.
7. Contacting End-Users for taking product and Service feedback.
8. Analyzing software usage patterns for improving product design and utility.
9. Analyzing anonymized practice information for commercial use.

If the SPDI is shared with a third party or used for research purposes, the data should be made non-identifiable. Also, if a user wishes to stop receiving promotional and other communication from the company, then they should be provided with the option of “Opt-out”.

The MoH&FW is in the midst of enacting a sector-specific legislation called DISHA or Digital Information Security in Healthcare Act[8] (elaborated in detail later) . In addition to laying down guidelines for digital platforms, this law will also provide civil and criminal recourse for breach of data privacy.

The Data Protection Rules apply to any corporate entity in the same way as they do to any individual doctor. When collecting the sensitive information, consent is taken from the user which is supposed to be an informed one on the above mentioned aspects.

These Data Protection Rules were put in place at an earlier time when the use of Digital was not that extensive for sensitive personal information. But in today’s age, a greater need is felt for more regulation, laying down of concrete, unambiguous laws and also to account for liability on breach of the data privacy tenets.

DISHA is the result of these requirements of the industry for higher security measures in healthcare information. Once it is enforced it will replace the Information Technology Rules of 2011 and be a landmark Act of its kind.

Critical argument on a few areas which are still vague or contentious

There is a lack of clear definitions and guidelines on data safety, storage, access and sharing norms. Moreover, there is no watch-dog or regulatory authority which ensures the adherence to these Data Protection Rules. Companies can abuse this loophole for monetary benefits and thus violate the right to privacy of their users. The coming of DISHA and the establishment of NeHA as a regulatory authority is a welcome move and the need of the hour.

Also there is lack of transparency by the e-Health companies on the exact use to which their SPDI is being put and with whom it’s being shared. Many a times the “Opt-out” option is not available or easily accessible for users to stop receiving communication from the companies or get their information deleted from databases if they choose to.

Consent represents the legal and ethical expression of the basic right to have one’s autonomy and self-determination. Consent is now globally recognized as an essential first step in the acquisition, storage, processing, usage and transfer of personal data. For healthcare, consent takes on a very significant role and is imperative because if a medical practitioner attempts to treat a patient without a valid consent, then he will be liable both under tort and criminal law.

Some online consultation platforms like Practo Tab have introduced digital consent forms[9]. Practo Tab is a practice management system for doctors which includes patient registration, appointment management, billing etc. Including a consent form in the online consultation module ensures that the patients understand the risk and complications before a treatment and be aware of alternate treatment options. It also safeguards the doctors against any grievance or negligence lawsuit post the treatment. These digital consent forms have to be legally compliant and use digital signatures as per Sec 2 of the Information Technology Act 2000[10].

In order to make it more air tight, the Practo consent forms are further made tamper-proof so that once signed, they cannot be modified in anyway by anyone.

Also in accordance with MCI guidelines, consent should have the following characteristics:

• Consent should be freely given
• Consent should be an informed one, wherein all the risks, complications and alternative treatment options have been informed to the patient
• Consent can be implied, expressed or written depending on the procedure in question. For routine treatments an implied consent would suffice. For a more detailed examination an express oral consent is required.  Finally, for complex treatment procedures, express written consent is required
• The validity of consent also needs to be determined carefully

Carte Blanc consent

At the time of logging on to any of the e-health platforms, users are required to agree to policy terms and conditions, without ticking which, one is not allowed to proceed and avail the services of the e-health platform. These T&Cs may include a lot of things which are not necessarily ethical or in alignment with the patient’s consent. Moreover, these policy T&C are many times not even read by the users or patients. Yet they give their approval for terms of data usage, waiving off liability and negligence on part of the e-Health platform. In consultation cases, where a written informed consent is mandatory, can such a consent be considered valid, where the patient, though being informed, is not aware? Can it amount to coercion, where services are denied based on agreement to all terms?

Recommendation: The consent should be broken down into sub segments and each consent should be separately taken. Also each time that patient data is to be shared with a third party, a separate consent request should be raised by the e-health company.

Doctors and patients share a legal fiduciary relationship which is contractual in nature. Due to this contract, the doctor owes a reasonable duty of care towards his patient. In case there is any harm caused to the patient resulting from the negligence of the doctor, the doctor in turn can be subject to liability. The liability can be both contractual and tortious. It may even be vicarious. It can be a Civil or a criminal Liability. In the case of digital healthcare, the liability will be different for the doctors and the service providers such as the online platforms and institutions which are hosting these doctor, patient interactions.

Civil Liability

Civil Liability suits can come from a breach of contractual obligations between the e-Health service provider and the patient or user. It can also be initiated by the patient under tort due to negligence on part of the doctor or the service provider. A breach in the contractual obligations can result in charges that can be compensated for by payment to the patient at an amount that is decided at the time of execution of contract or based on the decision of the court.

In order for the negligence to be established in court it should be a breach of duty caused by omission to do something or failed to exercise a standard of care which a normally skillful member of the profession may reasonably be expected to exercise in actual circumstances of the case in question. Not every slip or mistake counts as negligence[11]. The case of civil negligence is judged on the basis of whether a mistake was made by the doctor or the healthcare provider and if so, whether the mistake was one which another reasonably careful and skillful medical practitioner would not have made.

To establish negligence in a civil case, the following three points should be proved:

• There was a legal duty to exercise due care
• A breach of the said duty
• There was damage to the patient/user because of the breach of said duty

In the context of a doctor-patient relationship on digital healthcare platforms, the platforms categorize themselves as intermediaries where the service provider just acts as a facilitator. As per the Supreme Court, “a person who holds himself out to give medical advice and treatment by implication undertakes that he is possessed of skill, knowledge and the necessary qualifications to do so. Such a person when consulted by a patient owes him certain duties like:

• A duty of care in deciding whether to undertake the case or not
• A duty of care in deciding the diagnosis and what treatment to give

A breach of any of these duties gives the patient a right to sue for negligence and claim damages[13]. There is no limit to the damages that can be claimed under this breach.

Vicarious Liability

In the provision of e-Health services where there is an employer-employee relationship, the employer can also be sued due to the principle of Vicarious Liability. It means that the service provider or platform can also be held responsible for negligence and the damage caused to the patient by the acts of the employee or doctor working for them.

Liability under the Consumer Protection Act, 1986

The CPA was enacted with a vision to enable consumers to address their grievances in a comparatively easier and quicker manner than having to do so at a civil court which can turn out to be expensive and time consuming. The CPA allows consumers to claim compensation from service providers in case of deficiency of in the service provided. Apart from deficiency of services, consumers can also institute claims for defective products and unfair trade practices. Consumer forums have been set up at the district, state and national level in order to deal with such matters. Medical services now fall under its ambit and is a legitimate case under the CPA if the patient has been charged for the services rendered.

For claims raised with the consumer forums, there is no limit as to the amount of the compensation that can be claimed[14].

Criminal Liability

It is decided before a criminal court and a high degree of negligence is necessary to prove the charge of criminal negligence. To fix the charge of criminal liability on a doctor or surgeon, the standard of negligence is required to be proved to be as high as can be described as gross negligence. If it is a matter of error of judgment, which can be made by any other careful and skilful doctor in the same circumstances, then it is not criminal liability. In case of e-health services, if a doctor is rash or negligent in rendering a service and such a service results in bodily injury or death of the patient, then the person may be charged with criminal negligence. It can be a case of either death by negligence[15] or an act endangering the life and personal safety of others[16] or causing hurt by aforementioned act. In the case of conviction under criminal negligence, the punishment can be imprisonment as well as fine.

The Supreme Court has taken a sympathetic view in such cases and requires the proof of gross negligence for imposing criminal liability against the doctor. It must be established that the negligence of the accused went beyond mere carelessness and that the damage to the patient caused is because of the direct result of such negligence. The credible opinion of another doctor of similar field of expertise is necessary to initiate criminal prosecution in such cases.

The principle of vicarious responsibility does not apply in the case of criminal prosecutions. This means that the institutions/online platforms that provide the digital healthcare services would not be criminally liable for the acts of its employees.

Disciplinary Action by the MCI (now the National Medical Commission)

A consumer is entitled to raise a compliant with the relevant state medical council against the doctor for professional misconduct. If a complaint against a doctor has not been decided by the state medical council within six months from the date of receipt of the complaint, the MCI may, on its own or on the request of the consumer, impress on the relevant state medical council to decide on the complaint or refer the same to the Ethical Committee of the MCI for expeditious disposal[17]. Consumers who are not satisfied with the ruling of the state medical councils also have the right to appeal to the MCI within a period of 60 days[18].

These cases of professional misconduct are specified to the MCI code, such as non-maintenance of medical records[19], refusing treatment on discriminatory grounds like race, caste, performing surgeries or other procedures without a written informed consent[20] etc. They can even sue for acts of omission that are not covered in the MCI Code as well. if the complaint is found to be justified, the doctor faces the risk of suspensions or even cancellation of his medical license.

Responsibility of the e-health platforms

The e-health platforms claim to act as intermediaries and do not take any responsibility for the information provided on their platform or the consultation received via them. The current stance is that they are hence not liable for any of the following;

1. User interactions and associated issues User has with the Practitioner;
2. the ability or intent of the Practitioner(s) or the lack of it, in fulfilling their obligations towards Users;
3. any wrong medication or quality of treatment being given by the Practitioner(s), or any medical negligence on part of the Practitioner(s);
4. inappropriate treatment, or similar difficulties or any type of inconvenience suffered by the User due to a failure on the part of the Practitioner to provide agreed Services;
5. any misconduct or inappropriate behaviour by the Practitioner or the Practitioner’s staff;
6. cancellation or no show by the Practitioner or rescheduling of booked appointment or any variation in the fees charged, provided these have been addressed

The uncertain environment in which e-Health players are currently operating has made it difficult to effectively perform such services. At the same time, it also acts as a deterring factor for new entrants to venture into this field. It has become abundantly clear that the large scale adoption of e-Health is the need of the hour in a country whose population is in need of better access to healthcare.

Some of the policy changes that would go a long way in ensuring the smooth adoption of e-Health services and digital in healthcare in India. The government, the Ministry of Health and Family Welfare, and the National Medical Commission should all be vigilant of the changing dynamics of the healthcare industry with the coming of digital technologies. The current laws were written in an era of no digital tech, hence many of them may require updating, modification or complete deletion as traditional methods change and/or become obsolete. The interests of the patients will have to be borne in mind as their personal information lies in the hands of companies who, for the lack of proper regulations, may take their liberties with this sensitive data. The risks need to be recognized here as is the need for stringent regulation. The National Electronic Health Authority (NeHA), which is coming up with the passing of DISHA, will have a huge responsibility on its shoulders to supervise, manage and regulate the ever evolving digital healthcare landscape. With these evolving digital technologies, the doctors also need to step up their game and constantly be updated on the exciting new innovations every day. The NMC will have to rethink the MCI code of professional conduct, etiquette and ethics for doctors to include virtual practice of medicine and its dos and donts in its tenets.

The e-health companies also have a responsibility of exploring the seemingly limitless potential of digital in healthcare in a conscientious manner and be respectful of the data entrusted to them by the patients. Digital also has the capability to connect all the different aspects of the industry like emergency care, hospitals, diagnostics, insurance providers, medical device companies, pharmaceuticals, patients, healthcare professionals seamless across the continuum of care (from prevention, diagnosis, treatment to recovery) and provide all citizens of the country with the healthcare that they deserve rather than a privileged few.

About Author

Dr. Sneha Singh: A doctor (MBBS) by eduction and with an MBA, she is currently working in Healthcare marketing with a prominent MNC. She can be reached at drsneha2121@gmail.com.

[1] SearchCIO. (2014) SMAC (social, mobile, analytics and cloud). Retrieved from http://searchcio.techtarget.com/definition/SMACsocial-mobile-analytics-and-cloud

[2] World Bank data, PwC analysis

[4] F. Zamin-Malik (2017, September 15), Let’s Get A Grip On Artificial Intelligence In Healthcare, Retrieved January 5, 2018, from https://www.accenture.com/us-en/blogs/blogs-lets-get-grip-artificialintelligence-healthcare

[5] PwC (2018). An overview of the changing data privacy landscape in India. Retrieved from https://www.pwc.in/publications/2018/an-overview-of-the-changing-data-privacy-landscape-in-india.html

[6] ENS (2016, December 3), Maharashtra website hacked: Diagnostic lab details of 35,000 patients leaked, Retrieved January 5, 2018, from http://indianexpress.com/article/india/diagnostic-lab-detailsof-35000-patients-leaked-hiv-reports-4407762/

[7] Rule 3 of the Data Protection Rules defines Sensitive personal data or information of a person to mean such personal information which consists of information relating to (i) password; (ii) financial information such as Bank account or credit card or debit card or other payment instrument details; (iii) physical, physio­logical and mental health condition; (iv) sexual orientation; (v) medical records and history; (vi) Biometric information

[8] F.No Z-18015/23l2017-eGov Government of lndia; Ministry of Health & Family welfare (e-Health Section). Retrieved from https://mohfw.gov.in/newshighlights/comments-draft-digital-information-security-health-care-actdisha

[9] https://www.practo.com/company/terms

[10] PwC (2018). An overview of the changing data privacy landscape in India. Retrieved from https://www.pwc.in/publications/2018/an-overview-of-the-changing-data-privacy-landscape-in-india.html

[11] Jacob Mathew v. State of Punjab & Anr. (2005) 6 SCC 1

[12] https://www.practo.com/company/terms

[13] Laxman Balkrishna Joshi v. Trimbak Bapu Godbole and Anr. 1969 SCR (1) 206

[14] INR 5.9 Crore plus interest; Balram Prasad v. Kunal Saha; (2014) 1 SCC 384

[15] Section 304-A of the IPC

[16] Section 336 of the IPC

[17] Regulation 8.7 of the MCI Code

[18] Regulation 8.8 of the MCI Code

[19] Regulation 7.2 of the MCI Code

[20] Regulation 7.16 of the MCI Code

The post The Medico-legal Discussion of the Digital and AI Revolution in the Indian Healthcare Industry appeared first on New Age Healthcare.

Influx of patients demands cutting edge imaging solutions to improve patient care.

With the aim of touching the lives of 2 billion people, Philips Healthcare, a leading name in the diagnostic technology introduced a new line of imaging device. DuraDiagnost F30 is an easy to use analog system that delivers functionality essential for general radiography examinations and is designed for improved workflow and long-lasting durability. This imaging solution was released by Philips at the recently concluded AOCR 2018 (17th Asian Oceanian Congress of Radiology) in Mumbai, India (Jan 25-28, 2018).

Diagnostic Confidence

Philips UNIQUE mutli-resolution image processing technology ensures consistent diagnostic images. It harmonizes the contrast levels and hence provides uniform clinical image quality for all anatomical areas by adjusting the balance between overexposed and underexposed area.

Clinical Excellence

DuraDiagnost F30 offers fixed and wireless portable flat detectors depending upon the room configuration thus providing the flexibility needed for general clinical applications. The key advantages include: easy handling of diverse clinical procedures, a short installation time, and a high system uptime.

https://youtu.be/Ml0bpMfPPaE

Ergonomic Design

It’s designed to facilitate fast positioning and can be adjusted to support a wide variety of radiological examinations thus maintaining the speed and quality of the diagnostic images.

Easy Learning

This latest digital radiography solution from Philips offers high quality images immediately on the Eleva workstation, which requires only three clicks to complete an X-ray exam. It also comes with a self-guided learning tool to train the radiologists and other professionals. Many of such tutorial videos can be accessed here.

Learn more about Philips Healthcare’s DuraDiagnost radiography solutions by clicking here.

Philips digital radiography solutions portfolio also includes a mobile radiography system, MobileDaignost M50, which can be easily manoeuvred through crowded spaces in the OR, ER, ICU and general wards with ease, bringing digital imaging right to the bedside. Based on decades of Philips expertise and innovation this powerful compact mobile digital X-ray system is designed for all-round performance and fast return on investment. The Eleva workspot’s on-board battery maintains systems uptime and makes the workflow smoother.

At the event, Philips also introduced a new line of imaging devices: Access CT, and Prodiva 1.5T MRI.

The post Digital imaging solutions to enhance clinical diagnosis appeared first on New Age Healthcare.

Health systems around the globe acknowledge the potential of digital health in transforming the industry over the past decade. The advent of cloud computing, analytics, mobile devices etc. have made rapid strides in making healthcare delivery more effective and also less complex to some extent.

But are these stakeholders ready to embrace the next powerful wave in IT adoption which includes complete digitization of their entire enterprise, products, channels, and processes, and utilize advanced analytics & cognitive computing for their business models? Even though IT adoption is advancing rapidly, the issues pertaining to regulations, privacy and overall costs stills looms high over health IT industry. Organizations still struggle to unlock the full potential of newer tech such a blockchain and IoT. Different models have been suggested to drive more innovations and more importantly implementation of these innovations into the processes.

A lot of these models are being debated globally amongst industry experts on various platforms. Philips Digital Healthcare Conclave 2017 on July 28^th in Bengaluru, India, is one such platform that will bring together healthcare leaders, government dignitaries, industry stalwarts, digital influencers, healthcare innovators, infrastructure operators, ambitious startups and media correspondents to have an insightful discussion around the scope, challenges and trends for connected care and digital transformation in Indian healthcare industry. You can register for the event here and be a part of this jamboree of great minds.

The post Digital Transformation: Reordering the Healthcare Landscape appeared first on New Age Healthcare.

A 23yr old young and vibrant engineer living in a southern state of India was under constant stress when he underwent a surgery to get a cancerous growth scooped out of his left hip. The prognosis of the surgical procedure was good and doctors predicted a full recovery within 6 months. But little did he know that the next step towards complete recovery is regular physiotherapy sessions that he has to undergo, which in itself is a painful ordeal. But he was delighted to meet doctor ‘Virtual Reality’ (VR), the latest buzzword in healthcare technology which not only alleviated the pain during his exercises but made the entire session for him much enjoyable.  He strapped a VR headset and would watch videos comprising of calm and serene landscaped and locales around the world. This immersive experience took his mind away from the pain that he suffered during the leg movement as a part of his daily regime. Pain levels dropped to 30% due to this VR treatment and he is on track of a full recovery within 4 months instead of the speculated 6 month time.

The Market

Medical practitioners, hospitals and pharma manufacturers are increasingly employing the services of VR and AR (augmented reality) to improve delivery of care, increase patient satisfaction, and reduce recovery time, marketing and spreading medical awareness. This has encouraged many start-ups to emerge in this domain which are partnering with many small and big healthcare provider and pharma players to develop an entire ecosystem based on AR & VR. Global Industry Analysts projects that the worldwide market for virtual reality in healthcare will reach $3.8 billion by 2020, which indicates that the demand for such technology is not going to die soon.

The Applications

Medical Training and Education: VR is increasingly being proven as a safe and cost-effective tool for imparting clinical education and training as it provides a far more immersive and realistic environment for healthcare professional to learn than the traditional videos and books. Loop Reality, an Indian start-up in this space is working on to develop a tool that will allow doctors to visualize a tumour in VR, analyse in 3D and help to perform dry-runs of the actual surgery. zSpace deploys an immersive medical learning platform for anatomical representation to procedural planning, adding a completely new dimension to the way medical education is provided.

Pharma Marketing: InceptionX, another innovative start-up, partnered with a major pharma player to create a virtual reality vertigo attack experience, which provided a first-hand experience of vertigo to doctors helping them to understand the symptoms in a better way before offering a treatment regime. This kind of ‘experiential marketing’ is being widely used by drug manufacturers to educate practitioners about the brand and drug benefits.

Empowering Patients: VR plays a major role in pain management, rehabilitation, social cognition training, and treatment of depressions, trauma and imaging. Psious, through its tools and interactive platform has been instrumental in treating mental-health patients.

This infographic powerfully explains some of the other application of VR in healthcare.

The Future

Inspite of the superb benefits and widespread adoption of VR/AR techniques, the technology is still in a very nascent stage in terms of application to a wider range of treatment regimes. It is under constant scrutiny for delivering clinical efficacy. We are at the cusp of an inflection point where we could witness the integration of VR with big data, predictive analytics and cognitive learning which will change the way healthcare is delivered. Let’s wait and watch. So far, people are still happy with their appointment with ‘Dr. VR’. Learn more about how AR & VR is transforming the healthcare industry.

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Healthcare had no records of patients’ history

Then one day… Health care became costlier and non-interoperable

It was a long day for the physician at the office. The desk is cluttered with clipboards, papers scattered all over, patients lining up outside the office – the physician just couldn’t manage available time between seeing patients and finishing off all the mandatory tedious administrative work. Most days, the physician has to spend hours at the end of each day ticking off “necessary” administrative tasks.

However, with the number of patients increasing every day and the claims paperwork gathering dust on the table, 24 hours suddenly didn’t seem long enough.

As soon as the physician entered the home, a weary look on the face made it clear that the old patient was in a fix. As it turns out, moments before physician returned, the patient had another encounter with an old running disease; a long running trouble. The patient had been looking to find a simple, hassle-free solution to this problem by seeing a specialist, on the recommendation of the regular doctor, and that one episode alone came with numerous challenges: contacting the doctor, sending medical records to the specialist, obtaining lab test results from a distant lab, and the biggest of all- bringing in multiple sets of relevant clinical information from various sources to give one complete picture.

The physician couldn’t bear looking at the patient’s strained face, struggling to understand the challenges along the way and trying to find a way to navigate this complex landscape that was healthcare. The physician began thinking about all that had been done and all that could be done. The physician tried to see every patient they could and guide them in the best possible way, they tried to keep errors on their end to a minimum, they strongly believed in communicating to their patients and following up to remind them about their visits and medications. The physician even made use of those EHRs, fellow health systems were using. Where did they come up short? What could possibly be done to make things better for the patient?

The physician kept pondering how the challenges the patient mentioned, could be troubling other patients as well. A patient’s clinical information was scattered and had to be brought in and put together to form a complete picture. Not only was that task manual, tiresome and time-consuming, it came with its own set of errors and redundancies. There had been cases where a single patient was registered under more than one record. Referrals had become as annoying and burdensome – locating a specialist, sharing vital patient information over a fragmented channel, exchanging lab test results and orders, documenting that information and update records yourself, etc.

Another major challenge was figuring out what to do after the patient has been discharged. Other physicians working with them often faced questions like, “how to follow-up with the patient for the next visit?”, “how to remind patients of their medications?”, “how to inform the health coaches and nurses of any recent developments?” and whatnot.

Then there were a new set of troubles. There were new laws and payment models that the administration had brought on the frontlines, and physician would have to comply with several measures, drive better care, and strive to outdo themselves.

The new scenario everyone was talking about – value-based reimbursement that aimed to put quality over quantity in healthcare was something the physician agreed with. However, if the challenges the physician just put on a mental list persisted, they would most often lose money. Not to mention how the quality of care will erode and the costs, skyrocket.

Physician jumped out to fight these troubles. High time something was done.

Physician walked through the brisk evening and went to a place a solution most definitely could be found. The sign on the door read, “healthIT.”

HealthIT, or as physician used to say, “health IT guy” was an eccentric scientist, though physician thought he was on to something. healthIT had hooked him up with several inventions, and physician was sure healthIT would have some solution to this new problem. A face looked out the door, breeze blowing away raspy hair- no one could imagine this person would have anything in a dingy apartment that could solve the issues physician was facing.

Physician began talking and told healthIT all about how healthcare was broken. How the care is disoriented, and there is no coordination in care delivery. There is data, a huge amount of data, but physicians and health systems fail to acquire it and derive meaning out of it well in time. Either physicians don’t have complete access to a holistic patient record, or there are duplicate records. If only there was a way to exchange and integrate data seamlessly, if only there was a way to have a vague idea about a patient’s future health based on present trends, if only risks and their effects could be determined beforehand.

HealthIT grinned, placed one hand on physician’s shoulder, and began the introduction of the futuristic world. HealthIT introduced physician to little, but significant ideas that had the potential to change how care would be delivered in the future. The future of healthcare would have comprehensive, end-to-end solutions that health systems could deploy; the one that took the incoming data from no matter how many sources, and integrate them to put together a holistic, 360 patient profile.

The future where physician wouldn’t have to worry about putting away three hours for documenting basic clinical and financial information; the one where physicians would have a clear idea of their patient’s health as well as the performance of their health system; the one where every vital information is shared and available easily, at the right time. A future where self-learning algorithms and powerful analytics do the heavy-lifting, leaving physicians to develop a one-on-one interaction with their patients. No episode could impair any patient with any amount of challenge – value-based care would only be a step away.

Physician couldn’t believe what was happening! HealthIT was beaming with satisfaction and optimism. Although physician had a doubt remaining, “HealthIT, I don’t think we have enough paper to make a note of all of this.”

“Paper? Where we’re going, we don’t need paper,” HealthIT grinned. “A click of a button and you deliver care at the doorstep, quality paramount.”

Mr. Abhinav Shashank, Co-Founder & CEO at Innovaccer, is an expert in population health management and robust technologies. For the better part of the decade he has been working to revolutionize healthcare delivery with 25+ value-focused organization and making over 10 million lives better. He has also spoken at numerous healthcare conference on the role of HealthIT in modern healthcare. You can reach out to him at: abhinav.shashank@innovaccer.com

LinkedIn: https://www.linkedin.com/in/abhinavshashank/

Twitter: @abhinavshashank

The post Back to the Future: The Future of Healthcare is Now appeared first on New Age Healthcare.

The post Virtual Reality Applications in Healthcare appeared first on New Age Healthcare.

Earlier in 2016, a baby in Miami was born with only one lung and half her heart. The doctors in Miami told the parents to not have any hope. Two months later the parents turned to a surgeon who agreed to conduct a surgical experiment which might save the baby’s life. He used a mobile app to create a virtual reality (VR) model of baby’s heart that was viewed from Google cardboard. Within virtual reality, the doctors could view the heart from every possible angle and could position the heart in relation to baby’s rib cage and other organs. The surgeon rerouted baby’s one ventricle so that it could effectively perform the task of a complete heart long term. Four weeks after the surgery, the baby is on the road of a full recovery. That’s the power of virtual reality (VR) and how it can transform the way healthcare is provided.

VR Applications in Healthcare:

Sample these couple of use cases. A middle-age woman in Jaipur, India is receiving exercise regime as part of the treatment for vertigo. But this exercise regime has a twist. It is delivered via virtual reality (VR) by NeuroEquilibrium – a super-specialty healthcare startup chain of vertigo and balance disorders clinics. Many patients who undergo exercises to treat vertigo often complain of heaviness in head and rocking sensation while performing those exercises. Application of VR with these exercises have reduced such issues considerably and patients can easily perform them at home without assistance. Patients, after strapping on a VR headgear like Oculus Rift or Samsung VR gear, are totally immersed in the experience.

MindMaze, a Swiss start-up founded in 2012, is using a combination of augmented reality (AR) and virtual reality, brain imaging and video games for rehabilitation of patients suffering from strokes and Parkinson’s disease.

Globally, even though widespread use of VR is visible in industries like entertainment and real estate, its usage in healthcare industry is in a nascent stage. VR’s application is mainly seen in performing complex surgery, training of healthcare professionals, diagnostic measures, physiotherapy, programs for reducing stress, anxiety and pain management. Learn more about healthcare companies which are making innovations in virtual reality.

Training of Healthcare Professionals:

Immersive virtual simulation is increasingly being used to train surgeons, nurses and other HCPs and this technique is pioneered by NHS in UK. With increase in patient awareness and demand for more experienced surgeons, trainee doctors are not able to get sufficient hands-on experience in performing major surgeries. Here VR comes to rescue and is used to train doctors in real-time scenarios providing valuable experience to them. Pre-programmed scenarios are used to help doctors train in real time challenging situations that they come across in an operation theater on daily basis. Very soon, VR devices such as Oculus Rift will be used in combination with the existing robotics and haptic technology to conduct the simulated operation while wearing goggles, transporting them into a virtual environment helping them to fine tune their motor skills. Currently, more than 20 specialist simulation centers across the UK are using these techniques to train medical professionals.

Future Growth:

A recent Goldman-Sachs report forecasts the market for AR/VR in healthcare, next only to gaming, will reach $5.1 billion by 2025. The report addresses the technology as disruptive and expects access to increase as price of production drops with widespread implementation in various healthcare domains. Clearly, this technology will be having many adopters in near future.

The post How Virtual Reality is Disrupting the Healthcare Industry? appeared first on New Age Healthcare.

PIC Healthcare, with its major focus on constantly improving patient care, has been a preferred choice and one of the leading suppliers of diagnostic systems. They plan to revolutionize the healthcare diagnostic and medical device market through the following introductions:

Heart Navigator: As the name suggests this helps cardiac surgeons to view live images of catheters and heart valve positions in real which will aid in effective and efficient device positioning such as required for heart valve replacement procedures.  It enables an automated planning to help simplify complex structural heart disease procedures by creating an excellent 3D image.

Tumor Tracking Application: This application is made to assist clinicians in detection, diagnosis, staging and monitoring of cancer by measuring patient’s tumor progression over an elongated period of time and thus provide more robust treatment planning. It provides comparison and in-depth analysis by measuring changes in tumor volume and metabolic activity which simplifies the treatment regime.

eICU Programs: It creates a single ICU hub, monitored by critical specialists, which will connect several remote hospitals’ ICU through bed side connected monitors and real-time video images of patient conditions. This will be a blessing in hospitals in a country like India where there is a shortage of skilled clinicians and other healthcare professional. Moreover, imagine the role eICU program would play in remote areas of India where majority of the population do not have access to best doctors and healthcare facility by creating a virtual ICU. Philips has installed this in few Indian hospitals and plan to expand its services in several others.

iDose⁴: This advanced iterative reconstruction technique allows radiologists to personalize image quality based on each patient’s needs with an enhanced image quality. More importantly, it reduces the radiation exposure of the patient to considerable extent thereby reducing the complications involved with radio-diagnostic procedures.  Watch this video to understand the advantages of iDose⁴.

These innovations by Philips Healthcare are here to improve quality of care and provide easy access to efficient healthcare to all. What are your views on it?

The post Transforming Healthcare Through Innovation appeared first on New Age Healthcare.