Their front end essentially resembles the cold drinks/potato chips dispensers one sees at airports. What they will dispense, however, is free drugs based on a prescription — unless they refer the patient to a doctor.
Five healthcare ATMs have come up in four states — MP, Himachal Pradesh, Odisha and Andhra Pradesh — under a Health Ministry pilot that combines telemedicine with a rudimentary free drugs programme. The ministry is hoping these would tide over the massive shortage of doctors in the country and also the risks of pilferage that free drugs programmes are fraught with.
Each ATM will be manned by a multipurpose public health worker (MPHW) or an auxiliary nurse midwife (ANM) armed with a multi-parameter patient vital monitor and other devices required for checking basic health parameters. After the patient has been registered, these indicators would be transmitted to a medical call centre through a GSM-based monitor. For starters, basic health parameters such as temperature, blood pressure, blood glucose and blood haemoglobin will be checked and the data instantly transmitted.
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At the call centre, doctors will evaluate the condition of the patient — and if necessary talk to him or her — and decide whether the person needs to be referred to a centre where a doctor is available or whether can be treated locally with medications. In the latter case, a prescription will be generated and a command given automatically to the ATM to dispense only the drug prescribed, and no other. The MPHW will explain the dosage to the patient. And in case urgent referral is required, the 108 ambulance service will be made available at the sub-centre.
With 5 to 8% of India’s rural health centres running without a qualified medical practitioner, these ATMs are meant for such centres. India currently has 0.51 doctors per 1,000 population, half the 1:1,000 ratio recommended by World Health Organization. Rural India’s ratio is 0.63 per 10,000.
Studies have also shown that 80% of all out-of-pocket health expenditure in India is on drugs, of which 70-80% are for patients who have not been hospitalised. Given the wide variations in prices of the same drug depending on the brand and various other factors that come into play in the private sector, the only way for the government to dispense drugs is if the prescription comes from someone in the government sector. Hence the decision to try out the ATMs.
The concept of an ATM for healthcare, where the machine is essentially a patient portal that delivers a limited set of medical services, is catching on across the world and being tried out in various forms. While commercial versions have a built-in payment option, the one the ministry if trying out will be free for the patient, sources said.
Initial reports of how the first five machines are functioning are yet to come in but the ministry hopes it will take care of some of the common ailments, at least, and reduce not just morbidity but also the rush at community health centres and hospitals.
Technical support is being provided by the division of healthcare technology, National Health Systems Research Centre.