Complex problems often have simple solutions. A team of young software engineers,designers and developers from six continents and working under the leadership of a US-returned doctor-scientist believes this adage can help resolve the myriad problems of Indias health-care system.
Dr Surajit Nundy,MD and PhD from the United States,works out of a two-room office in Hauz Khas. Since he returned to India in 2009,he has been trying to develop a software to help maintain detailed Electronic Medical Records (EMR). The procedure has been open-sourced,and designers from San Francisco,Germany,Colombia,Singapore have chipped in.
Over the last month,the EMR software has been made available free on the web,with an iPad application. Complete with separate modules on lab reports,out-patient appointments,X-ray and other imaging records,and a pharmacy section,the software works as a one-stop shop for maintaining ones medical history,which can be accessed on any smartphone. The software has been named Raxa software,after the company Dr Nundy formed.
The journey,Dr Nundy says,began with a simple question: What does any patient expect from a doctor at a fundamental level? The answer,he says,lies in accurate information delivery and dispensing. When patients go to doctors,they want that information about their health problem is taken accurately,processed,and some additional information that helps resolve their problem is passed on. With widespread access to smartphones,this information is now just a tap away. And access to accurate and detailed database of medical records,Dr Nundy feels,can empower people like nothing else. So,we are not drastically increasing expenses on goods or manpower,because we have a shortage of doctors. We are instead using technology to find solutions, he says.
In the last month,about 100 people have voluntarily registered their records,and an equal number of doctors are being roped in. Google is providing online support for the software access. Records of slum dwellers near Chawri Bazaar and villagers from Chhattisgarh have been created on the software. In the future,Dr Nundy says,Raxa can hold the key to telemedicine,removing the need for the doctor to go to the spot.
Over the last two months,the team has been trying to form a consortium of private health-care providers,pharmaceutical companies,NGOs working on community health,representatives of the Health Ministry,and officials from the UID,to promote exchange of medical records across platforms through this software. The response so far has been very positive. Our basic idea is that we want to try to promote exchange of medical records between different hospitals and pharmaceuticals every provider a patient seeks, he says.
While some private hospitals have their own EMRs,patients usually do not have access to electronic records,and generally there is no sharing of records between hospitals.
Designers have made special efforts to ensure that the software is a thinking one. If a doctor is prescribing certain drugs,which the patient with an underlining problem like a history of high blood sugar should not take,the software will warn the doctor. Similarly,if there is a disease which is commonly misdiagnosed,the software will send a warning with a database of published medical literature that explains the reasons and necessary checks, Sathyan Velumani,the lead designer says. Susan Wolfe,a software designer from the US,heads Raxas design team.
For the rural sector,special steps have been taken to send voice reminders on phones to improve compliance. An instruction for a patient says: Din mein do baar lal dawa jo ki narangi packet mein hai khani hai. Dawai ko bachchon aur garbhwati mahilaon se door rakhein. (Take the red pill in the orange packet twice a day. Keep it away from children and pregnant women).