What does the Health Stack mean for you? Part 3 by Anukriti Chaudhari, @anukritichaudh2



The National Health Stack is a set of foundational building blocks which will be built as shared digital infrastructure, usable by both public sector and private sector players. In our third post on the Health Stack (the first two can be found here and here), we explain how it can be leveraged to build solutions that benefit different stakeholders in the ecosystem.
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Re-Imagining #EMR for India by Kumar Satyam, @kr_satyam



I was out of doctor’s room in couple of minutes with a scribbled prescription in hand, not very sure if the physician had actually understood my problem. Clinic’s pharmacist words gave me confidence “Doctor is very experienced, he can diagnose problems within a minute. You will get better in couple of days”.  

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How #telemedicine technology can reduce healthcare costs by Dr. Arjun Kalyanpur, @arjunkalyanpur

Studies have highlighted the multiple benefits that telemedicine lends to screening, including TB detection, PAP smear for cervical cancer and mammogram analysis for breast cancer.


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The case of #AI medical software regulation in developing countries by Dr. Sandeep Reddy, @docsunny50




Has the cart been placed in front of the horse? The case of AI medical software regulation in developing countries.

Medical software is defined as the use of software for medical purposes. The uptake of medical software in healthcare has increased in line with increased application computation in healthcare delivery. Examples of medical software include software used in bedside monitors, MRIs, PACs, radiation therapy software, infusion pump rate devices, smartphone-based health applications. Etc. 

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Data as an identity, diagnosis, health coach, drug and treatment by Prof. Rajendra Pratap Gupta, @rajendragupta

Electronic Health Records make data the identity for the patient. It can be in form of UHID or ADHAAR (in India). The data reveals the identity of the patient

Recently, I was in Bangladesh on the call of the Prime Minister’s office to speak on Big Data, Artificial Intelligence (AI) and to help draft the AI strategy for Bangladesh. I shared, that Big data is going to change the way we deliver healthcare, and how “big data combined with AI is not just data, but an identity, diagnosis, health coach, a drug and treatment when it comes to healthcare delivery”. It was based on the enormous possibility of what data & AI can do to healthcare delivery. 

Data as Identity: Electronic Health Records make data the identity for the patient. It can be in form of UHID or ADHAAR (in India). The data reveals the identity of the patient 

Data as diagnosis: According to Intel, AI in a single heartbeat can look at 10,000 attributes with 90 % accuracy and traditional methods look at 7 attributes with 56 % accuracy. Google’s AI algorithms help in diagnosing diabetic retinopathy. AI has been proven to be accurate in radiology for reading images and diagnosis. During the recent floods in Kerala, AI backed system, UptoDate was used by about 320 doctors in diagnosis and treatment. This solution has millions of cases in its repository and is used by clinicians worldwide, and the list goes on, on how Big Data and AI are helping in diagnosis. Big data and AI are increasingly being used as a diagnostic tool and its accuracy is of ‘clinical grade’ in specialties it has been used. 

Data as a health coach, a drug & Treatment: More than four years ago, I wrote an article on Software as a drug (SaaD) https://bit.ly/2TfWWDG 

Blue Star by Welldoc is a great example of how insulin dose can be calibrated by AI and does not need doctors. This mobile app for diabetes management is cleared by the US FDA, and it guides the patient to adjust the dosage of insulin with options of activity and diet (healthy choices with restaurant helpers), and provides with over 20,000 coaching messages and has been proven to reduce HBA1C by an average of 2 points between 3-6 months. This is considered a great achievement in the field of endocrinology. 

Need for an AI strategy: It is time that countries shape up their AI roadmap / strategy for every sector. Imagine if public hospitals in India like AIIMS, PGI Chandigarh, JIPMER, SGPGI & Tata Memorial feed in the daily OPD / IPD data and create an AI tool? How much the tool can help the ‘young medical graduates’ in accurate diagnostics and treatment? Today, timely diagnosis and treatment remains the biggest challenge in healthcare and it leads to over diagnosis and wrong treatment! With Ayushman Bharat covering over 500 million population, the data from this scheme can be used to create an AI tool in healthcare which can be shared with LMIC countries, and can serve as an important tool in form of healthcare diplomacy. Moreover, young medical graduate with such an AI tool with millions of cases in its repository will have the experience of a senior doctor with decades of experience when he or she uses an AI tool to diagnose and treat patients. Also, such a tool can prove to be a boon in rural areas as well, where people suffer the most.

In 2015, when I was writing a book on healthcare reforms (Healthcare Reforms in India – Making up for the lost decades), I did a survey with patients of RML & AIIMS and it was revealed that, patients visit an average of 6 doctors before visiting AIIMS, and add to this, the fact, that the reason for their AIIMS visit is, ‘treatment failure or not diagnosed’ from the earlier facilities or doctors visited! Moreover, it is not possible for everyone in India to reach AIIMS, Delhi or Tata Memorial in Mumbai. In such a serious situation, it makes sense for India to invest in developing an AI tool based on patient’s data in public healthcare facilities, and the patients covered under Ayushman Bharat. Also, this data can be used for fraud detection. 

AI is likely to create jobs and add to the economy. If India builds a proper AI strategy, it needs to look at the following components; Data storage, data security, data transfer, certifications and compliance, and each has the potential to add billion dollars to the economy 

Components of AI strategy: India needs a detailed roadmap for data storage, networking infrastructure, data governance, Sensors & IOT, training and human resources & research and development 

Big Data & AI hold a lot of promise for outcome driven healthcare which is accountable and affordable and India must aim to be a global leader in Big Data & AI.

(Prof. Rajendra Pratap Gupta is a leading public policy expert and is a former advisor to the Union Health Minister, Government of India ) 

The article was first published here, its republished on the HCITExperts Blog, with the author's permission

Author
Rajendra Pratap Gupta
Rajendra Pratap Gupta (Rajendra) is an original thinker and an innovator and one of the most influential and sought after public policy expert in the country. He has worked with some of the largest organizations across the world and was nominated to the Global Agenda Council of the World Economic Forum for 2012-2014 in recognition of his work.

He was conferred; 'Global Healthcare Leader of the Year' award in 2012 by the sheriff of Los Angeles; named the 'Thought Leader of the Year' three years in a row by ICT Post; Featured amongst the ’25 living Legends of Healthcare in India’ and is listed amongst the “100 Most Impactful Healthcare Leaders”.
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Data Analytics for cell and gene therapy by Dr. Ruchi Dass, @drruchibhatt



Cell and gene therapies are becoming more and more popular because of encouraging clinical results worldwide. Major pharma manufacturing companies have invested in the concept's commercialization worldwide. Recently, we read about Takeda’s license for commercialization of Aloficel (developed by TiGenix), Celgene’s acquisition of Juno Therapeutics or Gilead’s acquisition of Kite Pharma.

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Helping healing via the HORIZONS, The Tata Trusts Magazine

An ongoing transformation of Nagpur’s urban primary health centres has made affordable medical care more accessible to people

The patients sitting in the freshly painted waiting room have Amitabh Bachchan for company, even if it’s only a video of the movie star — with a message on measles vaccination — playing out on a television screen behind the reception desk. Red signboards provide an attractive pop of colour amidst the off-white walls. The well-appointed space could be part of a private hospital … except that it is not. It is the new look of a government-run urban primary health centre (UPHC) in Nagpur that has undergone a radical upgrade.

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