Friday, December 02, 2016

How medical colleges can improve healthcare in India



There is no doubt that the municipal corporation teaching hospitals such as KEM, Nair and Sion are brilliant medical institutions. I've been trained at them , and the clinical training is excellent because there are so many patients who throng to these hospitals for their treatment. They do an outstanding job, especially when you consider the constraints which they have to operate under. Thus even though their bed capacity may be 2000, they will often have a far larger number of inpatients ( many of whom are nursed on a mattress on the floor ) because they don't turn any patients away.

While they are doing a great job, there's plenty of scope for them to do even more.

The biggest strength of a teaching hospital is its human capital - their medical staff . At present , this is being underutilised, because they are only being used within the hospital .They have so many renowned leading medical teachers and professors , who should be producing Indian language patient education materials, which should be shared online. This will allow them to reach out to people in their homes, through their mobile. By providing them with accurate, reliable, local language information, we can help patients to get better medical care. Sadly, the opportunities for reaching beyond the four walls of the hospital are being overlooked.

It's not just the medical professors - it's the medical students and residents as well. These junior doctors are hard working, but all they seem to be forced to do is cram for their exams, so that they can pass these. Why can't they be used to create clever apps to help doctors to reach out to patients in their homes. If we can go to there the patient is, we don't inconvenience patients ; and we don't overload hospital facilities by forcing patients to come to hospitals. We can use telehealth to amplify the expertise and experience of the hospital's medical staff. This is good for the students as well, because it will increase their clinical exposure , and they will be able to learn a lot more "real life" medicine, rather than stuff their heads with the exotic illness and rare diseases which hospitals attract. It will also help them to become more empathetic, because they are reaching out to patients, rather than limit themselves to the comfort zone of the hospital.

These apps can be used for triage; combined with the ability to talk to a doctor live, as needed. This will be much more convenient for the patient , who will then not have to wait for hours , waiting to be see in the hospital OPD. This will be much more cost effective as well, because the corporation won't have to spend so much on each patient. The truth is that lots of the problems which cause patients to seek medical attention are simple problems , which can be solved in the comfort of the patient's home, without the patient actually having to come to the hospital.

This is a great opportunity, and the numbers which you're talking about are mind boggling. Technology can be used to connect hundreds of medical students, residents and doctors with the millions of citizens who live in Mumbai.

The problem is that we still are stuck with an archaic top heavy model , where everything seems to revolve around the hospital , and the tertiary care facilities it provides. We need to flip this model around, and think about what we can do to make sure that patients don't need to come to the hospital in the first place.

These hospital should partner with the IITs and IIMs to create medical entrepreneurs, where the next generation of doctors can cope up with clever out of the box solutions , adapted to Indian needs.
Health insurance companies should be happy to fund these efforts, as they can use these to improve their outreach activities.

4G is now easily available, and most people have mobile phones. Why can't we make use of these new options so that we can provide care in a new format which is much more patient friendly ?

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