Improving Health in India: Putting People First

Chronic diseases are soon going to become the No 1 killer in India and just building more hospitals and training more doctors will never help us to tackle this growing menace. The only long-term solution is to rely on the one resource which is almost inexhaustible—the people themselves. Within its one billion people lie India’s greatest untapped resource for combating the rise in chronic disease and for reducing its burden.

This proposal presents a sustainable plan to engage millions of at-risk individuals in the state of Maharashtra (population 100 million, capital: Mumbai/Bombay) to adopt prevention, monitoring and self-management behaviors which will significantly reduce the burden of chronic disease in India .

The Goals and Objectives

Patients should be the true experts on their own chronic diseases and expert patients are those who are able to take more control over their illness by understanding and managing their disease, leading to an improved quality of life. Unfortunately, even though Information Therapy – providing the right information to the right patient at the right time – can be powerful medicine, patient education has been sadly neglected completely in India .

We plan to set up a network of ten consumer health resource centers established at hospitals and retail malls will provide a real-world cluster for the program. We will use these as a showcase for the program; a place to evaluate its impact on patients; and a place to influence medical students , doctors and policy makers on the importance of chronic disease self-management.


The Plan

Over the next 3 years, we will set up 5 hospital-based patient education resource centers in Bombay and Pune. Hospitals have a captive population of patients and their family-members, who are highly motivated to seek information about medical problems.

We will partner with corporate and government hospitals to do so. Hospitals will provide us the space; and we will offer them a free value-add service which would help them to attract more patients and improve the quality of care their provide to their patients. Each library would have a core collection of about 1000 books; and a network of 5 computers connected to the internet to help patients search for information. Each library would have trained staff to help people look for information relevant to their needs ( librarian-mediated information therapy). We will also setup 5 mini-libraries at a chain of health and wellness centers located in malls , in partnership with retail health chains . This will help us to attract a large number of footfalls and spread awareness in the community about our activities.
This cluster of libraries will serve as the real-world hub of our activities. They will be used to empower patients to form self-help groups; and will also serve as reliable sources of information on chronic diseases for journalists and media.

In order to be useful, information needs to be provided at the “point of use”. We will develop a health knowledgebase ; translate this into Hindi and Marathi; and develop innovative methods to deliver this to patients in their homes, through the mobile and the web. We will provide patients with a free PHR ( personal health record) developed by our partner, YosCare ( www.yoscare.in). Patients who suffer from the same illness can form online communities and interact with each other using Web 2.0 social networking tools. The PHR will also help patients with a chronic illness to get second opinions and remote consultations ( for example, if the patient develops a complication and needs an expert re-assessment), thus making more effective use of limited specialized medical resources. We will use the mobile phone to provide real-time information and feedback to patients to support improved medication adherence.

We will also publish patient educational materials in the major Indian languages in multiple formats, including: books; leaflets and CDs and DVDs. Multimedia materials would be developed by our partners, Infoseek Media ( some of these videos are online at http://www.drmalpani.com/health-videos/.)


Working with the Government

Since we offer our basic services free of cost , it will be easy to forge partnerships with the Health Department of the Bombay Municipal Corporation and the Maharashtra State Government . We would set up additional mini-libraries in Government Hospitals, at no cost to the government ; and also provide the government with authoritative patient educational materials in Hindi and Marathi.


The Policy Model

o The Government has agreed to champion public-private initiatives in order to improve healthcare services to Indians, and our proposal fits in very well with their model
o Support from the media. HELP has a tie-up with the Times of India Foundation, the publisher of the world’s largest English newspaper, and this will help us achieve the needed publicity
o Support from health insurers. Health insurance has recently become privatised in India ; and this is a huge market which needs to be addressed. We will partner with health insurance companies to help their clients to manage their diseases better.
o Support from retail chains. With the opening of the retail industry in India, many large players are now setting up specialty health and fitness stores to sell fitness products and healthcare services and we will use this platform to reach out to the community
o Well-informed patients will demand better healthcare services ; and this will act as a catalyst to improve the quality of care the healthcare industry provides them