Wednesday, April 29, 2015

HEALTH SPECIAL................... Health is a call away

Health is a call away


The Piramal Foundation helpline uses the ubiquitous mobile phone to touch lives in rural India.
Since 2007, the Health Information Helpline has extended to a complaint redressal system, clinical and psychological counselling, anti-addiction helpline, mother-and-child tracking system, and India's only AIDS awareness helpline.
29 million calls (that's more than the population of some countries) addressed in the HIHL's existence have not merely enhanced convenience; they have helped avert more than 950 suicides and nearly 15 million outpatient visits.


I have a short-term solution for all us urban ites who complain till kingdom come each time we feel miserable with something as basic as a cold. We only need to remember that in rural India, about half the population has no access to healthcare, and over threefifths need to commute beyond 5 kilometres to reach a healthcare centre.
I also have a solution for all those who crib each time the domestic support staff (we called them `servants' once) falls ill and we have to pay for their treatment. Poor rural patients receiving private outpatient care for chronic conditions spend an average 44 per cent of their monthly household expenditure per treatment. The result is that a number of them don't just fall ill; they become indebted as well.
The Piramal Foundation recognized this inequity and did something about it ­ a comprehensive primary healthcare solution touching the lives of rural Indians through a complement of initiatives. Their Health Information Helpline is what I will discuss in this column.
What makes the helpline different from similar initiatives is the delivery backbone ­ the means by which Piramal Foundation reached the remotest corners of this country without blowing resources on overheads. The foundation turned to that ubiquitous trusted complement of our daily living ­ the mobile phone.
The Piramal Foundation recognised that the mobile phone could help faster than most conventional healthcare service providers. It could reach everywhere, connect in seconds, understand patient needs and administer solutions ­ in less time than a villager would have taken to reach the bus stop to go to a healthcare service provider.
Overnight, Piramal's network could be everywhere a mobile phone reached. The harder a telecom service worked, the wider Piramal's health footprint became.
This is how Piramal's health helpline is structured at the back end. The service is driven by a call centre. The service comprises trained counsellors, paramedics and doctors who respond telephonically to medical queries. The interaction is facilitated by a sophisticated computer based template programmed to “comprehend“ a patient's medical reality on the basis of questions asked and answers provided. The result is that when a call centre executive plugs basic details, the “intelligent“ computer throws up the right prescription.
Critics have argued that such a service has downsides. How can the “computer doctor“ get it right each time? Piramal's answer is that the service addresses primary healthcare needs, the bulk of which concern headache, cough, cold and viral infections. These ailments have been so comprehensively mapped for symptoms and probable remedies that there is no satellite science in being able to recommend a paracetamol or analgesic.
The result is that this combination of technology, core medical knowledge and commonsense has helped create one of the widest and deepest networks delivering primary healthcare.
What is fascinating is how the extension of an urban service in a rural setting has transformed realities. Over the years, rural patients have moderated the need to travel long distances and expend precious resources; a solution can be competently delivered in a fraction of the time, effort and cost by the simple leverage of the country's telecom network.
You would think that the service would end with this simple telephone call. Interestingly, when you encounter a voice at the other end that is as patient as it is caring, you start talking. You feel you have found someone you can trust. You feel that a “doctor“ at the other end understands you. You feel the world is sympathetic. And that is how this simple telephonic service has evolved: it is no longer seen just as a functional service provider; it is seen as a “friend“ at arm's each; it is a confidante to those needing an inducement to consume their prescribed medicines; it is seen as the unseen guide to issues that may extend from the medical to the social.
Since 2007, the Health Information Helpline has extended to a complaint redressal system, clinical and psychological counselling, anti-addiction helpline, mother-and-child tracking system, and India's only AIDS awareness helpline.
The Health Information Helpline operates 24x7 across seven states. All patient details are recorded electronically. Medically validated algorithms and disease summaries provide a valuable building block of prevailing realities, around which paramedics and doctors deliver competent and reliable medical services. The service is supported by 200 full-time doctors and 1,000 qualified paramedics.
I have a different way of looking at this: the 29 million calls (that's more than the population of some countries) addressed in the HIHL's existence have not merely enhanced convenience; they have helped avert more than 950 suicides and nearly 15 million outpatient visits. Commend this service only for its environment-friendliness, even if you don't get the full import of its sweeping therapeutic impact.
MUDAR PATHERYA

MM20APR15

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