Why India needs Healthcare Information Technology (HIT) by Dr Pramod D. Jacob


India with its vast population of over 1.3 billion firstly has a challenge in keeping a track of this vast population’s health, much less keep them healthy.  One of the major reasons for this is lack of timely, accurate and reliable healthcare information in today’s paper world

State of Health in India

In healthcare India ranks very poorly, even compared to our neighbouring countries. For example in the following health indicators: –

Maternal Mortality Rate (year 2015): defined as number of women who die during pregnancy and childbirth, per 100,000 live births. India has a rate of 174 maternal deaths per 100,000 live births, which is worse than Bhutan (148 /  100,000) or Sri Lanka (30 / 100,000 ). China which also has a large population is much better (27 / 100,000) 

Infant Mortality Rate (year 2017): defined as number of children who die less than one year of age per 1000 live births. In India the figure is 39 per 1000 live births, behind Bangladesh ( 32 / 1000 ) and Nepal ( 28 / 1000 ). China is 12 / 1000.

State of healthcare information collection for events like epidemics in India

Before 2010, it would take about six months for the health information to be collected, collated and analysed to prove that a given region in India had an epidemic as the entire process was paper based. By that time the disease (with most being self-limiting) would have struck, had its toll of morbidity and mortality and run its course. With most data collection being paper based this delay costs India loss of lives and productivity with high morbidity, especially in rural areas ( in urban areas- private hospitals and clinics have a process of notifying the public health authorities for notifiable diseases, hence epidemics are identified earlier in urban areas) .

To top it all there is general disbelief in the official published health statistics in India. For example, official data claimed that Malarial deaths in India was only 1,023 in 2010, however a Lancet published study showed the figure to be actually 46,800. Following the Lancet article, the official data agreed that they had their figures off by twenty to thirty times.  Even for a common disease like Cholera, which strikes every monsoon in endemic areas along the Ganges and Brahmaputra, the official estimate for India is 3,631 cases per year, while research has shown this to be about 22,200 per year.   

While the immediate reaction is to blame the public health authorities and Government in India, one must understand the limitations in a paper world to collect health information of 1.3 billion people across 3,200,000 square kilometres. Compare that to collection of information electronically – an electron can travel around the world in about 19 seconds. 

The solution – Healthcare Information Technology (HIT)

The solution is to produce healthcare information in a timely manner with accuracy and reliability. To achieve speed, it is best to do so with Information Technology – hence HIT. To achieve accuracy and reliability, it is best if the patient’s data is put into the HIT system by the providers of healthcare such as doctors, nurses, pharmacist etc at the point of care. This patient level data can then be collated and processed to get timely, accurate and reliable population-based healthcare information.

 In addition, HIT systems provides the power of IT to healthcare such as giving alerts for drug-drug interactions, duplication in lab tests and bringing about efficiency in processes and workflows in a healthcare setting, producing reports quickly which will help in planning and deployment of healthcare. It is estimated that healthcare doubles in knowledge every few months and it is difficult for doctors to keep up. With HIT it will be possible to keep up with the latest and deploy best practice evidence-based medicine applicable for India.

The proof of HIT bringing exponential improvement in speed and access to important healthcare information like epidemics even in Indian public health, is best exemplified by the IDSP program. The IDSP program has gone digital from district level upwards to state and then to the National Centre for Disease Control (NCDC), Delhi. As a result, the NCDC now publishes data on epidemics and events on a month to month basis and will soon be publishing it on a weekly basis. Will cover the details of this program in a future write up. 

This article has been republished here with the author’s permission. The article was first published here.

Author
Dr Pramod D. Jacob (MBBS, MS- Medical Informatics)

After completing his medical degree from CMC Vellore and doing his Master of Science in Medical Informatics from Oregon Health Sciences University (OHSU) in the US, Dr Pramod worked in the EMR division of Epic Systems, USA and was the Clinical Systems Project Manager in Multnomah County, Portland, Oregon. He has been a Healthcare Information Technology consultant to Benton County, Oregon and Santa Cruz County, California. In 2007 he relocated to India and did consultancy work for the state governments of Tamil Nadu and Himachal Pradesh. He was a member of the HIMSS Global EHR Task Force and the lead for India in the task force.

At present he is the Chief Medical Officer of dWise Healthcare IT solutions, involved in the designing and implementation of Clinical Information Systems and the EHR for the company. He is also a consultant for WHO India in the IDSP project and for PHFI for a Non Communicable Diseases Decision Support Application.

Advertisements

KPIs on fingertips – Healthcare by Jyoti Sahai @JyotiSahai


During a recent conversation with the CEO-Doctor of a multi-specialty hospital our discussion veered towards how data-driven decision-making using analytic insights could benefit the hospital. His response, typical of most of the CEOs (for that matter from any industry) was – Oh! I really don’t need any analytics! All the facts I need to run my organization are on my finger-tips!



My takeaway from that conversation were the two keywords ‘facts‘ and ‘fingertips‘! For running a successful organization, you do always need to have near real-time relevant and critical (may be up to ten, one for each fingertip!) facts on what is happening within the company. However, just the facts (measures) may not always be sufficient to arrive at a decision unless those are benchmarked against the desired performance and/or trends over different periods for those measures. Deployment of analytics enables the stakeholders to have that additional edge over the decision-making, by making the exercise based more on validated data than just a gut feeling.

That set me thinking on what could be those top key performance indicators (KPIs) which if available on fingertips (at the click of a button) could aid a CEO in achieving the organizational objectives more effectively, and what could be the ones relevant for a hospital CEO!   .
I presume that any hospital CEO’s top priority is to strive to earn the patients’ trust, and that is possible only if the hospital could meet and exceed patient expectations.

Meeting the patient expectations

What a patient expects from the hospital is a treatment that is effective, timely and fair. The following KPIs keep the hospital CEO and other stakeholders informed on how effectively that is happening?

Treating the patients effectively …

The top hospital stakeholders should be worried if higher % of patients who have been already discharged (whether out-patients from day-care or inpatients with hospital-care) return to hospital for re-treatment or re-admittance for the same ailment. That will show that either the initial diagnosis was flawed, or some critical elements were missed out while administering the treatment. Either way it would be matter of great concern for the hospital CEO, who should always be aware of the Re-admittance Index – % of discharged patients who required re-treatment or re-admittance.

... and timely …

One of the most critical performance indicator within a day-care hospital is the TAT, the turnaround time – the elapsed time between entry of the patient in the hospital (registration) and start of consultation of that patient by the physician. Other important TATs that are tracked within a hospital include – for a test being conducted, the elapsed time between the ordering of the test till the report collection, and most importantly for an inpatient, the elapsed time between the decision to discharge and the actual vacating of the bed. Inordinate delays in these lead to irritated patients, increased costs, and avoidable queueing issues too. Typically hospitals set internal benchmarks, or compare with any available industry benchmarks, to track the various TATs. In case of inordinate delays, hospitals could carry out a root cause analysis and take preventive and corrective actions.
What any hospital CEO should strive for is that the TAT Index for any given period is less than 5%, that means not more than 5% patient-visits experience a delay beyond a set benchmark in treatment or in discharge.

… and fairly …

I remember once a CEO of a hospital was concerned about if any of the eleven consultants in the hospital were at any time prescribing investigations and/or medicines that were not warranted for the observed symptoms and the medical condition of the patient. Periodic audit of all prescriptions comparing those prescriptions with a defined set of rules (lines of treatment) for corresponding symptoms will give a fair idea of the deviations if any. What a CEO has to do to control it, is to always ensure that the Unfair Treatment Index (% of possible deviations from an appropriate line of treatment) is kept below the minimum acceptable tolerance benchmark.

… and thus earning patients’ trust!

A hospital may expect that it has earned a patient’s trust by providing treatment that is effective, timely and fair, but it can really know that for sure by arriving at the Patient Satisfaction (P-SAT) Index only. P-SAT can be derived by analyzing the feedbacks received from the patients, results of internal surveys, and the comments (adverse or commending) on the social media. A prudent CEO always depends upon the P-SAT Index to accurately gauge the extent of the hospital’s success and reputation.
We have now understood that patients’ trust can be earned by providing effective, timely and fair treatment. However none of that is possible unless the hospital itself is run efficiently and profitably.
How does the CEO keep track whether the hospital is run efficiently?

Managing the hospital operations efficiently

For meeting and exceeding the patients’ expectations it is imperative that the hospital operations including administrative and clinical processes are efficient and stable. Primarily it means that the all the hospital resources are used optimally, and are available for use when needed. The above-mentioned TAT Index is one such KPI. The following other KPIs too provide an indication of a hospital’s operational efficiency.

Are the resources and infrastructure used optimally?

Hospital resources and infrastructure, if not used optimally, lead to lost opportunity, frittering away of resources, and most importantly increase in operating costs. The Management has to ensure that the various Wards, Operation Theaters, Labs, and various equipments, and even the service providers (human resources) are available for providing service to the patient when needed. Out of these various parameters, tracking of the bed utilization (% of hospital beds occupied at any given time) is considered very critical for any large hospital as it has a direct impact on the efficiency of that hospital. A consistently low bed utilization could mean among other things, either faulty planning (resulting in over-investment) or a low P-SAT. On the other hand a consistently high bed utilization could lead to severe strain on resources and maybe result in declining quality of service.
Thus it is imperative that the hospital CEO constantly monitor the Bed Utilization Index.

Are the patients kept in hospital for a period that is necessary and sufficient?

One of the most critical KPIs for a hospital is the Average Length of Stay (ALOS) of inpatients for specific types of ailments or procedures carried out. The hospital could compare its such averages with either the industry benchmarks, or internally set benchmarks. For example assume that for a specific operation procedure (including the pre-operation and post-operation in-hopsital care) the ALOS is 6 days. If elsewhere in the industry the ALOS for the same procedure is 7 days, that will mean either your administrative and/or clinical processes are more efficient than others or you may be missing out on some necessary hospital-care (a point not in your favor). On the other hand if the ALOS elsewhere is 5 days, that will mean either you are providing some additional necessary services that others are not offering (a point in your favor) or your treatment more often is less efficient (your processes take extra time and/or resources for the same procedure).
Either way the CEO should keep a close watch on ALOS to optimize the services provided under the various procedures offered by the hospital.
However, even an efficiently run hospital having earned it patients’ trust to may fail if it is financially weak.

Monitoring the financial health of the hospital

For a hospital to ensure efficiency in its operations, it is imperative that its finances are stable and profitable. Without that the hospital will not be able to sustain its efficient operations for a longer period. It is the hospital CEO’s prime responsibility to ensure that that does not happen. The hospital CEO can depend upon the following KPIs to keep a check on the financial health of the hospital itself.

What is the hospital’s margin on an average for each patient-visit?

Whether you are an individual or an establishment, the universal fact remains that you cannot consistently spend more than what you earn if you have to sustain financially in the long-term.
What is critical for the hospital Management is to know what is the hospital earning on an average for each visit that a patient makes to it for treatment. Once ARPV is known for a period, and is compared with the average cost of operations for that period (ACPV), the hospital CEO knows whether the hospital operations at the current levels are sustainable or not.
Trends of ARPV and ACPV over a period give sufficient insights to the CEO to arrive at fair pricing of services, and take steps to manage optimal utilization of resources.
However a strong ARPV or a manageable ACPV alone will not be sufficient for financial stability unless the cash management is also strong.

Are the insurance claims being settled in time by the insurance companies?

Once a CEO of a 100-bed hospital was complaining that though he knew that the hospital had been having a strong revenue stream during that period, he was finding it difficult to pay on time for even the relatively small purchases made for materials and services. Why was that? A quick look at the hospital accounts revealed that (as is typical of all medium-large hospitals) almost 75% of the hospital revenue was derived thru insured patients, provided care under cash-less treatment schemes. It was also found that a substantial portion of that money was blocked in over-due claims submitted to the insurance companies and remaining outstanding for various reasons. That meant that the cash-flow was heavily dependent upon the timely settlement of insurance claims.
Any prudent CEO keeps a tight watch on the number of days claim outstanding (DCO) with the insurance companies; monitoring closely the TPAs – Third-party Administrators – ensuring that the claims are settled by the insurance companies as per agreed contractual terms. Timely settlement of insurance claims results in improved and predictable cash-flows and strengthens financial stability.
A hospital CEO may track the above-mentioned KPIs and ensure that the hospital is earning patients’ trust, and is operationally efficient and is financially stable too. But the litmus test of a hospital’s reputation and success is when its performance is compared with its peers, the other similar hospitals in the geography or with the same specialization.

Where does the hospital stand when compared with its peers?

Several independent agencies periodically rank the participating hospitals based on various performance factors, and the ranking could be geography-wise, type of hospital-wise, or specialty-wise.
For a CEO it is imperative that whichever ranking is most important for the hospital is thoroughly analyzed, and a proper strategy to improve/maintain the ranking in future put in place.

In conclusion

How does the CEO keep track of the above-mentioned top KPIs? The CEO’s Dashboardcould display the current status of the KPIs, available at any time at the click of a button (literally putting those on fingertips). A typical dashboard containing the critical KPIs could look like as shown below:
(The numbers and the traffic-light shown against each KPI in the dashboard are for illustration purpose only and do not represent any industry benchmark or desired value)
The above list contains the typical KPIs critical for gauging any hospital’s performance on various operational and financial parameters. However depending upon the criticality for a particular hospital, different and more relevant KPIs could replace those less relevant for that hospital.
By design, I have not included any KPIs or insights produced by clinical analytics, as those will be specialized and specific to each individual hospital.
My suggestion is that let the CEOs use their fingertips for recalling critical tricks of their trade and expertise only, and let an analytics system recall the KPIs for them whenever needed for reference!
[Glossary:
ACPV – Average Cost per Patient-Visit; ALOS – Average Length of Stay; ARPV – Average Revenue per Patient-Visit; DCO – Days Claims Outstanding; KPI – Key Performance Indicator; P-SAT – Patient Satisfaction; TAT – Turn-around Time]

Note: A version of this article also appears in my blog gyaan-alytics and more…

Author
Jyoti Sahai

Jyoti Sahai has over 42 years of experience in banking and IT industry, and is currently the CMD of Kavaii Business Analytics India. Kavaii provides analytic solutions in Healthcare and IT Services domains.

#DigitalHealth as a tool to Protect the National Health Protection Scheme by Dr. Oommen John @oommen_john


Author: Dr. Oommen John, Date: 12/02/2018

Digital Health would have a pivotal role towards efficient implementation of the National Health Protection Scheme announced in the #budget2018.


Healthcare related costs is one of the leading cause of impoverishment in India. In recent times, there has been a growing “trust deficit” between the consumers of healthcare services and the care providers.


The Budget 2018 announcement of ” #Ayushman Bharat ” aimed at financial risk protection from catastrophic healthcare expenses is a clearly articulated strategy towards providing Universal Health Coverage and India’s march towards achieving the UN sustainable development goals #SDGs.
Government sponsored health insurance schemes in India have run into the risk of becoming scams in the past, where the availability of insurance cover have been an incentive to perform investigations and procedures that were perhaps clinically unnecessary and in some cases physiologically impossible, such as males having their uterus removed ( procedure called hysterectomy, when one thinks of a male undergoing the same would roll hysterically !) and worse still these procedures being reimbursed by the insurance providers under the government sponsored schemes. 
There is an urgent need to empower the citizens to make informed choices and participate in shared decision making process. The National Health Portal has a wealth of information around health conditions and tools that aim to empower the citizens towards informed choices around health, there has also been concerted effort to make these available in regional languages.
Also, since a significant provision of secondary and tertiary care is in availed in the private sector, seamless referral mechanisms between the primary healthcare systems (which are mostly in the public sector and closer to where majority of the rural communities live) and the specialized private healthcare establishments would be fundamental to the successful implementation of the National Health Protection Scheme #NHPS.
The frontline healthcare workers empowered with #electronic health records of the populations they serve and using #clinical decision support tools could serve as the gatekeepers to triage and refer those needing higher level services into the healthcare delivery institutions. #electronic tracking of the referral would not only ensure that the healthcare delivery systems are not overwhelmed with sudden influx of a large number of patients wanting specialized services that the current healthsystems are ill-equipped to deliver but also serve as a regulatory mechanism for these well intended schemes from being misused and protect the vulnerable citizens from being exploited and their organs being sacrificed at the alters of greed (akin to the killing of the golden goose). Any well intended scheme is a potential scam unless robust mechanisms prevent them from being misused.
Health Systems generated Electronic health records or better still patient held electronic health records such as MyHealthRecord as envisaged by the ministry of health and family welfare along with functional regional and central health information exchanges would be the backbone for the national health protection scheme to be efficiently operationalized.
Currently, most insurance linked health care provision is administrated through third party agencies, while few of the government insurance schemes are cashless, Ayushman Bharat is an immediate opportunity to scale up #digitalhealth based real-time health insurance handshakes that enable citizens to avail the benefits of this scheme without being pulverized in bureaucratic pain in addition to their physical pain from undue delays for “preauthorization” before they can avail essential healthcare services.
The implementation plan of the #NationalHealthProtectionScheme is an opportunity to leverage #designthinking concepts and establish thought leadership towards integrated people centered healthcare systems
While we have several islands of excellence in #mhealth, many of them still at national level pilot stag , a national Digital Health Platform would also help connect these islands and help navigate through the muddy waters towards a well-functioning digital health ecosystem with an aim to ensure a level playing field for all the stakeholders in the healthcare delivery space, thereby paving the path for more efficient and transparent healthcare delivery.
More over a national digital health platform / grid backed by a robust health information exchange would also create an enabling environment for “start up entrepreneurs” to plug in and contribute to the transformative vision articulated by the government towards achieving universal health coverage for all Indians.

The article was first published in Dr. Oommen John’s LinkedIn Pulse page, its been re-published here with the authors’ permission

Author
Dr. Oommen John

is a Consultant Physician, Public Health Research and Policy Expert. He is the current President of the Indian Association for Medical Informatics and a Senior Research Fellow at the George Institute for Global Health

<!– Place this data between the tags of your website –>
#DIGITALHEALTH AS A TOOL TO PROTECT THE NATIONAL HEALTH PROTECTION SCHEME BY DR. OOMMEN JOHN @OOMMEN_JOHN


Healthcare Summit – Disruptive Indian Healthcare Innovations for the World


Press Release: Healthcare Summit, held on 23rd December 2017 at Dayananda Sagar University, Hosur Road campus; discussed the future of the fast-evolving Healthcare sector and is of relevance to healthcare start-ups, academicians, policy makers, NGOs, social healthcare entrepreneurs and industry building innovative solutions in the healthcare space. 

The event was organised by World Economic Forum’s Global Shapers Bangalore Chapter in collaboration with Dayananda Sagar University & Autodesk.

Summit Agenda
To showcase applications of new age technologies in the field of Healthcare. How digital and hardware technological adoption in the field of healthcare, is making patient treatment better, therapies more effective and extending human longevity.


Summit Takeaways for audience

Event registration was via an online registration link and we had attendees from leading hospital management teams, healthcare professionals, startups, academic researchers, students and industry leaders. Audience learnt about the efforts being taken to create Make in India products for the global market and about Healthcare innovations globally and in India that will positively impact our lives in the next decade.


Welcome Speech

Role of academia in creating innovative thinking and programs run towards bridging the academia – industry divide

by Mr. R Janardhan – Pro Vice Chancellor, Dayananda Sagar University

  • DST Funded Startup Incubation centre
  • GE Healthcare, Nvidia, Autodesk and Bosch few of the many companies that have already set up labs within the Innovation centre on campus (DS University, Kudlu Gate, Hosur Road)
  • Set up of a privately funded Innovation Centre at Dayananda Sagar Innovation Campus to instil the spirit of entrepreneurship amongst students

Keynote
Precision Medicine and growth of personalized medicine in the 4th Industrial Revolution Era – creating policy and ecosystem to keep pace with innovation
by Dr. Vijay Chandru, CEO Strand Life Sciences and World Economic Forum Technology Pioneer Awardee

  • 1/3rd of India’s Biotech companies in Bangalore – Study by ABLE
  • Ecosystem is ripe for disruption in the field of personalised medicine
  • Discussion about the growth story of Strand Life Sciences, an independently held private company
  • Strand Life Sciences working towards creating affordable genomics solutions
  • Bioinformatics is today helping early screening for cancer and providing testing methods to determine probability for occurrence of a hereditary disease
  • World is moving towards personalised treatments and neo-natal gene modification is leading to a future where we will have “designer babies”
  • Strand has 30% market share in its segment and currently has both local and international clientele


Panel Discussion
Healthcare solutions for the masses. Indian Healthcare innovations for the World.

Dr. Vijay Chandru (CEO – Strand Life Sciences, World Economic Forum Technology Pioneer Awardee); 
Dr. Jagadish Mittur (Head – Biotechnology Facilitation Cell – KBITS, Department of IT BT and S&T, Government of Karnataka); 
Mr. K Chandrasekhar (CEO, Forus Health); 
Dr. Dheepa Srinivasan (Additive Manufacturing, General Electric); 
Mr. Anurag Ramdasan (Global Shapers Bangalore and VC at 3one4 Capital)


Key Highlights

Gene editing (CRISPR technology) has lots of potential in this fourth industrial revolution era and policy is being framed with Indian Council for Medical Research (ICMR) and Department of Biotechnology (DBT), to enable Indian innovators to stay ahead of the curve and innovate in the space of genomics – Dr. Vijay Chandru

Government of Karnataka was the first state to come up with a biotechnology policy (circa. 1999) and last month released the third updated version of the policy. Gov. of Kar is focussed towards creating clusters for innovation in healthcare (Bangalore Bio innovation Centre, IBAB); deploy funds for early/ growth stage start-ups via their Idea2PoC and Elevate funding programs; create quality human resource personnel (Bioinformatics graduate students from IBAB centre are in global demand for their skills). Government is also focusing on creating new clusters of innovation across the state – Hubli / Dharwad Agri-Tech cluster, Mangalore Marine Biotech cluster being some of the many to be set up. – Dr. Jagadish Mittur

3D Printing in Healthcare is a 3 Billion Dollar opportunity. GE is focused on utilising the power of additive manufacturing (3D Printing) to create affordable healthcare devices. Work with certifying aerospace grade parts similar to what needs to be done by medical sector to certify medical grade implants. Various advantages of using additive manufactured in designing medical grade implants, equipment and lab testing tools (3D Bioprinting). Solutions to cater to needs of India’s large diabetic population can come from 3D Printing. – Dr. Dheepa Srinivasan

Inspired by the Aravind Eye Hospital chain, Forus Healthcare set forth on their journey in 2010 to develop an affordable eye screening device with the goal to eradicate avoidable blindness. Their key product is 3nethra. Forus has sold products in 26+ countries and truly represents the Make in India for the World dream of our country’s Prime Minister. Ecosystem was supportive to provide inputs and collaboration, when they started off. Challenged faces along the way to building a global product company include lack of support from government run regulatory bodies, slow time from prototype to product. 
– Mr. K Chandrasekhar

Private VC firms already working with government to help their portfolio start-ups tackle various on ground challenges and to deploy technology to improve government efficiency in fields ranging from agriculture to IT. Most VC funds have a shorter life cycle than a deep tech focused life sciences company that is looking at 10-year plus gestation period. This requires exploring other routes for VCs to be able to work better with startups in this space with special structures, incentives and better liquidity through proposed SME exchanges. VC community will continue to better engage with the healthcare ecosystem with the goal of supporting novel Make in India Healthcare companies. – Mr. Anurag Ramdasan


We also had the following Healthcare companies and start-ups showcase their work through 10-minute presentations followed by audience Q&A

1. DocsApp: Doctor consultation and chat via Mobile Application
https://www.docsapp.in/

2. Niramai: Pre-screening AI tools for Breast cancer 
http://niramai.com/

3. Next Big Innovation Labs 3D Bioprinting: 3D Skin Tissues for cosmetic R&D testing & Maxillofacial Models for use as pre-surgical guides
http://nextbiglab.com/

4. Gangagen: Developing Drug Resistant Bacteria
http://www.gangagen.com/

5. Biodesign Innovation Labs: New age ventilator for emergency rooms accessible to the bottom of the pyramid 
http://biodesigninnovationlabs.com/

An event by Global Shapers Bangalore (World Economic Forum Chapter), Dayananda Sagar University and Autodesk

Event Photoshttps://goo.gl/HNJS2m


For Further Details regarding the event, please contact –
Mr. Alok Medikepura Anil -alokanil@gmail.com, +91 8971909120
Member of 3D Printing Expert Network
World Economic Forum & Global Shapers, Bangalore

Team HCITExperts

Your partner in Digital Health Transformation using innovative and insightful ideas

Artificial Intelligence #AI Could Add $957 Billion to Indian Economy, According to New Research by @AccentureIndia


In a recently published report by Accenture, they have highlighted the need for india to invest in AI, we bring you the excerpts of the report. (The following content is sourced from the Accenture report).

Artificial intelligence (AI) has reached a tipping point. The combination of the technology, data and talent that make intelligent systems possible has reached critical mass, driving extraordinary growth in AI investment. Across the world, G20 countries have been building up their AI capabilities. The power of AI starts with people and intelligent technologies working together within and across company boundaries to create better outcomes for customers and society. But India is not fully prepared to seize the enormous opportunities that AI presents. Even with a tech-savvy talent pool, renowned universities, healthy levels of entrepreneurship and strong corporations, the country lags on key indicators of AI development. Much work remains. 


The report, ‘Rewire for Growth,’ estimates that AI has the potential to increase India’s annual growth rate of gross value added (GVA) by 1.3 percentage points, lifting the country’s income by 15 percent in 2035. To avoid missing out on this opportunity, policy makers and business leaders must prepare for, and work toward, the AI revolution. 


The era of AI has arrived. Established companies are moving far beyond experimentation. Money is flowing into AI technologies and applications at large companies. The number of patents filed on AI technologies in G20 countries has increased at a more than 26 percent compound annual growth rate since 2010. Funding for AI startups has been growing at a compound annual growth rate of almost 60 percent.

AI is a new factor of production that can augment labor productivity and innovation while driving growth in at least three important ways:

Mobilize Intelligent Automation
Automate complex, physicalworld tasks that require adaptability and agility.

Empower Existing Workforces
Complement and enhance the skills and abilities of workforces.

Drive Innovations
Let AI be a catalyst for broad structural transformation of the economy. Do things differently, do different things.


The report points out AI is expected to raise India’s annual growth rate by 1.3 percentage points—in a scenario of intelligent machines and humans working together to solve the country’s most difficult problems in 2035

AI TENDING TO INDIA’S HEALTH
India’s healthcare providers have embraced artificial intelligence, recognizing its significant value in better diagnostics with data intelligence and in improving patient experience with AI-powered solutions.

Take Manipal Hospitals, headquartered in Bengaluru, which is using IBM Watson for Oncology, a cognitive-computing platform, to help physicians identify personalized cancer care options across the country.

In cardiac care, Columbia Asia Hospitals in Bengaluru is using startup Cardiotrack’s AI algorithms to predict and diagnose cardiac diseases, disorders, and ailments.

And in eye care, Aravind Eye Hospital is working with Google to use AI in ophthalmology for diabetic retinopathy screening. Also, the government of Telangana is planning to use Microsoft Intelligent Network for Eyecare (MINE), an AI platform, to reduce avoidable blindness, which would make it the first state in India to deploy AI for eye care screening as part of the Rashtriya Bal Swasthya Karyakram program under the National Health Mission.

Accenture, for its part, has developed an AI-powered smartphone solution to help the visually impaired improve the way they experience the world around them and enhance their productivity in the workplace. The solution, called
Drishti, was initially developed and tested through a collaboration with the National Association for the Blind in India.


AI has the potential to have a broad-based disruptive impact on society, creating a variety of economic benefits. While some of these benefits can be measured, others, such as consumer convenience and time savings, are far more intangible in nature. Our analysis focuses on measuring the GVA impact of AI.

Read the press release here >> 
https://newsroom.accenture.com/news/artificial-intelligence-could-add-957-billion-to-indian-economy-according-to-new-research-by-accenture.htm

Read the complete report here >> 
https://www.accenture.com/in-en/insight-ai-economic-growth-india

Author
Team HCITExperts

Your partner in Digital Health Transformation using innovative and insightful ideas

‘‘Doctor on the Go” Revolution Ready To Change The Reality of Healthcare by @Guneet_B


Digital technology in healthcare is booming at a rate that no one would ever have imagined. From smartphone apps to self-monitoring healthcare devices, the healthcare delivery system has started to change for the better.
Digitization in itself, however, must not be blamed for introducing changes in how healthcare has always been traditionally delivered to patients. The digitization of healthcare is expected to and has, in fact, successfully managed to handle some of the most common problems associated with traditional healthcare delivery models – long waiting times, ever increasing cost of healthcare, shortage of trained workforce, infrastructure problems, and intrusion into patient privacy and confidentiality. 


One of the major breakthroughs enabled by digitization of healthcare is telehealth, often referred to as telemedicine. It dates back to the time of the Civil War and the Indian Independence, when telephone and telegraph were actually used to order medicines and send radiology imaged over a telephone line.
Telemedicine has been making our lives easier for many decades. However, recent advancements in this burgeoning technology make it an integral part of the current and all future healthcare delivery models.

Telehealth vs. Telemedicine
Even though both telehealth and telemedicine are used interchangeably, there is a slight difference between these. Telehealth is a broader term that includes a myriad of clinical services. Telemedicine, on the other hand, is a subset of telehealth that does not necessarily include delivery of clinical health services and other services such as medication adherence, patient education, and troubleshooting. The Federal Communications Commission [1] talks about the thin line that demarcates telehealth, telecare, and telemedicine


In simple terms, telemedicine involves the use of telecommunications services for information exchange to impart clinical services to patients. For example, imagine a doctor providing consultation to his or her patient through a mobile app or over a phone call, thus eliminating the need for a patient to personally visit a doctor’s office.

Teleconferencing, videoconferencing, messenger chats, emails, and transmission of images from one place to another are all considered a part of telemedicine and telehealth.


Depending on the type of specialty where it is being used to impart information, telemedicine can be of different types – teleradiology, telepathology, telepsychology, teledermatology and so on.

Telemedicine Delivery Systems
The health delivery systems that implement the principles of telemedicine have improved and evolved considerably in the recent past. There are several delivery systems that are currently used in different parts of the world to deliver or impart medical information to patients and healthcare professionals but the following three are the most common and important ones:
Remote Monitoring Through Healthcare Devices

Patients with chronic health illnesses can be looked after at home by their family members or an at-home caregiver. The health and vital statistics of such patients are often monitored around the clock with the help of a machine. The doctor concerned usually has access to the data recorded by the machine and can accordingly guide the family members of the caregiver if any intervention is required.
Such an application of telemedicine helps saves time, in addition to the ever-increasing hospitalization, transportation, and other miscellaneous healthcare-related costs that a person admitted to the hospital has to pay for.

Medical Report Storage and Transfer

How many times have you has a blood test done and asked the pathologist to send you the reports over email or Whatsapp? This is yet another example of telemedicine that is quite common nowadays. The information can not only be shared with the patient but also with the doctors over phone, email, or messenger. The information can, in fact, be shared with a physician located abroad for his or her special guidance
Real-time Communication
Interactive medicine also allows patients and doctors to communicate in real-time with the help of online chat sessions and videoconferencing. Such sessions can be used to deliver medical information, share reports, share reports, and look at the physical recovery of the patient to any specific signs and symptoms.
Such sessions can also be conducted in case both the patient and the doctor are present at different locations – in different cities or country. It is a great way to keep a track of a medical tourist after he or she has flown back to their home country. Such follow-up sessions are also conducted by medical tourism facilitators [2].
Telemedicine In India: The Current Scenario
India is the second most populous country in the world and that well-explains the healthcare disparity, among other social issues, that is bound to affect the masses. Telemedicine as a tool for healthcare delivery, has proved to be an effective way of reducing this disparity. While it would be inappropriate to state that telemedicine is likely to replace traditional healthcare anytime soon in the future, it is, indeed, a promising solution that can assure quality healthcare services to the masses in the underserved regions.
A review article published in the journal Primary Healthcare [3] explains how has evolved in the recent past, thanks to the efforts made by the state governments and the private sector. From setting up of village resource centers (VRCs) in the Northeastern states to the establishment of Hospital Information System ‘TEJHAS’ (Telemedicine Enabled Java based Hospital Automation System) and the PAN India Oncology Network dubbed ONCONET, a number of milestones have been achieved through the joint public and private sector involvement.
The Apollo Telemedicine Network, Practo, MediGence, and Lybrate are some of the healthcare initiatives that have gained quick popularity in India. These platforms strive to deliver quality healthcare patients by letting them find the right treatment option, search for the best doctor, and seek information about their diagnosis or medical condition. Some of these platforms also provide an option to interact with the concerned physician directly and post questions for them to answer.


What is the future of telemedicine?
Seeing the advantages of telemedicine – increased convenience, improved access to healthcare, reduced doctor appointment cancellations, and increased acceptance to healthier lifestyle choices – the field in itself is expected to evolve tremendously in the years to come.
For example, researchers are working on implantable devices and pills that can monitor the vital signs of the patient and around the clock. These little chips can be connected to a cloud server that can directly be accessed by the physician to look at the vital signs of the patient.
The radiotechnology communication systems for the ambulances are also expected to improve in the time to come. The new systems will not only improve the communication between the patient, ambulance care giver, and the hospital, but also expected to improve the lives of the patient, humanize care, and reduce waste.
Doctors around the world also look forward to using devices that can direct the patient when to adjust their dosage for medications and what changes to make in their dietary lifestyle. These devices can actually help manage chronic diseases such as diabetes and hypertension.
One such example is the Abilify Mycite, a technology by Proteus Digital, was recently approved by the Food and Drug Administration (FDA) in the US.The digital health solution, available by the name Proteus Discover [4], is a combination product with ingestible sensors that run on gastric acids. The Discover sends regular updated to the physician who can actually known whether or when the patient has taken the medication.
Novel solutions like Proteus Discover are being designed to improve medication adherence, less doctor visits, reduce costs, increase patient engagement, and optimize outcomes. Its is estimated that currently, non-adherence to medications prescribed by the physician costs a whopping $100 billion a year. The use of such ingestible sensors can actually help reduce the cost burden, while successfully managing chronic conditions such as diabetes and hypertension.
Other promising examples of how telemedicine is shaping up the future of modern healthcare delivery models include the remote care through mobile apps [5], digital therapist for mental health assessment [6], and driverless car health sensors [7]


References

Author
Guneet Bhatia

A Medical Content Writer and Manager, Editor and Blogger. Guneet Bindra is currently working as as a medical content writer and manager with different national and international clients, including medical practitioners and drug companies. She has worked as a team leader, science & health with International Business Times. 

A collection of Potential Usecases for #Blockchain in Healthcare

Every once in a while a new technology finds its way in the Gartner Hype Cycle for Technologies (in Healthcare) and its effectiveness and usability is applied to the management and interoperability of Healthcare Records. For instance, access to the Healthcare records by various stakeholders in the care continuum: care providers and patients. 



Gartner in their recent report defines Blockchain as a Digital Platform. And healthcare industry has been perennially on the lookout for a Digital Platform that will allow for an efficient and secure way to share patient data. Providing access to the healthcare data involves providing access to the patient data to relevant stakeholders at the right time and to the right person, not only ensuring the privacy but also providing the patient control of their data. 

Another problem that remains evasive in healthcare is driven by privacy of the patient data, and has been at times been seen to be impeding the flow of patient data between disparate systems, (i.e., Interoperability). 

We now have the Blockchain Technology and various companies are working to apply the technology to help solve not only the interoperability problem but also applying the same technology to solve various usecases in the Care Continuum, to save costs, improve efficiency, ensure privacy.

So what are the problems Blockchain is being applied to in the Healthcare context? What are the benefits one would accrue by applying Blockchain to Healthcare and what are the pitfalls.

The past august, ONC in the US setout a Blockchain challenge with the objective, 

The goal of this Ideation Challenge is to solicit White Papers that investigate the relationship between Blockchain technology and its use in Health IT and/or health-related research. The paper should discuss the cryptography and underlying fundamentals of Blockchain technology, examine how the use of Blockchain can advance industry interoperability needs expressed in the Office of the National Coordinator for Health Information Technology’s (ONC) Shared Nationwide Interoperability Roadmap, as well as for Patient Centered Outcomes Research (PCOR), the Precision Medicine Initiative (PMI), delivery system reform, and other healthcare delivery needs, as well as provide recommendations for Blockchain’s implementation. In addition to a monetary award, winners may also have the opportunity to present their White Papers at an industry-wide “Blockchain & Healthcare Workshop” co- hosted by ONC and NIST.”

As part of the Ideation Challenge, the following papers were the declared winners:

1. Blockchain and Health IT: Algorithms, Privacy, and Data: cThis papers discusses the need to create a peer-to- peer network that enables parties to jointly store and analyze data with complete privacy, based on highly optimized version of multi-party computation with a secret-sharing. An auditable, tamper-proof distributed ledger (a permissioned blockchain) records and controls access through smart contracts and digital identities. We conclude with an initial use case of OPAL/Enigma that could empower precision medicine clinical trials and research. 
Authors:  Ackerman Shrier A, Chang A, Diakun-thibalt N, Forni L, Landa F, Mayo J, van Riezen R, Hardjono, T.
Organization:  Project PharmOrchard of MIT’s Experimental Learning “MIT FinTech: Future Commerce.”


2. Blockchain: Securing a New Health Interoperability Experience: Blockchain technologies solutions can support many existing health care business processes, improve data integrity and enable at-scale interoperability for information exchange, patient tracking, identity assurance, and validation. This paper suggests these processes can be supported by three most important applications: Creating secured and trusted care records, linking identities and recording patient consent decisions and patient directives within the secured patient record.
Authors:  Brodersen C, Kalis B, Mitchell E, Pupo E, Triscott A.
Organization:  Accenture LLP


3. Blockchain Technologies: A Whitepaper Discussing how Claims Process can be Improved: Smart contracts, Blockchain, and other technologies can be combined into a platform that enables drastic improvements to the claims process and improves the health care experience for all stakeholders. The healthcare industry suffers from an inability to clearly communicate costs in a timely and easy-to-understand format. This problem is a symptom of interoperability issues and complex agreements between providers, patients, health plans/payers and government regulators. These agreements are encoded in legal language with the intent of being defensible in court. However, the focus on legal enforceability, instead of understandability, creates problems resulting in hundreds of billions of dollars spent annually to administer an inefficient, outdated and complex process for adjudicating and paying health plan claims. 

The process results in errors and often leaves the patient unclear on how much they need to pay. If these agreements were instead translated into computer code (smart contracts) leveraging Blockchain technologies, the claim process would not only be interoperable, but also drive standardization, research and innovation. Transparency and trust can be injected into the process when both the logic and the data driving these decisions is stored permanently and made available to all stakeholders through a peer-to- peer distributed database like blockchain. The result will be a paradigm shift toward interoperability and transparency, enhancing the speed and accuracy of cost reporting to patients. This paper discusses how smart contracts, blockchain and other technologies can be combined into a platform that enables drastic improvements to the healthcare experience for all stakeholders.
Author:  Culver K. 


4. Blockchain: A new model for Health Information Exchanges: Presentation of an implementation framework and business case for using Blockchain as part of health information exchange to satisfy national health care objectives.


Authors:  Krawiec RJ, Barr D, Killmeyer K, Filipova M, Nesbit A, Israel A, Quarre F, Fedosva  K, Tsai L.
Organization:  Deloitte Consulting LLP

5. A Case Study for Blockchain in Healthcare: “MedRec” Prototype for Electronic Health Records and Medical Research Data: A long-standing focus on compliance has traditionally constrained development of fundamental design changes for Electronic Health Records (EHRs). We now face a critical need for such innovation, as personalization and data science prompt patients to engage in the details of their healthcare and restore agency over their medical data. 

In this paper, the authors propose MedRec: a novel, decentralized record management system to handle EHRs, using blockchain technology. The system gives patients a comprehensive, immutable log and easy access to their medical information across providers and treatment sites. Leveraging unique blockchain properties, MedRec manages authentication, confidentiality, accountability and data sharing—crucial considerations when handling sensitive information. A modular design integrates with providers’ existing, local data storage solutions, facilitating interoperability and making our system convenient and adaptable. 

MedRec incentivize medical stakeholders (researchers, public health authorities, etc.) to participate in the network as blockchain “miners”. This provides them with access to aggregate, anonymized data as mining rewards, in return for sustaining and securing the network via Proof of Work. MedRec thus enables the emergence of data economics, supplying big data to empower researchers while engaging patients and providers in the choice to release metadata. 

The purpose of this paper is to expose, in preparation for field tests, a working prototype through which we analyze and discuss our approach and the potential for blockchain in health IT and research.
Authors:  Ekblaw A, Azaria A, Halamka J, Lippman A. 
Organizations:  MIT Media Lab, Beth Israel Deaconess Medical Center


6. The Use of a Blockchain to Foster the Development of Patient-Reported Outcome Measures (PROMs): This paper suggests the use of Cognitive Behaviour Therapy as a modality to treat Mental Health disorders. This the author suggests is achieved by the use of various applications that allow the patient to record information using SMS or applications. These applications keep track of any emergencies, provides patient coaching and guidance, recording of daily progress and medication adherence. While many patients feel ashamed of their mental state and feel a stigma associated with conditions such as depression and anxiety, the anonymous nature of these applications may make it more likely for them to seek help. 

These types of use cases are the first step in implementing blockchain technology as they help identify the system requirements and looks at the interactions between users and systems. In this case, the focus would be on personal health information that is highly sensitive and coming from mobile applications that require direct interaction between the patient and providers, as well as those involved in the care of the patient. 

Each scenario that involves a transaction, or data being transferred from the application to those who have “signed” the transaction would be documented so the information flow and usage is understood. In this manner, the appropriate permissions would be granted and provenance could readily be established. Use of the Internet of Things in combination with Blockchain technology for Patient Reported Outcome Measures (PROMs).
Author:  Goldwater JC.
Organization:  National Quality Forum

7. Powering the Physician Patient Relationship with ‘HIE of One’ Blockchain Health IT: ‘HIE of One’ links patient protected health information (PHI) to Blockchain identities and Blockchain identities to verified credential provider institutions to lower transaction costs and improves security for all participants. 

HIE of One, (Health Information Exchange of One) shifts the trusted intermediary role away from the hospital and into the blockchain. The blockchain can also provide the link between physician credentials and patient identity.
Author:  Gropper A.

8. Blockchain: The Chain of Trust and its Potential to Transform Healthcare – Our Point of View: This paper talks about Potential uses of Blockchain technology in health care including a detailed look at health care pre-authorization payment infrastructure, counterfeit drug prevention and detection and clinical trial results use cases. The paper also highlights what Blockchain is not. Some of the additional usecases as presented in the paper are listed below:


Organization:  IBM Global Business Service Public Sector

9. Moving Toward a Blockchain-based Method for the Secure Storage of Patient Records: Use of Blockchain as a novel approach to secure health data storage, implementation obstacles, and a plan for transitioning incrementally from current technology to a Blockchain solution. The author suggests a practical first step towards moving towards a blockchain enabled world, here is a suggested workflow by the author, from the submission: 

Author:  Ivan D.

10. ModelChain: Decentralized Privacy-Preserving Health Care Predictive Modeling Framework on Private Blockchain Networks:   ModelChain, to adapt Blockchain technology for privacy-preserving machine learning. Each participating site contributes to model parameter estimation without revealing any patient health information (i.e., only model data, no observation-level data, are exchanged across institutions). 

We integrate privacy- preserving online machine learning with a private Blockchain network, apply transaction metadata to disseminate partial models, and design a new proof-of-information algorithm to determine the order of the online learning process. 

We also discuss the benefits and potential issues of applying Blockchain technology to solve the privacy-preserving healthcare predictive modeling task and to increase interoperability between institutions, to support the Nationwide Interoperability Roadmap and national healthcare delivery priorities such as Patient-Centered Outcomes Research (PCOR).
Authors:  Kuo T, Hsu C, Ohno-Machado L.
Organizations:  Health System Department of Biomedical Informatics, University of California San Diego, La Jolla, CA Division of Health Services Research & Development, VA San Diego Healthcare System.


11. Blockchain for Health Data and Its Potential Use in Health IT and Health Care Related Research: A look at Blockchain based access-control manager to health records that advances the industry interoperability challenges expressed in ONC’s Shared Nationwide Interoperability Roadmap.
In this usecase the authors discuss the use of blockchain technology with a data lake for scalability. All medical data would be stored off blockchain in a data repository called a data lake. Data lakes are highly scalable and can store a wide variety of data, from images to documents to key- value stores

When a health care provider creates a medical record (prescription, lab test, pathology result, MRI) a digital signature would be created to verify authenticity of the document or image. The health data would be encrypted and sent to the data lake for storage. Every time information is saved to the data lake a pointer to the health record is registered in the blockchain along with the user’s unique identifier. The patient is notified that health data was added to his blockchain. In the same fashion a patient would be able to add health data with digital signatures and encryption from mobile applications and wearable sensors.



Authors:  Linn L, Koo M.

12. A Blockchain-Based Approach to Health Information Exchange Networks: 
Sharing healthcare data between institutions is challenging. Heterogeneous data structures may preclude compatibility, while disparate use of healthcare terminology limits data comprehension. 

Even if structure and semantics could be agreed upon, both security and data consistency concerns abound. Centralized data stores and authority providers are attractive targets for cyber attack, and establishing a consistent view of the patient record across a data sharing network is problematic. 

In this work we present a Blockchain-based approach to sharing patient data. This approach trades a single centralized source of trust in favor of network consensus, and predicates consensus on proof of structural and semantic interoperability.

The authors describe the Healthcare Blockchain as: 

Because a blockchain is a general-purpose data structure, it is possible to apply it to domains other than digital currency. Healthcare, we believe, is one such domain. The challenges of a patient record are not unlike those of a distributed ledger. For example, a patient may receive care at multiple institutions. From the patient’s point of view, their record is a single series of sequential care events, regardless of where these events were performed. This notion of shared state across entities, inherent to the blockchain model, is congruent with patient expectations. Also, it is reasonable to assume that each patient care event was influenced by one or more events before it. For example, a prescription may be issued only after a positive lab test was received. The notion of historical care influencing present decisions fits well into the blockchain model, where the identity of a present event is dependent on all past events.

Much like the Bitcoin approach, our block is a Merkle Tree-based structure[21]. The leaf nodes of this tree represent patient record transactions, and describe the addition of a resource to the official patient record. Transactions, however, do not include the actual record document. Instead, they reference FHIR Resources via Uniform Resource Locators (URLs). This allows institutions to retain operational control of their data, but more importantly, keeps sensitive patient data out of the blockchain. FHIR was chosen as a exchange format not only because it is an emerging standard, but also because it contains inherent support for provenance and audit trails, making it a suitable symbiotic foundation for blockchain ledger entries. FHIR in conjunction with the blockchain can serve to preserve the integrity and associated context of data transactions.


A Blockchain-based approach to sharing patient data that trades a single centralized source of trust in favor of network consensus, and predicates consensus on proof of structural and semantic interoperability.
Authors:  Peterson K, Deedvanu R, Kanjamala P, Boles K.
Organization:  Mayo Clinic


13. Adoption of Blockchain to enable the Scalability and Adoption of Accountable Care:  A new digital health care delivery model that uses Blockchain as a foundation to enable peer-to-peer authorization and authentication.

The recent trends in Accountable Care based payment models have necessitated the adoption of new process for care delivery that requires the co-ordination of a “network” of care providers who can engage in shared risk contracts. In addition, the need for sharing in the savings generated equitably is key to encourage the network providers to invest in improved care paradigms. 

Current approaches to digitize healthcare focus on improvement of operational efficiency, like electronic records as well as care collaboration software. However, these approaches are still based on the classical centralized authorization model, that results in significant expense in implementation. These approaches are fundamentally limited in their ability to fully capitalize on the peer-to-peer digital work- flow revolution that is sweeping other segments of industry like media, e-retail etc. 

In this paper the author formulates a new digital health care delivery model that uses block chain as the foundation to enable peer-to-peer authorization and authentication. The author will also discuss how this foundation would transform the scalability of the care delivery network as well as enable payment process via smart contracts, resulting in significant reduction in operational cost and improvement in care delivery. 

In addition, this block-chain based framework can be applied to enable a new class of accountable tele-monitoring and tele-medication devices that would dramatically improve patient care adherence and wellness. Finally, the adoption of block chain based digital-health would enable the creation of varifiable “personalized longitudinal care” record that can form the basis of personalized medicine.

Author:  Prakash R.



14. A Blockchain Profile for Medicaid Applicants and Recipients: A solution to the problem churning in the Medicaid program that illustrates how health IT and health research could leverage Blockchain-based innovations and emerging artificial intelligence systems to develop new models of health care delivery. The solution envisions a Smart Health Profile by thinking of the blockchain profile simply as a broker that can answer questions about you as the need arises, your identity remains distributed. No one can ever see everything about you at once, including yourself. 

What makes the profile smart is that the services it provides can be quite intelligent. It can make sophisticated queries and actually trigger an action when certain conditions are met. For example, suppose you had a smart drug dispenser that recorded every dose you take as a transaction on the blockchain. A profile service might check everyday to see if you’ve taken your pill and automatically order a refill when you’ve used up all the pills. Over time, however, an AI service might become much more sophisticated to use a combination of information about your vital statistics from your wearable device and population studies of people using the various medications for your condition and either recommend a different regimen to your physician or simply cut out the middleman and direct your pharmacist to deliver you a new prescription.

The solution goes on to discuss the use of Blockchain in a medicaid scenario and a much more comprehensive solution as a distributed infrastructure for health.
Authors:  Vian K, Voto A, Haynes-Sanstead K.
Organization:  Blockchain Futures Lab – Institute for the Future


15. Blockchain & Alternate Payment Models:  Blockchain technology has the potential to assist organizations using alternative payment models in developing IT platforms that would help link quality and value.
Author:  Yip K.


References
The content provided in the examples above have been collated from the various submissions to the ONC’s Blockchain Ideation Challenge. You can write to me or connect with me, in case you are interested in receiving the copy of the documents.

In my previous article on Blockchain I shared whats Blockchain and types of Blockchain. I also discussed some of the usecases companies and startups have focussed on developing Blockchain based solutions. In this article I will share some of the usecases based on Blockchain technology, in healthcare. 

Alternatively, you could follow the links here

You can also review the various articles on Blockchain on the HCITExpert Blog.

[1]: Blockchain Articles by David Houlding:
https://www.linkedin.com/in/davidhoulding/detail/recent-activity/posts/

Author

[tab]
[content title=”About Manish Sharma” icon=”fa-heart”]

Manish Sharma

Founder HCITExpert.com, Digital Health Entrepreneur

Connect with me via any of my Social Media Channels

[/content]
[content title=”Latest Articles”]

[/content] [/tab]