ACCESS Health India Perspectives: Digital Will Drive Access to Healthcare

India's Healthcare system is fragmented, the country is too diverse and large for a single unified system. Each state has its own healthcare programs. The central government provides the majority of the funds but the implementation largely rests with the states. States that are better off are independent in their decision making and show better outcomes. However, India can still aim for standardized protocols and interoperability across states. Interestingly, digital technology is proving to be a binding force between the three important stakeholders of healthcare namely, payer, provider and people. The new Ayushman Bharat national health insurance program is becoming the melting pot for public and private healthcare and emerging as the biggest driver for digital health. Healthcare in India has lagged in adoption of technologies, but digital technologies are now pushing the country in the right direction. Technology driven transformation has happened in many sectors like Mobile and Telecom, Aadhaar based eGovernance, Fintech and Banking. Healthcare is likely to go through a digital transformation now. Technology has already taken its toll on the Hospital Information Systems [HIS] market. Large HIS vendors have exited the market. Either they have lost interest and exited or have been acquired. On the other hand, many tier-II incumbent players are not able to shift out to cloud because of their long term negotiated contracts in client-server model. The newer cloud-based players are comparatively smaller in size and yet to reach size and scale. The HIS market is ready for complete disruption by Digital Health! Now is the Era of Mobile-First Apps. Small Data ^ = Big Data. The time has come when you don't need big monolithic HIS software to run hospitals. Now you can do a lot with small mobile based Apps for every function. Clinical evidence-based medicine has got a new meaning with Digital devices run on Artificial Intelligence being introduced. These devices can automate Laboratory Reports, read Radiology reports better, do accurate differential Diagnosis, pin point relevant Order sets, send Referrals, drug refill alerts and follow-up reminders. Disease management has gone Digital and the devices are learning fast and outcomes getting better with every new patient. However, the old HIS and EMR systems or even the new breed Digital Health Apps lack credible Global Digital Health Standards. Hence, they exist in silos and don't interact with each other or the larger Healthcare ecosystem. The data cannot be referred for any meaningful analysis. For example, we still don't know clearly the size, scale and depth of the Dengue, Chikungunya and H1N1, Flu epidemics that strike us every year. Hence, we are always left gasping for breath when the seasonal spike starts. India is already the Diabetes capital of the world with 70 million cases and counting. We still don't have standard protocols based Digital Disease Management Platform. The HIS/EMR market in India requires EHR and Meta Data Standards based XML wrapper objects that can help the existing systems to communicate with the external world in a Standardized format. We need centralized Registries for uniquely identifying the Patient, Provider and the Facility where the treatment was carried out. We need Reference data dictionaries for standardizing the Diagnosis, Prognosis, Procedures, Laboratory tests, Radiological examinations, Drug prescriptions. This should be the common lookup so that everyone can be interoperable. The need for such Central Registries and Lookup Dictionaries is of paramount importance. Though the vital question remains, as to who will build and manage it. Should it be privately owned and controlled or publicly funded and managed. Health Insurance sector has similar challenges. Private Health Insurance covers about 3% of India Population. There are 17+ Private Insurance companies that also do business in Health Insurance. 4 Public Sector Companies also cover Health Insurance. Four Private Insurance companies whose core business is only Health Insurance. Public Health insurance covers about 10-17% of India Population. 80+% is Out of Pocket expenses. About 2% of India's population falls below the poverty line every year due to unaffordable hospitalization expenses. Now the Central Government Pradhan Mantri Jan Arogya Yojana (PMJAY) has come to the rescue of most of the uninsured population. PMJAY is set to cover 40-50% of India's Population. In absolute numbers the market is set to expand from the current 150 million people and go up to 500 million people. Obviously, the TPA business which has been servicing only the private health insurance i.e. 3% of India's population, must gear up to support PMJAY covering over 40% of India's population. Hence TPA business is ready for disruption. The number of daily claims is set to go up by multiple times. All these claims pipelines cannot be processed manually. We need to use high end technology to process the claims. We need a Standardized Claims format. The TPA market in India requires XML based standard Claims wrapper object that can help the existing systems to communicate with the Hospital HIS/EMR world and the Health Insurance world in a Standardized format. Globally, winds of change are evident. Digital is totally changing the way Health Insurance business has been run in the past. CVS has been building retail Primary Care centers and Diagnostics in its Pharmacies. Now with CVS Purchasing Aetna! John Hancock is shifting from traditional Life Insurance model to incentivize longer, healthier lives. In brief, they will move away from Life insurance model to Disease management and Precision medicine. Blockchain based Unique Identifiers are emerging. AI based start-ups are working on meta data driven Discharge Summary, Hospital Billing and Claims, Intelligent Claims Adjudication and Fraud detections. The Digital Tech Giants are becoming Healthcare companies. The lines are beginning to blur. Is India far behind? Not really, India has a habit of leapfrogging stages, specifically with regard to Telecom and FinTech sectors. It will now happen to Healthcare. A Digital Healthcare Ecosystem is already taking shape.

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Health Futures Held Healthcare and Finance Innovation Forum in China

The 3rd International Healthcare and Finance Innovation Forum was held in Shanghai from November 23 to 24. Shanghai Health Development Research Center, Fudan University School of Management, and Health Futures China team jointly organized the event. The Forum also received supports from industry partners such as Pfizer, RGAX, Neusoft Viewhigh, and Nuohui Medical to discover the cutting edge topics related to social health insurance reform and health payment innovation. The Forum consists four sessions: innovation on drug reimbursement policies, innovation on healthcare service payment, commercial insurance innovation, and disease based financing and payment innovation. More than sixty guest speakers shared their respective insights and innovative practices, including Representative of World Health Organization in China Dr. Gauden Galea, Director of Shanghai Municipal Health Commission Dr. Jinglei Wu, and Dean of School of Management of Fudan University Dr. Xiongwen Lu. The total audience exceeded four hundred and more than thirty journalists attended the event. Health Futures research team together with Fudan University Healthcare and Finance Research Institute launched a white paper on Value Based Healthcare in China. It is the first white paper in China focusing on the cross sector collaboration and health system transformation built on the concept of value based healthcare. By documenting and analyzing innovative cases in China and abroad, the report reveals the key factors of value oriented health innovation in three sectors of drug and medical device, commercial insurance, and health information service. The report concludes with a detailed landing map for value based healthcare innovation in China. Please find the Chinese report HERE (accessh.org.cn/vbhc-report/)

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Aging With Dignity: Interviews with Elder Care Providers

Aging with Dignity: Innovation and Challenge in Sweden – The Voice of Care Professionals is available to download for free now, or to order in hard copy or in ebook form on Amazon. Read the full interviews and reports on long term care on which the book is based: Patient Centered Swedish Healthcare: An English summary of the Swedish Forum for Welfare report The Most Fragile Elderly Project: An interview with Maj Rom The Most Fragile Elderly Project: An interview with Dr. Eva Nilsson Bågenholm, National Coordinator for Elder Care Coordinating Care for the Elderly: An interview with Carina Kumlin and Pia Lagerström Elder Care Entrepreneurship: An interview with Stéphanie Treschow Government Efforts to Improve Long Term Care: An interview with Erik Weiman Integrated Elder Care: A five part case study on the TioHundra care company Mobile and Home Based Care: A case study on the Lidköping close care system Mobile and Home Based Care: A case study on the mobile emergency team in Uppsala eHealth Technologies and the Future of Healthcare: An interview with Henrik Ahlen Technology for the Elderly: An interview with Raymond Dahlberg How Technology is Revolutionizing Homecare in Sweden: An interview with eHomecare manager ?...sa Löwing New Technologies An interview with Magdalena Marklund Technology for the Elderly: A Swedish focus group study Is the Use of Welfare Technology Profitable? A lecture from Åke Dahlberg Technology and eHealth: A case study on the Estonian eHealth and eGovernance system Digitizing a Nation: An interview with Patrik Sundström A Palliative Approach to Dementia Care: An interview with Lotta Roupe on Stiftelsen Silviahemmet Improving Dementia Care and Care of the Elderly: An interview with Linda Martinson on Aleris Telecare Technology: An interview with Markus Merne and Everon upporting Relatives and Informal Caregivers: An interview with Christianne Simson In the Name of the Law: A lecture by Jeanna Thorslund

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9th US-China Health Summit Held in Boston and Wuhan

The annual U.S.-China Health Summit is dedicated to the advancement of global health by promoting the exchange of knowledge, ideas, and experiences of healthcare leaders from the United States, China, and other countries through high level strategic dialogues, leadership development programs, and applied research. Each year the summit takes place in either China or the…

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ACCESS Health Chair and President Delivers Keynote Address the 2019 Royal Australasian College of Medical Administrators Conference

In October 2019, William A. Haseltine presented a workshop on medical management and leadership at the annual Royal Australasian College of Medical Administrators Conference in Adelaide, Australia. He also delivered a keynote speech. Haseltine's interest in improving human health has taken him from the halls of Harvard Medical School and Harvard School of Public Health, where…

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ACCESS Health India Helps Celebrate One Year Anniversary of India’s Biggest Health Program

ACCESS Health India has been working closely with the government of India as it rolls out its flagship health insurance program in the state of Uttar Pradesh. Pradhan Mantri Jan Arogya Yojana, known locally by its acronym PMJAY, is a fully sponsored government health insurance program launched in 2018 by the Ministry of Health and Family Welfare.…

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ACCESS Health Board Member Diane Morris Steps Down

ACCESS Health Chair and President, William A. Haseltine, and the entire Board of Directors of ACCESS Health extend their deep gratitude to Diane Morris, the chairman and chief executive officer of Morris Capital Management, who is stepping down from her role as director as of November 1, 2019. As an active philanthropist in the arts,…

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Cisco Systems and ACCESS Health Southeast Asia Release New Report on How Digital Technology is Key to Achieving Universal Health Coverage

The American tech giant Cisco Systems recently partnered with the Southeast Asia office of ACCESS Health International to explore how policymakers can turn words into action and deliver on promises to provide universal access to high quality care. The report focuses on opportunities around the use of digital technology to improve access to care, focusing…

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Safe Care, Saving Lives: Leaving a Legacy of Quality Improvement

In 2014, ACCESS Health partnered with the public health insurance program in the Indian state of Andhra Pradesh to launch a quality improvement program called Safe Care, Saving Lives. The program worked closely with the public health insurer to develop institutional structures and capacity within the purchaser of care to work on quality improvement for newborn…

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Health Futures China Launches Whitepaper Project on Value Based Healthcare

One of the key trends towards the institution restructuring and policy innovation of the health system in China is value based healthcare. However, both public and private players are facing multiple challenges implementing such projects, including the fragmented health service system, the lack of health data and analysis, and gaps in health insurance coverage. In…

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