Sumit Pandey, Gandhinagar India
The issues faced by health services, primarily in developing and under-developed nations, are multiple. The following issues are at the core focus of Nidaan: 1. Lack of health facilities for the poor: Health facilities are a primary instrument for the well being of a society. Health is one for the key factors in determining the progress in a society. Even in developing countries like India and China, health facilities are flooded with patients seeking medical help. Timely care and access to health facilities for the poor is a huge concern pestering the governments of the developing and the under developed countries. 2. Fallacious treatment due to migration: Migration of Labor is one of the common phenomena witnessed in developing and under developed countries. In the search of better monetary support and higher financial standing in the society migration of labors from the villages towards cities is seen quite often. This is a correctly termed as “Upward Social Movement”. Land is often cheap in the suburbs as a result people in the lower income groups are forced to take up homes in the suburbs. Migrating Labor from rural areas to cities (based on the season) are termed as “Migratory seasonal labor”. People who come from far off to work in the cities are forced to live in slums as such migrating from their permanent place residence. This results in total loss of medical data that is kept in any form. This result is loss of any form family history that could have been kept. Family History often forma key in diagnosis of diseases as such for the poor slow diagnosis is a primary result of migration. 3. Lack of an effective Medical Supply Dispatch System: Medical Infrastructure in developing countries is already in a distressed state but to worsen the situation, medical supply dispatch systems are crippled by corruption. Also, the dispatch systems are not need based but rather schedule based. This causes many rural health centers (who cater to the BPL) being left lacking proper medicines, vaccines etc. This is despite the government spending huge amounts in the procurement of the medicines. The issue is not that these items are not present but that they are not timely and effectively distributed. 4. Lack of an Epidemic Tracking System: Epidemics are a harsh reality in third world countries in Asia and Africa. Cases of diseases that are growing to an epidemic scale are not timely reported due to lack of systems to monitor the same. BPL are the worst affected in this case. But, it is not only required that such a system should be built but it should also respect the privacy of all the citizens of the state. 5. Lack of a system for detecting Insurance frauds: In developing countries where monetary standing has a hand over moral standings frauds are very much prevalent. Insurance agencies have to resort to harsher measures to resolve Insurance conflicts and prevent frauds. To tackle this problem it is a prime requirement that an unbiased system be built and should be transparent to not only the Insurance Companies but should also be hassle free to the end users, who claim insurances.
THE IDEA Nidaan is a project that intends to address the healthcare needs of people at the grass roots. The system will manage the Patient ↔ Doctor ↔ Pathology ↔ Hospital ↔ Government ↔ Insurance chain in the following manner: 1. Patient: These are the main stake holders of the system since they form the bulk of the end-user category. The system will help them to manage their current medical portfolio along with their medical history. They will have ease of access of medical facilities at the member hospitals. The patients will be guaranteed complete pertaining to any patient whatsoever will be released in any form by the member organizations. The patients have been classified into two categories as per their insurance cover. The patients have been classified into three categories. The regular users have an option to sign up for exclusive ‘Premium Services’ by paying a higher insurance premium. Part of the revenue generated from this scheme would be re-channelized into paying the premium for the BPL patient’s treatment. The patients with this insurance cover will have exclusive benefits and ease of access to maternity care and emergency services. The BPL patients will be provided the basic cover for a predetermined list of diseases that are classified as being high risk by the Government. The premium for these patients will be covered by the government in part and via the revenue generated from higher insurance paying users (Premium Users). (see section 2.2.1) 2. Hospital: Member hospitals of this scheme will have to create electronic records for the incoming patients on Nidaan. The member will also transfer records to another member hospital on demand by the patient. 3. Government: The Government will be able to keep a track of medical data of the population in general and alerts will be generated in case of epidemics in sight by Nidaan’s Epidemic Tracking System. The Government acts as a regulatory body for the system. All the member hospitals will work in a frame set by the Government. The insurance companies will also form a consortium under the rules set by the Government. The Government will also be a layer coordinating between the insurance companies and the patients. They will also monitor transfer of medicines to various hospitals as such regulating drug consumption in a state with the help of Nidaan’s medical dispatch system. (see section 2.2.2) 4. Insurance: They will have a larger patient cover and better profits. With Nidaan, the Insurance companies will have transparent mechanisms for settling insurance claims and hassle free mechanisms for insurance. Nidaan will also help prevent insurance frauds (see section 2.2.5) and will also help the Insurance companies to have a better patient network. For details of Nidaan’s architecture and design refer section 2.2 of the attached document.
Nidaan, at its core, strives to solve the problem of providing effective healthcare to the underprivileged. In developing countries like India and under-developed countries, healthcare is one of the primary concerns. Currently majority of the healthcare related data is either stacked away in files or is not recorded at all. For the people living below the poverty line (BPL), the situation is even worse. Nidaan guarantees easier access of health services to the under privileged. Extension plans in Nidaan include services like child growth monitoring services free of cost maternity care for the BPL. Our system will result in data management of loads of medical data generated every day. Not only will the system be managing huge volumes of data, but will also be providing data on call as and when required. The issue of huge amounts of data generation is tackled with the help of a very highly distributed system design. The automation of the medical book keeping will help easier diagnosis for doctors. The doctors will have the complete medical history of a patient once a patient requests a treatment from a doctor. The parameters available at the disposal of doctors will be optimal and as such probability of easier and earlier diagnosis of the correct disease will increase. Tracking of genetic diseases will become easier by using Nidaan. Still, none of the features in Nidaan compromise on the privacy of the patient. Nidaan is more flexible and has also taken into account the problems faced by the migrating labors. Nidaan allows easy and flexible transfer of patient records from one place to another with minimal human intervention. This enables a person to get the right treatment irrespective of his/her location. The mechanism ensuring a free and hassle free service to the BPL is as a result of an insurance that is provided to BPL by the Government through a conglomerate of insurance firms. Benefits for the insurance firms include a greater number of people covered with a fixed and consistent source of premiums, since the premiums are paid by the government. Also Nidaan’s premium services will result in greater revenue for the insurance firms, part of which can be used to provide insurance premium rebates for the BPL people. The insurance premium is paid by the Government. Nidaan aims to network not only the Public Sector Medical Facilities, but also the Private Sector Medical Facilities. Medical support in private facilities will be covered by the insurance agencies. The distribution of load of patients is distributed to a larger number of medical facilities. This will result in a reduction of stress on government facilities. This will also ensure more effective use of medical facilities. Nidaan will monitor the medicines being supplied to the medical facilities. The medicines being supplied to the medical facilities will be monitored at a central system. This will prevent misuse of drugs by corrupt officials in the medical system. This will cause a reduction in the corruption the supply chain of drugs by the government. This will also result in effective distribution of drugs. The centrally located Government Server will be notified at regular intervals of the number of cases of various diseases being reported in the various medical facilities. This system will also notify the government administrator in case a particular disease increases beyond a certain limit. This will also keep track and regulate the medical dispatch system as per the diseases increasing or decreasing in a particular area. Thus an artificially Intelligent System will be controlling the Medicines Dispatched based on the incoming data coming into the Epidemic Detection System. This system will also put in place early bird procedures that the government can put to limit outbreak of diseases. **All the images present in the attached document have been taken by our team members during field trips conducted to study the medical infrastructure present in Gujarat, India.