Accelerating healthcare system in Jharkhand through application of technology
The Covid-19 pandemic posed a huge challenge to counter the threat to humanity. While tackling this pandemic, opportunities arose to utilize its negotiating strategies into a transformation catalyst, accelerating the implementation and adoption of changes in public health interventions. Thus, a new model of healthcare delivery emerged with more emphasis on preventive measures, remote care, and substantial technological dependence. However, these were juxtaposed against ongoing technical challenges to meet the surged capacity in laboratory testing, the fast-tracked implementation of new technologies, the mental health concerns, the ethical concerns on the potential rationing of insufficient resources, and the protection of privacy and personal data during times of crises. The transformation in healthcare would not be possible, if it was not associated with technological innovations in communication, machine learning, and transportation.
The Government of Jharkhand led a massive Covid-19 mission mode technology application to cater healthcare services to its citizens vide WhatsApp Chat-bot, Allopathy Video consultation 24×7, AYUSH Video consultation 24×7, Covid Bed Management Helpline, Covid Circuit Helpline, home delivery of Covid kits for home-isolated patients helpline, plasma donation helpline, follow up of home isolation patient helpline, etc.
In a state like Jharkhand, where close to half the population live in poverty, almost 48 percent of the population suffer from malnourishment, scaling the effort of such a scheme is an uphill task. Access to timely, safe, affordable, and quality healthcare are the prime concerns of the Government of Jharkhand to provide best possible healthcare system to the citizens.
Some of the Jharkhand’s major accolades under the healthcare ecosystem are as follows:
- Jharkhand ranked 11th among 28 states in the NITI Aayog SDG India Index – Good Health and Wellbeing (2020), with a score of 74.
- Jharkhand is consistently working toward improving its health outcomes like infant and maternal mortality rate (IMR, MMR), total fertility rate (TFR), and others, which has led to an increase in life expectancy.
- There has been an increase of 19 percent in the total allocations for tertiary care infrastructure in the budget in 2022-23 compared to 2021-22.
- The yearly increase in the budgetary outlay reveals that the government is prioritizing the development/strengthening of tertiary care institutions.
- Out of total allocations for the infrastructural development/strengthening, 90 percent of funds have been earmarked for tertiary care in 2022-23.
- Capital expenditure in the healthcare budget FY23 saw a significant increase of 43 percent, during the period driven by proposed investments in creation of medical colleges and associated teaching hospital infrastructure.
- Healthcare spend. The Government of Jharkhand allocated Rs. 5618 crore for the health sector in FY23, with 27 percent increase compared to FY22, with an increase of 19 percent in allocations for tertiary care infrastructure in 2022-23 compared to 2021-22.
- Budgetary allocation trend. The analysis of budgetary allocation indicates higher allocations toward urban health, medical education, and infrastructure creation, when compared to other programmatic areas.
- Capital expenditure in health sector. It saw a significant increase of 43 percent, during the period, driven by investments in creation of medical colleges and associated infrastructure.
- Health protection. Jharkhand has ~100 percent of the total population under various central and state government healthcare coverage schemes. BPL population (59.82 lakh) is fully covered.
In light of the above, the Government of Jharkhand has set for itself the vision “to provide universal access to quality and affordable healthcare services for all and sustained growth of the state.” This vision is based on the strong foundations built over the past few years through path-breaking initiatives in the health sector. Some of the major achievements and priorities for accelerating healthcare system are being flagged, as would be evident as below.
- Increase in the number of MBBS seats by upgrading existing district hospitals and attaching them with new medical colleges.
- Increase in number capacity of PG seats by upgrading of existing medical colleges.
- Construction of medical colleges at such places designated by the state government. Upgradation of district hospitals to 300-bedded and transforming them to Model Super-Speciality Hospitals.
- Establishing new nursing colleges and to increase the capacity of the existing nursing colleges, in adherence to UN recommendations and the Bhore Committee report.
- Strengthening public health institutions, especially state medical colleges, district hospitals, and FRUS by augmenting bed strength, improving manpower (MBBS, specialists, AYUSH, and paramedics) and increasing services (diagnostic, both pathological and radiological, ICUs, SNCUs, physiotherapy, dialysis, etc.). This has resulted in increase of 25 percent and 10 percent respectively of OPD and IPD, in public health facilities in last 3 years.
- Strengthening public health institutions like PHCs, dialysis centers, SNCUs, ICUs, Blood Banks, Jan Aushadhi Kendras, and DHs.
- Disease profile in Jharkhand: As per the National Family Health Survey-5 (NFHS-5), Jharkhand made considerable progress in reducing maternal, infant and under-five mortalities. It is one of the 11 states to have achieved the maternal mortality rate (MMR) target of less than 100 per lakh live births by 2020. Strengthening existing and setting up new medical colleges to augment tertiary care services in the state.
- Strengthening the state’s nursing and para-medical education by expanding such education institutes in the public sector.
- Jharkhand has almost 100 percent of the total population under the healthcare coverage scheme (central and state govrnment).
- Accelerating the construction of incomplete public health buildings and operationalizing them through the PPP model, which started during FY 2021-22.
Further, some successful operation of PPP initiatives undertaken in the state of Jharkhand are:
- Diagnostic services (both pathological and radiological) at public health facilities through Medall, SRL, Health Map.
- 104 health information helpline services.
- 102 Mamta Vahan and Mamta Vahan Helpline and stakeholders feedback services.
- 108 emergency medical ambulance services.
- 19 dialysis centers are functional through PPP mode in four medical colleges and 15 sadar hospitals. Two in-house dialysis centers are functional in RIMS, Ranchi and Shahid Nirmal Mahto Medical College, Dhanbad.
- Setting up of Medico City.
- Operation and management of various medical education biomedical equipment maintenance through PPP mode.
- Drug and vaccine distribution management system (DVDMS) e-Aushadhi through C-DAC.
- Mobile lithotripsy van.
- Mobile medical units to provide medical services in distant and remote areas of Jharkhand.
- Involving stakeholders from private players for safe disposal of bio-waste and its management.
- Telemedicine services: The state has initiated telemedicine through both government schemes and a PPP project with Apollo Hospitals group. Under the government scheme, the state has initiated teleconsultation, using e-Sanjeevani OPD. The introduction of more technology-based solutions to improve the continuum of healthcare in the field of electronic record-keeping, telemedicine, remote monitoring of health parameters, m-Health and supply chain management (medicine, vaccine and medical equipment).Telemedicine at the selected primary health centers (PHCs), community health centers (CHCs).
- Technology enablement: Implementation of the digital health initiatives under the ABDM, and focusing on developing digital health ecosystem to bridge the existing systemic issues and mitigate deficiency of resources to a large extent.
The National Health Policy, 2017, of India has laid significant emphasis on leveraging digital technologies for enhancing the efficiency and effectiveness of delivery of all the healthcare services, and has also identified the need for development of the National Digital Health Authority in India.
The silver lining for the post-Covid-19 era is the realization that a significant portion of healthcare activities in the wider sense can be improved by technologically empowered approaches, and some can even be done remotely equally as effectively. The Jharkhand healthcare sector, owing to its extremely low doctor-patient ratio, is taking certain drastic measures to change how things are currently done and the healthcare ecosystem’s new-age technology has been shifting the focus of the industry trend toward a patient-centric ecosystem.
The Department of Health, Medical Education and Family Welfare, Government of Jharkhand, has developed a healthcare system, which offers a wide range of potential solutions. New approaches to treat and diagnose patients effectively with the help of telemedicine, artificial intelligence (AI), Internet of Things (IoT), etc., have been developed. The adoption of technology in the healthcare ecosystem has been a catalyst to bring in a much more patient-centric robust approach as it streamlined the ecosystem by bringing in more transparency in operations. People are now much more aware of their diagnosis, treatment procedures, and routine treatments, which has helped place trust in the healthcare domain.
We are on the edge of very fast technological advancement, which includes usage of cellular technology, high-speed internet, and wireless communications. These technologies and their unique applications are creating lots of new dimensions in healthcare system, which is known as e-Health. The newly developed electronic health system can play a vital role in the remote regions of the emerging and developing state of Jharkhand. E-Health is an umbrella term that combines healthcare and technology to support people in a more efficient way, and it can also reduce health-related costs.
This open approach to integrate with all sets of stakeholders and integration of technology-based solution will pave a way for better reach and accessibility to the increased set of super-speciality services, marking an increased healthcare facility in the state of Jharkhand. A tailored approach is needed to transfer Jharkhand healthcare system and key stakeholders, which works in tandem toward the common goal. This will ensure the most effective use of Jharkhand’s scarce resources to the benefit of its people.
The biggest challenge is fragmented healthcare services hindering the seamless delivery of healthcare services. To address this, we are building a more patient-centric ecosystem and an outcome-based approach. As an end-to-end Government of Jharkhand, we aim to deliver superior health outcomes transparently and affordably with a patient-centric approach. High priority will be given to address the shortfall of healthcare professionals. Upskilling of healthcare workforce, a detailed mapping of the healthcare workforce in the state will be carried out, both from qualitative and quantitative perspective, for skill-based assessment of healthcare workforce.
As a part of the diligence process, meticulous planning for value development will become even more critical. The rise of healthcare-focused funds, with a scale equal to tech mega funds, will be one trend to monitor in coming years.
Providing quality is a journey. The expectations of people are changing as they experience healthcare services. At the same time, healthcare ecosystem is learning with ever-evolving citizens’ feedback and changing workflows to improve overall quality.
We aim to address the challenges in the traditional healthcare ecosystem, using latest technological development and adopting technology and its various tools. It offers comprehensive care solutions including virtual and in-person care anywhere, anytime, making sure a care continuum. We are aiming to create a 10/10 experience.