E-Health in India

In 2015, the Health Ministry had made plans to set up E-Health care systems in India, to promote and regulate the implementation of E-Health solutions and to set standards for the health sector. Electronic Health means to get aid and advice from doctors through the means of mobile phones and video chats. This program uses information and communication technologies for the same. It aims to improve treatment for patients, it focuses on delivering immediate response when in need and in improvising accuracy in diagnosing the patients. The patients, on the other hand, tend to benefit from the innovative experience.

This system has made a drastic change by overcoming traditional methods and practices. It provides patients with the ability to manage their health by giving them access to data from different sources. In terms of revenue, this digital market is estimated to expand from 2019 through 2024.  The increase in the need and demand for an electronic system puts immense pressure on stakeholders to manage their scarce HR and infrastructure while controlling the cost burden on the consumers.

Need for Digital Health

The Indian health care professionals benefit from the use of digital technology by enhancing their experience. For instance, professionals who use DHRs while practicing have a positive impact on the quality of care, professional satisfaction, and patient outcomes. Along with this, the professionals also agree that access to data of one’s own health creates a positive impact on the experience of the patient. Access to digital health will provide information and knowledge in the easiest way possible. Digital products will easily help us in explaining the complex concepts of the medical field. Plus, this flow of information will maintain transparency and there will be no chaos over the middle man causing distortions in the reports or the medicines.   

The current legal system that governs the digital health care system is very ambiguous. The scope of this system is vast and covers different models which makes it difficult to be regulated as a whole. The electronic system helps the patients to be more open, comfortable, and verbal about their health problems. With the help of data that is available on these platforms, India will derive this revolution when health care will turn into a consumer-centric market.

Legal Framework

  1. The Information Technology Act, 2000 – This platform uses the exchange of private information, and thus consent is the biggest factor that is involved before the party does anything with a patient’s data his/her consent in writing is mandatory.[1] The patient is also to be informed that what will be done to the data collected and whether there is an involvement of a third party or not.[2] There should also be a mandate Grievance Officer whose contact details should be available on the website.[3]
  2. The Drug and Cosmetics Act, 1940 – This Act regulates the sale and distribution of drugs in India. It lays down that all drugs must be sold under a license and creates a distinction between prescriptive and non-prescriptive drugs. To be a valid prescription it must be signed and dated by a doctor,[4] and it must be addressed to the person to whom such treatment is given and also include the quantity of the drug to be used.
  3. The Indian Medical Council Act, 1956 – This Act regulates medical profession and education in India. It provides that only those who have a recognised degree and are registered with the state medical councils can practice medicine in India. It lays down ethical and professional standards while dealing with a patient. Efforts are also made to computerise the medical data and records so that it can be revived easily.[5] This act is currently being replaced by The National Medical Commission Act, 2019.
  4. The Clinical Establishments (Registration and Regulation) Act, 2010 – All Clinics are to be registered under this Act. They should also follow the norms and standards prescribed under this act.

Government Initiatives

  1. National Digital Health Authority – It is a proposed authority which will be responsible for the healthcare information system in India. It will be responsible for creating applications regarding mobile health and will also be collaborating with different stakeholders. It will be the authority for issuing rules regarding privacy and other details regarding a patient’s information records. This is supposed to guide India towards a digital healthcare system.
  2. National Digital Health Blueprint – It lists out a set of principles and guidelines for a digital health system, it gives principles of privacy and confidentiality that the field of healthcare should incorporate in their system. It provides that internet and telecommunication should be available to all, a network of primary centres for service delivery as well as a trained healthcare workforce. This would lead to the effective creation of an electronic health care system in India.

Many m-health applications have also been developed to ensure the safety of people around them. The Vaccine trackers application tracks the vaccine given to children and helps parents in maintaining a proper track record and also reminds them when the next vaccine is due. The India Fights Dengue application helps in identifying the symptoms of dengue and helps in indicating the nearest hospitals and blood banks available. The Swasth Bharat application provides for detailed information on health care, healthy lifestyles, disease symptoms, treatment available, first aids, etc. Many audio-based training applications have also been established to expand the number of health workers based in villages.

For public hospitals, an online registration system has been established so that people don’t have to wait in long lines for getting an appointment. Instead, they can fill the online forms and book a date and time to meet the doctor. Many hospitals have been linked to this online registration system including AIIMS. An Integrated Health Information Platform is to be set up by the government to address the system of digital health in a better manner by looking into key factors like accessibility, lack of proper information, quality of data provided, etc. A National Health Helpline has also been created that includes reliable information regarding doctors. This helpline enables the rural population to get the information they need and save time and money by visiting doctors.

National Medical Library’s ERMED Consortium is an initiative to provide all the information or literature regarding the medical field at one platform. It contains journals from leading publishers as well as journals that were published a long time ago. The National Medical College Network Scheme is another initiative that has interlinked about 50 medical colleges for online consultation and e-learning. A web portal has been created that will assist the people in getting advice from specialists through their phones.

The other initiatives that are proposed are Digital Information Security in Healthcare Act and the Personal Data Protection Bill, 2019. They are to facilitate the exchange of information between the patients and their doctors online with an idea to put a stop on duplication of work as well as streamline resources. The government. is committed to financially supporting the digital healthcare programs and initiatives and is also involved in looking for stakeholders and partnerships to scale up the initiatives.

Barriers

Financial incentives, as well as reimbursements, are required to support the use of digital health across institutions. The development of new techniques tends to slow the established process as new devices and tools are needed to be implemented with the help of a good learning curve. The cost can also act as a barrier as new hardware and software is required to be purchased for advancing technologies.  Rapid upgrades are necessary and their maintenance costs are also high. There are no set guidelines for the e-healthcare system, handling patient’s information can include implications for providers of being involved in malpractice. This system also lacks interoperability and data exchange among the healthcare systems.

The concept of digital divide also creates a barrier between the providers and the consumers of digital healthcare. In this, one part of the society has access to the internet and advance systems but the other part doesn’t have a basic internet connection. Although access to electronics has been increasing rapidly, such an increase is not uniform with one side being extremely advanced and the other lacking behind. Literacy level, costs, availability of resources, protection of privacy, consent, confidentiality, cultural appropriateness, ease in using such advanced technologies are other significant barriers in the department of digital healthcare.

Recommendations

Digital health operates in a very uncertain environment at the moment and in such conditions, the services cannot be performed effectively. This acts as a deterring factor to new entries in the field of e-health. The need of the hour is to adopt a large scale digital healthcare system for the population of India because the want for medical assistance is also increasing. The nation requires a systematic policy for the working of this sector and for adopting EHRs. A well-drafted legislation is required for the sector because online pharmacies are operating in the gaps of law being neither legal nor illegal. This will also increase the number of stakeholders in the business. The government should also engage in adjustments with foreign jurisdictions where specialists available outside India could consult patients within the country and vice versa, this would benefit India as well as the foreign countries and will save a lot of time and money in traveling. The use of e-prescriptions can also reduce the chances of it being misused as there would be a definite record of the same. These methods have helped various other countries and if implemented in the manner it is intended to be, it can do wonders for the Indian patients and the Indian economy as well.

Conclusion

The E-Health market provides a lot of opportunities but there are some risks involved. Innovation is much needed in this sector, the introduction of new products and ideas in this field is encouraged. The industry has still not matured so there is not much development with the legislative framework. Regardless, the legislature is trying to formulate policies for the same, with one such example being the NIPR. Access to the affordable healthcare system is still an issue in this country and the public will gain immensely from the development of the digital healthcare industry. With the interest of the public in mind of both the regulators and the innovators, it is still to be seen if developing legal and regulatory frameworks will impede or ignite its growth in the nation. There is still a long way to go and it is hoped that the overall positive outlook and support that the industry is getting will sustain itself in the future.


[1] Rule 5(1) of the Data Protection Rules, 2011.

[2] Rule 5(3) of the Data Protection Rules, 2011.

[3] Rule 5(9) of the Data Protection Rules, 2011.

[4] Rule 65(10) (a) of the Drugs & Cosmetics Rules, 1945.

[5] Regulation 1.3.4 of the MCI Code, 2002.

Kavya Arora from School of law, UPES, Dehradun

Editor: Sanskriti Sood

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