By Pragati Verma, contributor
Ravanamma, a public healthcare officer for 28 years now, is on a mission—to help detect non-communicable diseases (NCDs) in Southern India as early as possible. NCDs are non-infectious chronic diseases caused by genetic, physiological, environmental and behavioral factors. Presently, they contribute to almost two-thirds of all deaths in India. Ravanamma is trying to change that.
“I have left my family behind and come to this place to serve people. I spread awareness about NCDs and try to reduce their presence in the community,” she says.
Using Digital LifeCare, a modern digital platform with mobile, cloud and analytics applications, she can monitor the health of thousands of people in the community. Easy-to-use pictorial workflows and digital records management enable Ravanamma to screen individuals in Bangalore Rural District, Karnataka for NCDs and provide sympathetic follow-up care at a village level.
If healthcare checks, like blood pressure and sugar levels, are higher or lower than the normal range, she encourages them to see a doctor who can provide the appropriate care.
Ravanamma is not alone. Almost a million community health workers, known as Accredited Social Health Activists (ASHAs), and more than 200,000 Auxiliary Nurse Midwives (ANMs) act as liaisons between people and the public health care system in rural India.
With Digital Lifecare, they’re helping scores of people, including Mrs. Siddhagangamma B, who became very tired and weak, experienced worrying burning sensations in her hands, legs and eyes and could no longer carry out her necessary household chores. Based on Mrs. Siddhagangamma B’s readings, she was taken to a doctor and diagnosed with hypertension and diabetes. With the right intervention she has reduced her tiredness, no longer gets dizzy, eats well and feels healthy. She believes that her village no longer needs to worry. They have access to the right care, through nurses that have been empowered with technology to look after them.
“The government has a huge task to screen over 300 million people. Without a scalable, robust technology platform, it is very challenging for government to run this program and manage it effectively.”
– Mallari Kulkarni, head of digital lifecare, Dell Technologies
India’s National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) tasks health workers with screening India’s population who are above the age of 30 years for five common NCDs—hypertension, diabetes, oral, cervical and breast cancers. Those suspected of any of these conditions are then referred to higher-level facilities where they are diagnosed, treated, and provided with follow-up care at lower-level facilities for effective management of NCDs.
Introduced by the Indian government in 2017, the population-based screening initiative aims to screen over 300 million people to detect NCDs. As Vishal Chauhan, joint secretary of the Ministry of Health and Family Welfare in the Government of India, explains in this video, “The national NCD program is working at the grassroots…the whole idea is that we can detect cancer or hypertension or diabetes as early as possible so the treatment is much easier.”
Sunita Nadhamuni, global head of social innovation at Dell Technologies, explained why: First is the rapid rise in NCDs. “One in five people suffer from an NCD in India. Like most other countries, India is going through an epidemiological transition from communicable diseases like typhoid and cholera to non-communicable diseases.” Secondly, NCDs are silent. “What that means is that when they have an NCD, most people don’t find any symptoms until it’s at a fairly advanced stage,” she added.
Of course, screening the entire 30 years+ population of the world’s second-most populous country in the world is not easy. One of the biggest challenges faced by the health workers was recording and reporting the data they collected via a paper-based system. To help make the system more efficient and improve the process of screening, referring and tracking NCD patients, Dell collaborated with the Ministry of Health and Welfare to develop Digital LifeCare—the brainchild of two Dell employees passionate about helping public health workers deliver life-saving primary care. Tata Trusts is now working with health workers to enable them to adopt the technology and ensure data integrity.
The easy-to-use and easy-to-carry tool simplifies the process of creating electronic healthcare records. Health workers can use the referral module to assign the patient to the appropriate level for further investigations or treatment. It creates a single, unique longitudinal health record for every individual on the government cloud, which allows healthcare providers to securely access and update patient information, as well as receive reminders and alerts guided by Government of India protocols. “It was created to enable a continuum of care for the patient. In the app, there are built-in reminders that will alert the health workers on which patient needs a follow-up on which day for which disease. This is very important because otherwise, people might miss their follow-ups,” explained Nadhamuni.
According to her, the CPHC NCD system has now achieved a national footprint with more than 135 million people enrolled in the system. It has been deployed in 32 states across 591 districts, and more than 94,000 health workers and doctors have been trained and are using the system. Its success is inspiring several South Asian countries, such as Bangladesh, Bhutan and Myanmar to consider using the technology for their screening program.
Digital Lifecare is a powerful of example of how digital technology, with mobile, cloud and analytics technology, can connect communities and save lives. Dell’s recent Breakthrough study points to businesses’ greater desire for connectivity, with 85% believing they would finally fix issues in their value chain. In the healthcare industry, the ramifications of this “fix” are profound. The “issues” are people’s health and the “value chain” is the population of a nation.
If the National NCD program of India and its collaboration with Dell’s Digital LifeCare platform is any indication, digital technologies seem set to alter the public health landscape and transform lives, by empowering health workers to improve the quality and coverage of health services, especially in rural areas.
To view more on this story, go to: A new frontier of healthcare | Caring with Courage | BBC StoryWorks