New Directions in Healthcare<br />Nachiket Mor, Ph.D.<br />Member, Board of Directors, ICTPH<br />OECD Conference<br />New...
About ICTPH<br /><ul><li>An action-research centre focussed on finding durable solutions to challenges of healthcare in Ru...
Set up by IKP Trust
Headquartered at IKP Knowledge Park, Hyderabad               (200 acre R&D, Incubation Facility within the Genome Valley)
President: Dr. Zeena Johar
Chairman of the Board: Dr. Ramesh Mashelkar</li></li></ul><li>Healthcare Challenges<br /><ul><li>Inadequate infrastructure
Low quality of care
Insufficient human resources
High out-of-pocket expenditure at point-of-care
Healthcare system not patient or wellness focussed
Need for policy level as well as field level innovations</li></li></ul><li>ICTPH Research Focus<br /><ul><li>Infrastructure
Interventions
Human Resources
Financing</li></li></ul><li>Desired Infrastructure<br /><ul><li>A well provisioned health-centre at 8,000 to 10,000 popula...
Technology to allow for:
Accurate diagnosis
Appropriate treatment
Quality control
Comprehensive enrolment and risk screening for landscape epidemiology and risk factor tracking</li></li></ul><li>The ICTPH...
GPS Enabled Android Mobile Phones
Rapid enrollment and risk screening
Geo-tagging
10,000 individuals in 7-10 days</li></li></ul><li>Geo-tagging and ID Card <br />Chelampatti<br />Pachur<br />Uppundarpetti...
Rural Micro Health Centre<br /><ul><li> One rural RMHC for 10,000 population
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New Directions in Rural Healthcare

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The presentation briefly outlines some of the research areas in rural primary healthcare that we focus on.

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New Directions in Rural Healthcare

  1. 1. New Directions in Healthcare<br />Nachiket Mor, Ph.D.<br />Member, Board of Directors, ICTPH<br />OECD Conference<br />New Delhi, June 14th, 2011<br />
  2. 2. About ICTPH<br /><ul><li>An action-research centre focussed on finding durable solutions to challenges of healthcare in Rural India
  3. 3. Set up by IKP Trust
  4. 4. Headquartered at IKP Knowledge Park, Hyderabad (200 acre R&D, Incubation Facility within the Genome Valley)
  5. 5. President: Dr. Zeena Johar
  6. 6. Chairman of the Board: Dr. Ramesh Mashelkar</li></li></ul><li>Healthcare Challenges<br /><ul><li>Inadequate infrastructure
  7. 7. Low quality of care
  8. 8. Insufficient human resources
  9. 9. High out-of-pocket expenditure at point-of-care
  10. 10. Healthcare system not patient or wellness focussed
  11. 11. Need for policy level as well as field level innovations</li></li></ul><li>ICTPH Research Focus<br /><ul><li>Infrastructure
  12. 12. Interventions
  13. 13. Human Resources
  14. 14. Financing</li></li></ul><li>Desired Infrastructure<br /><ul><li>A well provisioned health-centre at 8,000 to 10,000 population level with ability to deal with a wide range of conditions
  15. 15. Technology to allow for:
  16. 16. Accurate diagnosis
  17. 17. Appropriate treatment
  18. 18. Quality control
  19. 19. Comprehensive enrolment and risk screening for landscape epidemiology and risk factor tracking</li></li></ul><li>The ICTPH Approach<br /><ul><li>Clear identification of service area
  20. 20. GPS Enabled Android Mobile Phones
  21. 21. Rapid enrollment and risk screening
  22. 22. Geo-tagging
  23. 23. 10,000 individuals in 7-10 days</li></li></ul><li>Geo-tagging and ID Card <br />Chelampatti<br />Pachur<br />Uppundarpetti<br />Thekku<br />Ayyampatti<br />Kotaitheru<br />Adanakottai<br />Karkaripatti<br />Andipatti & Mudalipatti<br />
  24. 24. Rural Micro Health Centre<br /><ul><li> One rural RMHC for 10,000 population
  25. 25. Vision, Dental, Cancer
  26. 26. Internet, Computers, HMIS
  27. 27. Blood collection</li></li></ul><li>Drugs & Diagnostics<br /><ul><li>Haematology: Complete Blood Count(KX 21)
  28. 28. Biochemistry: Glucose, Lipid Profile, LFT, KFT (Chem 7)
  29. 29. Strip Tests:Malaria, Pregnancy, Urine</li></li></ul><li>ICTPH Research Focus<br /><ul><li>Infrastructure
  30. 30. Interventions
  31. 31. Human Resources
  32. 32. Financing</li></li></ul><li>Desired Interventions<br /><ul><li>Wide range of conditions
  33. 33. Standardised treatment
  34. 34. Rational prescriptions
  35. 35. Focus on risk factor management and early interventions</li></li></ul><li>ICTPH Approach<br />Patient removes footwear and enters RMHC<br />Interventions<br />Yes<br />Is the patient a pregnant woman?<br />Disease Management<br />No<br />Guide-Patient Protocol<br />Diagnostics<br />RMHC<br />Physician-Patient Protocol<br />Emergency Management<br />Vision<br />Diagnostic Tests<br />Procedures:<br /><ul><li>  Nebulisation
  36. 36. Suture
  37. 37. Suture Removal
  38. 38. Dressing (Minor/major)
  39. 39. Injections
  40. 40. IV’s </li></ul>Consultation:<br />1.Physical Examination<br />2.SOAP Methodology<br /><ul><li>Subjective
  41. 41. Objective
  42. 42. Assessment
  43. 43. Planning</li></ul>Dental<br />Screening<br />
  44. 44. Physician-Patient Protocol<br />Allows heightened diagnosis of disease:<br /><ul><li>Standardized format - signs & symptoms, diagnostic tests, treatment, and prevention (specific to a disease/condition).
  45. 45. Pictures to allow visual confirmation
  46. 46. Physical assessment protocol allowing targeted disease & condition specific physical examination</li></li></ul><li>Otitis Media<br />
  47. 47. Risk Factor Assessment<br />Population<br />PISP<br />
  48. 48. Infant Nutrition Supplementation<br />We recommend Sprinkles micronutrient powder<br />Is your child between 6-24 months old?<br /><ul><li> Iron (12.5 mg)
  49. 49. Zinc (5 mg)
  50. 50. Folic Acid (160 µg)
  51. 51. Vitamin A (300 µg)
  52. 52. Vitamin C (30 mg)</li></ul>Unless you child has one of the following:<br />Acute infection<br />Severe Anaemia<br />Severe Acute Malnutrition<br />
  53. 53. ICTPH Research Focus<br /><ul><li>Infrastructure
  54. 54. Interventions
  55. 55. Human Resources
  56. 56. Financing</li></li></ul><li>Human Resources Challenge<br /><ul><li>Unwillingness to serve in rural locations
  57. 57. Inadequate supply of MBBS doctors
  58. 58. High salary & support costs
  59. 59. Poor quality of care</li></li></ul><li>Clinical processes (HMIS, PISP & pre – consultation protocols), Basic Procedures<br />Physiology, Patho-physiology, Diagnosis & Standard Treatment Protocols<br />Pharmacology, Medication and Diagnostics and Procedures<br />ICTPH Approach<br /><ul><li>Recruit licensed Ayurveda and Siddha practitioners (BAMS, BSMS)
  60. 60. Offer bridging certificate course in modern medicine
  61. 61. Combine with a general inductionprogram &soft skills training</li></ul>Clinical Practice<br /><ul><li> Gastro-intestinal
  62. 62. Respiratory
  63. 63. Cardio-vascular diseases
  64. 64. Cancer
  65. 65. Diabetes
  66. 66. Dermatology
  67. 67. Musculo-skeletal
  68. 68. Ophthalmology
  69. 69. Dentistry
  70. 70. Diagnostics</li></li></ul><li>Structured Environment<br /><ul><li>Certified Physician
  71. 71. Health Extension Worker
  72. 72. Real-time HMIS data entry
  73. 73. Real-time Centralised Audit</li></li></ul><li>ICTPH Research Focus<br /><ul><li>Infrastructure
  74. 74. Interventions
  75. 75. Human Resources
  76. 76. Financing</li></li></ul><li>Financing Challenge<br /><ul><li>Low levels of pre-payment
  77. 77. Entirely a fee-for-service model
  78. 78. Standalone insurance schemes such as RSBY are well run and therefore run the risk of:
  79. 79. Relative over-supply of higher levels of care
  80. 80. Not focussed on wellness
  81. 81. Expenditures could tend towards 100% utilisation</li></li></ul><li>ICTPH Approach<br /><ul><li>HMO / ACO approach towards integrated primary, secondary and tertiary care
  82. 82. Strong focus on risk factor management and gate-keeping function at the primary care level
  83. 83. Move away from FFS and OOP to capitation and pre-payment models
  84. 84. Overall annual costs to remain below Rs. 1300 ($30) per capita per year (2.6% of GDP)</li></li></ul><li>Thank You<br />
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