Mallari Kulkarni, Director-Digital LifeCare, Dell Technologies talks about the role of technology in NCD management
It has been over five years since we partnered with the Tata Trusts and Ministry of Health & Family Welfare for its national Non-Communicable Diseases (NCD) program. In this time, we have observed the strengthening of public health systems through a holistic approach that encompasses all aspects of healthcare systems, including technology, people and processes.
In India, change management is a critical component of successful technology deployments – A memory comes to mind. Our team was monitoring a technology training with healthcare workers from Aganampudi (Andhra Pradesh). These trainings were being carried out for the government’s national NCD (non-communicable diseases) program, which aimed to screen, diagnose, and manage hypertension, diabetes, and common cancers. A well-respected senior worker who was visibly unhappy with the additional work of learning the technology. As she expressed her displeasure to the group, it became apparent how digital inclusion was a vital piece of the puzzle to improve India’s healthcare services delivery. It was clear that she needed to understand how technology was creating a systematic approach to managing NCDs, providing continuum of care for her patients and personally empowering her. It was important for her to know what she was getting into and why. Eventually, she warmed up to the idea, becoming a vocal proponent by the end of the training.
NCD management in the new digitised India
Tackling the Goliath of diseases is how I would term this agenda. NCDs have been nicknamed a silent killer – hard to detect, chronic and invisible. Unlike communicable diseases, NCDs are difficult to manage and have poor survival rates, requiring a stringent plan of action for management. Unfortunately, the cost of care for NCDs is high and the low health-seeking behaviour of underserved communities is a significant barrier in delayed diagnosis and treatment. With NCDs, preventive screening can play a significant role in mitigating its spread while also encouraging early detection and treatment for better patient outcomes. For healthcare workers and officials who are tasked to maintain outreach with patients across India, the primary challenge lies in creating a continuum of care to ensure that a patient follows through with all levels of treatment.
Over the last decade, technology adoption has skyrocketed both in public and private sectors globally. The most notable case study is India which has created the largest digital public good (DPG) ecosystem in the world and cemented its position as a leader in technology for public progress. India’s Health Stack, ‘Ayushman Bharat Digital Mission’ (ABDM), has enabled the government to promote interoperability of health data and services thereby creating an open digital health ecosystem for the country. Today, this national digital health ecosystem encompasses Health ID, Health Information Exchange, and Health Registries among others. It brings to life the aim of ABDM. Under its aegis, the government is solving the mammoth fragmentation of the health tech sector while delivering quality healthcare to its citizens. I’m proud to witness this tech revolution in public health and the NCD program is one such successful example.
Today, the NCD program’s technology enablement is empowering on-field healthcare workers to become digitally skilled and gain a comprehensive view of a patient’s journey. Having a view of this journey in the palm of your hands is the first step in grassroot impact. For healthcare officials and doctors, standard protocols and data dashboards are ensuring a quality of care and improved performance management at all levels.
Thanks to the partnerships forged between the government, institutional networks and corporations, a 360-degree multi-stakeholder approach is leading the way in NCD management. What the national NCD platform has enabled is a digital public interface that is designed to be modular with open protocols that are published, allowing room for innovation and opportunities to build new solutions on top of existing digital infrastructure. The integration with ABDM is extending this interoperability of the NCD system with all other health tech systems, public and private.
Digital inclusion means to deliver the benefits of technology for all and India, is a shining example for the world.
On another visit to a Primary Health Center in Osmanabad (Maharashtra), we encountered a remarkable young healthcare worker, Shubhangi who had mastered the use of the NCD mobile application. In an instance, she happened to note that the digital health record for her patients was discontinued abruptly at the next care level. Independently, she began to train the data entry supervisor and log her patient data into the system, thus ensuring that the loop was closed. Shubhangi is the face of the progress taking place in small towns and villages by championing the use of technology for social benefit.
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