Shankar Manajare, Founder, Aapka Doctor

Shankar Manajare, the founder of Aapka doctor, completed his B-Pharm from Karad and his M.S degree from a reputed institution in London. Further, he continued his M.B.A from Mumbai. He has a decade of experience in the International and national healthcare sector. A strategist, young, and dynamic personality, he enjoys building the network and learning new techniques. Shankar believes that urban slum dwellers suffer from adverse health conditions owing to mainly two reasons – the lack of education and thus lack of awareness and the unwillingness to lose a day’s wage in order to reach the nearest medical facility. And that’s how the idea of Aapka Doctor, came to his mind. A non-profit organization providing mobile healthcare services in Maharashtra. Currently, Aapka Doctor foundation is working as a front line warrior and fighting against Corona by providing free healthcare facilities to the underprivileged community in Maharashtra. Aapka Doctor vans are manned by a doctor, pharmacist, lab technician, and a driver. They administer free healthcare services.

What is Mobile Health Technology?

The term mHealth is used for the practice of medicine and public health supported by mobile devices. The m-healthcare applications can be used for patient’s records, disease monitoring, communication, workflow management, medical surveys, documentation and alarms etc. It includes less time spent in evaluating the medical history of a patient, searching data and other relevant information that is available when making decisions and less time consumed in the documentation. It also facilitates physicians with the latest medical knowledge at any time through connection to standard medical databases. It allows patients with chronic conditions to remain under constant observation without a need of being physically present at the hospital. 

mHealth (Mobile Health) = Doctors – Hospital Visits + Mobile Technology = mHealth

  • Difficulty for Users

The input systems are miniaturized keyboards, keypads or pen-based handwriting systems, none of which is suitable for inputting medical information such as EHRs. Data entry containing special signs as well as symbols is tedious. Use of the keyboard with hand gloves or in cold conditions by medical staff appears to be difficult and time-consuming. The data entered in the dark is nearly impossible unless the screen is angled towards the keyboard or a self-illuminated keyboard is provided. A healthcare-specific speech-recognition tool for faster data input and better accuracy is not yet available. Doctors, patients turn away from applications of mobile healthcare solutions that are complex and difficult to use. Various tools like blood pressure monitors, fitness bands and glucometers should connect to these applications.

How to Overcome

The developers must keep ease of use in mind while developing such apps. The user experiences input is something that healthcare providers should investigate. The apps should not only take into consideration the availability of several devices in the market, but also the scope for the incorporation of health and fitness devices with the app.

  • Patient’s Concern over Data Privacy

The right to information privacy must be interpreted with due attention to a duty of care owed to patients, particularly those vulnerable to significant negative consequences with information sharing. So, a balance must be struck between preserving the autonomy of individuals and preserving their life and good health. So, access to information should be under the control of the patient or appointed guardian or surrogates. Collecting the data is very significant for healthcare providers to recognize their consumers and provide to them professionally; the patient’s concern over the privacy of their information is genuine. It is imperative to impart a sense of security and uncompromised privacy to patients.

The trust in m-Healthcare can be a decision about medication or therapy, which is taken without face-to-face communication with patients or relatives of the patient. As m-Healthcare systems are becoming more complex, there is a need to define an ‘informed consent’ in such a mobile environment where face-to-face communication may not be possible. The life expectancy between rich and poor differs by at least 5% of lifespan. Advanced healthcare is already available if one has the money to spend. The ageing population is rapidly increasing all across the globe. The m-Healthcare applications can help to take the healthcare applications to masses with lesser costs just like other mobile services. 

How to Overcome

It is essential to ensure that there is ignorance on rules set by the Health Insurance Portability and Accountability Act’s (HIPAA) or General Data Protection Regulation (GDPR) for data privacy. Healthcare mobile apps must comply with their guidelines and safeguard the patient’s privacy.

  • Responsibility of errors 

The history of healthcare information systems is plagued with various examples of medical errors producing serious harm to the patients. Medical error is a leading cause of death along with different scenarios and medical negligence. Some errors can be fatal, causing bigger emotional as well as economical loss to the family of patients.

How to Overcome

If anything goes wrong in m-Healthcare systems and harms patient, a clear medical policy and guidelines should be defined. These guidelines may include regulations about who is to blame and how will be the resulting costs covered.

  • Security

The hardware limitations of mobile devices prevent usage of strong encryption algorithms, which are necessary for a better level of security for commercial transactions in healthcare. Modern operating systems used in mobile devices are not designed for carrying out secure transactions like transfer of EHR or payment of bills. However, over 50% of all the healthcare institutions fall prey to at least one cyber-attack and one in three of these attacks are a success for the attackers. With the convergence of mobile and computer technologies, high throughput and low bandwidth cryptographic algorithms need to be developed to exchange information across various devices, applications and networks. Patient data stored on mobile devices could mean the difference between life and death and thus must be protected from accidental loss. One solution is to fit a free-fall detector on the device, which shuts down the system if it falls to the floor.

How to Overcome

In m-Healthcare applications, many operators like doctors, medicinal staff, patients, superintendents etc. are involved. If their access to EHRs as well as other medical data with m-healthcare applications is not controlled it can be a real threat to the security of the system. Though public records can be accessed by all users, vital medical data should be accessed only by related authenticated users. Thus, there should an authentication process for confirming the identity of users. These identified users should be authorized to access related functionalities as well as data as per requirements, e.g. only the physicians and no other users are authorized to update critical medical data in EHR. With m-Healthcare systems, an authorized physician should be confident that he/she can access the EHR and communicate with a hospital or patient if required.

  • Health Awareness and Literacy

While the medicinal communal is health literate, the patients may or may not come with a reasonable medical understanding.

How to Overcome

Healthcare providers need to think from the perspective of the users. The answer lies in learning the requirements and the health literateness level of the target audience and then delivering such an experience as resonates with them. Healthcare providers either need to adapt to the audience’s health literacy level or find a way to help them make sense despite the gap in knowledge.

  • Patient Engagement

However, a great number of applications end up feeling like a monologue and fail to involve patients. If the app flops to improve the medicinal knowledge of the persons through vital evidence and data, it fails the drive.

How to Overcome 

Transparency in the interaction between the healthcare providers/doctors and patients is the pulse of mobile healthcare services. To engage the patients, it is not only necessary to resolve their pain points, but also to provide them with the health and treatment-related data and information they need. The healthcare app must offer user-friendly features such as the ability to schedule/cancel an appointment, request prescriptions and easy access to medical records. 24/7 consulting service should be made mandatory if a patient is in need.

The World Health Organization defines mHealth as “medical and public health practice supported by mobile devices. In short, mHealth is likely here to stay. Hospitals and health systems are continuing to explore innovative ways they might use mHealth to further engage patients, improve patient health outcomes and patient satisfaction and even reduce costs. Innovators in the mHealth space are also considering how the increasing number of devices people have in their homes, Amazon’s Alexa or other voice-activated in-home assistants could do more than just add items to a grocery list or order diapers.

With an increasing number of companies trying to get a foothold in the mHealth market, it’s also a challenge for practices and health systems to determine which mHealth apps are the most effective that will meet the needs of their patients and providers. It’s something to watch and something that has the power to transform the way healthcare is delivered.

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