In 2012 Hewlett-Packard and the Government of India’s Council for Scientific and Industrial Research formed a partnership to develop the eHealth Center (eHC), cloud-enabled healthcare infrastructure that can be rapidly rolled out to provide affordable basic care along with telehealth services in remote areas. The programme quickly took off and is now being rolled out across in India and in other countries
India suffers from acute healthcare inequalities. Some 75 per cent of its healthcare infrastructure and resources are concentrated in urban areas where only 27 per cent of the population lives. Nearly nine in 10 rural patients have to travel more than eight kilometres (five miles) just for basic medical services. Existing clinics often do not provide quality healthcare.
In 2012 Hewlett-Packard (HP) and the Government of India’s Council for Scientific and Industrial Research (CSIR) formed a partnership to develop the eHealth Center (eHC), a cloud-enabled healthcare infrastructure that can be rapidly rolled out to provide affordable basic care along with telehealth services in remote areas.
Telehealth, or telemedicine, is the use of telecommunications and information technology to provide health-related services and information at a distance. The eHC was designed to overcome several limitations in existing telehealth systems, including the non-integration of vital diagnostic equipment, the absence of centralised electronic records or files, no monitoring of management systems, poor institutional support and a limited integration with government health services.
Adopting a Public-Private Partnership (PPP) model, HP works with the CSIR and other public, private, and nonprofit organisations, to provide quality healthcare services to people in remote, resource-poor locations in India.
Objectives and Delivery
The first obstacle that had to be overcome before setting up the first eHC was the apprehension of villagers who had not come across telemedicine before. HP spent several months working in the community to address their concerns. Once the villagers understood what the project could offer, the elected village head volunteered to ensure the management of the eHC, taking the PPP to a local level.
The eHC can be retrofitted to work with a pre-existing clinic or designed to fit in a standard shipping container that is engineered to be hermetically sealed and robust. They can be transported by rail, road and sea, making the eHC affordable and easily deployable in comparison to the old “bricks and mortar” alternatives. Factoring in frequent power outages in rural areas, the eHC comes equipped with power generators and 2 MBPS of Internet connectivity, making it self-sufficient.
The eHC integrates medical diagnostic equipment. The direct uploading of patient data creates electronic medical records that are stored on an HP cloud. The combination of device integration, electronic records and videoconferencing enables consultation with specialists in a distant location, saving critical time for the patient.
The eHC addresses the challenge of medical manpower shortages as the cloud-enabled medical consultation eliminates the need for highly skilled manpower at each eHC location. The first eHC was deployed in Chausala, a small town in western India that did not even have a government health Center.
Remote monitoring of medical records, eHC equipment and the provider is an integral part of the eHC system as it brings accountability, accuracy and transparency. Remote monitoring of the medical records can assist the government in real-time disease surveillance and provide data for healthcare analysis by the government. Monitoring of equipment such as eHC refrigeration facilities ensures that alerts are sent out if temperature-sensitive medicines are damaged by power cuts.
The eHC delivers remote monitoring of the provider through a combination of biometric solutions and videoconferencing. In order to create a sustainable public-private partnership model, the eHC is integrated with the government’s healthcare delivery system. Government medical personnel such as Accredited Social Health Activists are trained to use the eHC at eHC locations.
The next wave of the programme’s expansion is already well under way. In July 2014 it was announced that a further 14 HP cloud-enabled eHCs were to be established in partnership with Narayana Health, a private firm, taking the total to 20. To serve the network, HP and Narayana Health will launch three support centers where staff can get help on technical and medical issues related to operations. Narayana Health intends to create understanding of the programme in local areas through outreach camps, public awareness campaigns and healthcare education programmes.
The eHealth Center was officially launched on December 11, 2012 and in just six months was rolled out in three different locations, Chausala, Lakhimpur and Aliabad, which together recorded more than 18,000 patient visits. HP was subsequently approached by Narayana Hrudayalaya Hospital to roll out eHCs in Calcutta and Guwahati, taking the concept to new states. By September 2014 the six established eHCs had recorded over 48,000 patient visits – underlining the capacity of the programme to help large numbers of people over a short period of time.
The eHC has quickly emerged as a successful example of a public-private partnership and HP is developing this aspect: in Jamshedpur, Jharkhand state, it is collaborating with Tata Steel, one of the world’s top steel companies, to roll out an eHC with the support of the local member of parliament.
The Indian Government has underlined its interest in the concept. Professor Samir Brahmachari, former director general of the CSIR, had earlier indicated that his organisation will work to upgrade about 28 villages in economically backward regions, helping those living below the poverty line to take advantage of the eHC.
The project is already providing valuable information on region-specific disease trends. In Chausala, for example, an outbreak of skin disease was linked to water pollution, while chronic obstructive pulmonary disease was associated with the use of wood-based fuel in closed kitchens.
HP is actively working with the government, NGOs and local communities to enable smooth implementation and acceptance of eHCs in order to address pressing issues of access to healthcare.
HP India Country Manager Neelam Dhawan believes HP’s cloud-enabled technology is changing the dynamics of the healthcare system in India: it is helping bring high-quality medical care to rural areas, allowing early intervention and treatment of common health problems without patients being forced to travel great distances. The programme also delivers economic progress: healthier people lead more productive lives.
Now the initiative is venturing further afield, in collaboration with the Asian Development Bank. A pilot programme has been set up with the government of Bhutan and HP is partnering with the Philippines Disaster Recovery Foundation to bring two eHCs to the Tacloban and Eastern Visayas areas as part of continuing recovery and reconstruction efforts after typhoon Haiyan in November 2013.
HP will continue to explore opportunities for expansion in other regions around the world.
This case study was written by SharingValueAsia in consultation with HP and its partners. It will appear in special report entitled “Partnership in Action” produced in association with Hewlett-Packard in August 2014
About the lead participants:
HP creates new possibilities for technology to have a meaningful impact on people, businesses, governments and society. With the broadest technology portfolio spanning printing, personal systems, software, services and IT infrastructure, HP delivers solutions for customers’ most complex challenges in every region of the world.
More information about HP (NYSE: HPQ) is available at http://www.hp.com
About Narayana Health
Narayana Health is among India’s largest healthcare service providers and also one of the world’s most economical. From a humble beginning of a 225 bed hospital in 2001, Narayana Health group of hospitals has grown to become a 6,900 beds healthcare conglomerate with 26 hospitals across 16 cities in India and a hospital in the Caribbean at Grand Cayman, North America. Accessibility strengthens as Narayana Health relentlessly continues to expand. For more information visit www.narayanahealth.org
The Council of Scientific & Industrial Research
The Council of Scientific & Industrial Research (CSIR) is the premier industrial R&D organization in India. It was constituted in 1942 by a resolution of the then Central Legislative Assembly. It is an autonomous body registered under the Registration of Societies Act of 1860. CSIR aims to provide industrial competitiveness, social welfare, strong S&T base for strategic sectors and advancement of fundamental knowledge. CSIR is recognised as one of the world’s largest publicly funded R&D organisations having linkages to academia, R&D organisations and industry.
Other participants regionally:
The Asian Development Bank
Philippines Disaster Recovery Foundation
The Government of Bhutan