At AllizHealth, we believe, many of the health conditions we face as adults could have been prevented by timely health interventions. However, preventive care, in India, is yet to be perceived in any serious light. We believe it to be our neighbors problem till the time we come across a crisis situation, which could have been completely avoided.
Isn’t it ironic that a country which is home to 62 million diabetics, second only to China and number expected to cross 100 million by 2030, 25% of heart patients below the age of 50 and 5% of population affected with morbid obesity, still treats preventive care as a western concept?
Same time, moment we speak of preventive health, we always seem to look at the adult population. Not surprisingly then, preventive care recommendations are mostly based on an individual’s lifestyle, dietary habits and existing medical condition. So, isn’t it paradoxical that we need to wait for an individual to be on a slippery slope before intervening and the only option being left at that point is to moderate the fall? Isn’t true preventive care about preventing someone being on that slope to start with? Is there something fundamentally wrong in our approach towards preventive health?
Every other day we receive notifications from health groups, trying to sell us a preventive check-up package. Have any of those groups made an effort to know an individual better before recommending those check-ups? More importantly does the role of that provider stop the moment it hands us back our report/result? Do any of the groups take ownership of guiding us on the next course of action and following up with us to ensure we did take those steps? Unfortunately, the answer to most of these questions is a sad no.
There are multiple reasons which could explain the shortcomings in the approach. If we scratch the surface a bit we figure that Indian healthcare system, built around a very curative care model, has never really placed a patient at the center of the ecosystem. There has never been any diligent effort to empower a patient to be better control of his/her health. It has always been a push approach where our healthcare providers tell us what’s best for us and we, for lack of options, blindly follow those words. We, as patients have never been empowered enough to question back, for we seldom have a complete view of things. It is no strange then that even in preventive care aspects; we rely on a healthcare provider to suggest what’s best for us.
For preventive care to really be preventive there has to be a culture of coordinated care. For coordinated care to be feasible there has to be a seamless flow of information across all entities in this space. However, interoperability as an option has not gone down too well with any of the entities, even in developed nations. Had it not been for government regulations, even many developed nations would have been still struggling to implement mechanisms for effective flow of health information. So, while the lack of exchange may not be a critical factor when it comes to curative care, it is absolutely vital for the success of preventive health model.
Knowledge is for the past, insight is for the future and preventive care is all about insights which can help achieve a healthier tomorrow. In order to come up with such inferences, we need to have information flowing into a common place, from all the entities involved. We need to have a centralized repository of health information, which could be analysed to come up with health interventions, not just at an individual level, but, also at a family or even community level. For a centralized repository to be a possible, the ecosystem needs to be built around the patient. We need to be empowered with options to select what we want to receive and what we want to share. Till the time a user or patient is at the center of this system, it is going to be extremely difficult for this thought to materialize. There have been brilliant attempts made by Google and Microsoft HealthVault on very similar line, but, they haven’t really caught the fancy owning to various reasons, not enough patient incentive being among one of them.
So, trying to wrap things up, for preventive care to be really preventive, few things need to happen, a) user needs to be at the forefront or center of this whole model, b) a centralized repository in control of the user and finally, c) real meaningful insights derived from this data which could alert us, well in advance, of any health concerns we might be heading towards.
For people with pre-diabetes, lifestyle changes, including a 5%–7% weight loss and at least 150 minutes of physical activity per week can reduce the rate of onset of type 2 diabetes by 58%. A 1% reduction in health risks such as weight, blood pressure, glucose, and cholesterol risk factors would save ~ Rs. 5000/annum in medical costs/person. For every gram of salt reduced in diets daily, a quarter of a million fewer new heart disease cases and over 200,000 fewer deaths would occur over a decade.
So, do we still believe that Preventive health is a western concept?