Patient Empowerment through Online Healthcare

Introduction Technology has found its way deep into our lives that the blurry line between usage of technology and co-existence with technology has long disappeared. Internet and the web is one such entity. With India seeing a phenomenal rise in the number of Internet users and with the increasing awareness about the plethora of information available on the web, the Health sector is not one to be left behind and it is seeing an increased number of online takers. This has given rise to a number of health portals as well as online consultation portals which brings in medical advice and care right to the people. Floating online health portals is a fairly new business avenue which has many takers as proven by the number of users of these sites. The popularity of such companies among the investors is quite evident with the amount of investments made on them. In the last few years the number of such sites is increasing, however only time will tell how many of these will be economically viable and sustain the initial surge. Internet usage in India has been rising at a steady pace with metros and urban cities propelling this growth since 2000. According to a study by Internet and Mobile Association of India, on an average there has been more than 30 per cent year-on-year increase in the Internet adoption among urban population. Close watchers of the trend point out that in another couple of years, India will become one of the countries in the world having the largest number of internet users, second to China. But, this teeming increase of usage is not only in the metro cities. Interestingly, there has been high growth of users in non-metro cities lately, clearly indicating the mediums popularity in these tier II cities. In contrast, there are few takers of technology in rural India; however they are also catching up on the trend with reports predicting 24% increase in users from rural areas by 2012.

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This trend clearly indicates that now more people are accessing the Internet on a regular basis. What is even more eye catching is the number of people using the Internet for health related searches. Indians are becoming more and more aware of their health and healthcare needs and are increasingly using the internet to seek answers. According to one of the health e-portal, 12% of all internet searches out of India are related to health. And a staggering 40% Indians use Internet for health information. Internet Customer Profile Although the pundits in healthcare sector are interested in this rising avenue for growth not many are aware of the profile of these Internet customers. An international research released by Max Bupa in January 2011 has found that more than one third Indians go online for health information. Additionally, higher levels of education and income are associated with higher levels of online searching. 28% of the respondents in the higher income bracket made use of the Internet to search for information often. Bupa Health Pulse 2010 also indicates that use of the internet to search online for health information varies with age and its use drops sharply in those aged 35 and over across the countries surveyed. The survey also reveals that more people look for information on medicines and selfdiagnosis while surfing the net. Primary use of the internet for health purposes continues to be finding information about medicines (68 per cent of respondents) in all countries surveyed. Other uses include searching for information to make a self-diagnosis (46 per cent) and seeking other patients experiences (39 per cent). The use of the internet for interactive activities, such as emailing a medical professional, remains limited. According to the survey 18 per cent of respondents use social networking sites to find out about healthcare issues. Online Consultation Opportunities This paper was submitted for eINDIA 2011 conference Page 2

A patient portal offers the benefit of more engaged, involved patients. As defined by the Center for Advancing Health (http://www.cfah.org) engagement includes the actions individuals must take to obtain the greatest benefit from the healthcare services available to them. In contrast to compliance, which suggests a patient obey a providers directive, engagement means a patient is involved in a process through which he harmonizes robust information and professional advice with his own needs, preferences and abilities in order to prevent, manage and cure disease, says CFAH. Patients come first, but the best patient portals are designed around the lives, workflow needs and priorities of both patients and providers. Providers who use a patient portal gain a newfound power and ease to streamline appointments, track patient care, accelerate the pre-admission process and reduce the costs of admissions and readmissions. Patients, in turn, can tap into a portal to enter health history, monitor test results, access provider-driven education and collaborate with clinicians. As much as the rising trend in health searches online has opened new doors for business, it has also given the busy doctors a new platform to interact with their patients. Many doctors feel that web presence is definitely a boon for their profession in todays world. Doctors are reachable to the people either through their own personal websites or through the websites of the hospitals they are associated with. Nevertheless, the trend to have an online consultation is on the rise. The reach of technology has enabled people to use online health-related information to help them understand various health related issues and make more informed choices. In a country like ours, use of internet and social media will be a key source for seeking health care information and advice. With Medical tourism becoming an increased avenue for the doctors in India, it is becoming more preferable to the Physicians and Hospitals to have websites showcasing This paper was submitted for eINDIA 2011 conference Page 3

their details, ready to provide necessary information to care-seekers world-wide. Such websites and portals are designed to include information about various treatments being offered, surgery techniques, success stories and accomplishments. It also allows continuity of care for patients who travel far and wide and gives information on the doctors skills and achievements which may not always be easy to communicate with the patients in short consultation. Why Online Consultations? Online consultations are not only convenient they are the need of the hour. The main factors limiting the access to face-to-face consultations in India are time constraints, lack of organized information about doctors, lack of ease in accessibility of consultation beyond physical boundaries and mobility. These limiting factors have in turn increased the rate of growth for online consultations/portals. In addition, the availability of Broadband access, patient awareness and familiarity with online payment mechanism are propelling the growth of online consultation in India. One of the primary benefits of online portals is that patient choice can be increased as a result of better access to health information. Moreover, better information about how to maintain good health may have public health benefits. Patients are empowered by being better informed of their symptoms; whenever they start feeling worried about certain symptoms, they can check online first and gain some understanding of the disease and treatment options. Online health information may also be used to fill in perceived gaps in the information provided by healthcare professionals. The use of internet services is particularly popular with some population groups, such as young people, who have been shown to make use of online health information because they value the anonymity and quick response. Access to good online health information can potentially reduce the amount of contact time between health professionals and the worried well (i.e. individuals who go to a This paper was submitted for eINDIA 2011 conference Page 4

medical facility with no discernible signs of ill health, or who are experiencing minor health problems such as coughs that may be managed without the need for medical consultation); this can free up resources that can be re-directed to people with diagnosable/severe diseases. While there are many positive impacts, it is imperative to understand that there is a number of potential trade-offs between more empowerment and choice versus the risk of misleading information, misdiagnosis and unnecessary treatments. Challenges It should be noted that some challenges with the internet go well beyond its use for healthcare purposes. These concerns include data protection and worries about the security of information, risk of fraud and identity theft, etc A key issue is the veracity of online health information. The benefits primarily rely upon the patients ability to make informed choices. We have to consider the fact that not all consumers are knowledgeable enough to distinguish between high and low quality information. Hence, increasing individual awareness of the need to make use of online health information with caution is something that needs to be undertaken Website users should be made aware of the potential influence of sponsors on third party websites. Users should also obtain information on who runs each website and the registered address of the organization. Online healthcare portals are a budding market. To get an estimated size of the market one can look at the estimated number of users online or number of people who have credit card and online banking facility. Considering this fact, it will show that online consultation is a sizable market. This is also further evident by the fact that there are already many sites mushrooming online to grab the share of this market. Some of the

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known names in this segment are Healthcaremagic.com, TopDoctorsOnline.com, Ask4healthcare.com, MediAngels.com, and IndiaHeartBeat.com Some of these internet-based platforms work to connect doctors and patients round the clock through live chats, electronically maintained health records and open forum discussions on symptoms. In addition their services also include searches to help locate an authenticated doctor, fix appointments and help store medical reports and scans online to be accessed by a doctor at any given time. These websites not only direct a patient to his closest doctor, but also connect him to an international specialist for a second opinion.

Revenue Model Some of the services on these sites, such as the open forum discussions on symptoms posted by individuals, are free, whereas private chats with GPs and specialists can range anywhere from Rs 100 to Rs 5,000. Apart from the fee that the sites charge as a percentage of the doctors fee, corporate clients, advertising, retailing and annual subscription by hospitals on the networks also help monetize these businesses Investment and Growth The growing popularity of online portals is evident by the investor interest in such ventures. HealthCare Magic raised funds close to $2.5 million from early-stage fund Accel Partners in 2009, its second year of operations. The Mumbai-based startup firm which launched its operations in January 2011 has raised seed funding of Rs 3 crore from HDFC Private Equity. Both TopDoctorsOnline.com and Ask4health.com are looking to raise funds for further expansion..

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Conclusion Online consultation and potential use of internet for health-related purposes is indeed promising. There is however some benefits as well as challenges in accessing healthrelated information via the internet and the government should consider what steps may be taken to improve the potential of using the internet for health-related purposes. One of the most crucial benefits to the patients is that the online health information empowers the consumers to make better informed choices about their health and healthcare needs and can help reach population groups that would not otherwise have come into contact with face-to-face healthcare services. References 1. BUPA Health PULSE 2010 2. I-CUBE 2009 2010 Internet in India Bio Deepak Padmanabhan works as Lead Business Analyst in the Health IT field. His areas of interests include Health Reforms, ICD-10, and Health Innovations. He is a certified Project Management Professional (PMP) and Fellow, Academy of Healthcare Management (FAHM) Name: Deepak Padmanabhan Address: 23/205, Malaysian Township North Phase, Kukatpally, Hyderabad 500072 Email: padmanabhandeepak@gmail.com Mobile: +91-9701768420

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