The use <strong>of</strong> IT will bring the latest medical knowledgeto India, says Dr. Rohini ChowguleLasers, robotics, nuclear isotopes,calls or rush to visit their wards –CT-scans, X-rays, magnetic resonanceall that they would have to do wouldimaging (MRIs), these are some<strong>of</strong> the technological tools that doctorshave utilised to fight disease and toimprove the health <strong>of</strong> the people. Today,India has turned into a centre forthe best medical care – at a fraction <strong>of</strong>the price paid by patients in advancedcountries – and people from all overthe world have been coming here toavail <strong>of</strong> the excellent medical facilities.This welcome development has beenattended by two phenomena that canno longer be ignored. One, thanks tothe advent <strong>of</strong> ever-new technologicalinnovations, patients have startedbe to check the status <strong>of</strong> patientson their respective tablets (notmedical pills) or i-Pads.Once put in place, this systemwould also help track diseases in thecommunity. For example, if some patientsin Patna were down with a particularinfection and if a similar trendwas noticed in Pune or <strong>Bombay</strong>, itwould indicate that the infection wasspreading in the community. Chronicdiseases could also be tracked in thesame way.While working on chronic care andmanagement <strong>of</strong> diabetics in Washington,said Dr. Rohini, it was observedsearching for details about their illnesseson the Internet and telling doc-that older people did not have rela-Thanks to people searching for illnesses on the internet, one man has decidedto call himself ‘Dr. Google’. Dr. Rohini Chowgule at the last meetingtors about their “findings”.tives to take them to hospital; the authoritiesTwo, while some members <strong>of</strong> themedical fraternity appear to have takenumbrage to this fad (one <strong>of</strong> them jokinglysaid he was changing his name toDr. Google), there are others who believethat it’s better to flow with thetide rather than resist the sweep <strong>of</strong>technology.Dr. Rohini Chowgule, the renownedchest physician who is recognised bothas a champion golfer and an asthmaspecialist, belongs to the second category.She has worked hard on bringingthe benefits <strong>of</strong> information technology(IT) to bear on modern medicinethrough innovative s<strong>of</strong>tware systemsfor health data management andremote consultation.Speaking on “Information and communicationtechnology in health caredelivery” at the last meeting, shepointed out that everybody talkedabout health care, nobody about healthcare delivery, a subject that she wouldconcentrate on in the course <strong>of</strong> her talk.Tarjani Vakil introduced her as a“Goan, full <strong>of</strong> life and one who lovesfish, music and dancing”; she had beenand would be a role model “for India’schildren who are getting lost in aglobalising world”.Dr. Rohini started by pointing outthat although it was the people whowere driving doctors to use new technology,its benefits were enjoyed onlyby those in urban areas while peopleliving in rural areas were being ignored.But IT was a powerful tool to takegood health care to rural populations.Most countries used 9% <strong>of</strong> theirGDP on health care. The USA, Franceand Germany spent 10 to 17%. Indiaspent 4% and other Asian countries 2to 3%. However, these figures representedthe amount spent by governments.Large numbers <strong>of</strong> people inIndia paid for health care from theirpockets and these figures were not includedin the GDP spend.“And because it is the governmentthat spends this amount, that’s why itis (becoming increasingly) botheredabout health care technology.”The trend was set <strong>of</strong>f by AmericanPresident George Bush in 2004 whenhe noted the money being spent onhealth care and felt that something hadto be done about it. He drew up a tenyearplan to develop and implementan electronic medical system acrossthe US to improve the efficiency andstudy <strong>of</strong> health care.Research conducted by Rand HealthCare showed that if the USA pulledup its socks, it would save $81 billion,reduce adverse health care events(which were <strong>of</strong>ten created by doctorsand hospitals) and also improve thequality <strong>of</strong> care.Finally, in 2009, President BarrackObama brought a law. He <strong>of</strong>fered acarrot to the health care industry, tellingit that if it gave up paper and shiftedto electronic medical records, it wouldnet a windfall <strong>of</strong> $19 billion.He set aside $2 billion for healthcareproviders to implement HIT (healthcare IT) and a whopping $17 billion inincentives from Medicare and Medicaidfunding if they adopted HIT by2015. Obama also <strong>of</strong>fered incentivesto healthcare providers implementingelectronic records (again through Medicareand Medicaid funding).Dr. Rohini said that apart from theUS, the UK and other European countrieswere also spending huge sums <strong>of</strong>money to move towards electronichealth records.What made them go for this change?They realised that health care IT (HIT)provided the umbrella framework todescribe the comprehensive management<strong>of</strong> health information across computerisedsystems and its secure exchangebetween the stake-holders suchas the consumers, the providers, insurersand government and qualityentities.Further, HIT could yield severalbenefits: (a) improve the quality oreffectiveness <strong>of</strong> health care; (b) increasehealth care productivity andefficiency; (c) prevent medical errors;(d) reduce health care costs; and (e)improve administrative efficiency bydecreasing the paperwork.When a person went to hospital,there was needless repetition <strong>of</strong> thatperson’s medical data. This was donefirst at the registration counter, thenupon arrival in the ward and also whenhe was taken to the operation theatre.Each one <strong>of</strong> the nurses/clerks at theseplaces required the patient to repeatthe same information over and overagain.This was a colossal waste <strong>of</strong> everybody’stime. (And time being money,it was no surprise that Rand HealthCare had shown that if the USA pulledup its socks, it would save $81 billion,reduce adverse health care events andalso improve the quality <strong>of</strong> care.)If a system <strong>of</strong> electronic data storageand dissemination was put inplace, doctors and medical personnelattending to the patients wouldnot have to make or receive phonethen opened a cell whereonline data could be transferred fromtheir homes to the centre. Nurses wereposted 24x7 and kept a watch on patients’data.When a patient conducted a glucosetest, the reading went through a phoneto the cell. If the nurse felt that theblood glucose was down, she immediatelycalled and asked what was goingon. If the person said he felt a bit dizzy,she told him to stop taking insulin.This was one way <strong>of</strong> managingchronic patients so they that didn’thave to first go for a blood sugar test,then go to a doctor, wait for him, meethim, chat with him, show him the reportand return home. That was a threehourprocess best avoided, thus reducingcosts all round.At present, most big hospitals in theUS were giving tablets to their juniordoctors that were loaded with guidelinesfor treatment, side-effects <strong>of</strong> drugs,information about drug interactions, reactionsand so on. When one went tothe main page, one found full information,including, for example, which medicineto avoid if a patient was going foran abortion. This was another way toprevent doctors’ errors.Another benefit was that when theywere in the company <strong>of</strong> other, seniordoctors, they could turn on their tabletsand discuss the modalities <strong>of</strong> treatmentfor their patients.Dr. Rohini revealed that one <strong>of</strong> themajor hospitals in <strong>Bombay</strong> was on theverge <strong>of</strong> starting a similar programme.When that happened, it would ensurethe quality <strong>of</strong> care provided even byjunior doctors.(Continued on Page 4)June 25 to July 1, 2013 THE GATEWAY, The Bulletin <strong>of</strong> the <strong>Rotary</strong> <strong>Club</strong> <strong>of</strong> <strong>Bombay</strong> Page 2
Wear this <strong>Rotary</strong> lapel pin every day and wear it with pride. President Nowroze Vazifdar formally inducts two new members, Manish Kejriwal (left) and AnupAgarwalla. While Anup has been loaned the Classification ‘Mining: Coal’, Manish will represent ‘Finance: Investment’Two new members are formally inductedTwo new members, Anup Agarwallaand Manish Kejriwal, were formallyinducted at the meeting <strong>of</strong> June18, the penultimate meeting <strong>of</strong> the<strong>Rotary</strong> year.While Anup has been loaned theClassification “Mining: Coal”, Manishwill represent “Finance: Investment”.Manish Reshamwala, who wascalled upon to introduce AnupAgarwalla, said that Anup graduatedfrom H.R. College and had done hisBachelor’s <strong>of</strong> Science and BusinessAdministration from Washington University,St. Louis.With over 20 years’ experience inthe coal and commodity business inIndia, he had experience in developing,financing, construction and management<strong>of</strong> projects in coal-mining,coke manufacture and power.On returning to India, he trainedunder PP Sandip Agarwalla in his companies,BLA Industries and BLAPower. While BLA Industries was one<strong>of</strong> the first private coal-mining companiesin India, BLA Power was thefirst independent power plant generatingthermal power in MadhyaPradesh. BLA Industries was a member<strong>of</strong> the World Economic Forum.Anup was very active in businessand his companies conducted manyCSR programmes, including threemedical clinics, medical camps in ruralareas and supporting NGOs.He was married to Namrata, also agraduate <strong>of</strong> H.R. College, and thecouple had two daughters Urmi andShreya. He was a tennis enthusiast.Vice-President Shailesh Haribhaktiintroduced the second new member,Manish Kejriwal.He said that Manish had started startlingthe world when he was at schooland topped the ICSE. After that, hehad a brilliant career, obtaining anMBA from Harvard Business School.He returned to India, marriedSunaina, the daughter <strong>of</strong> the Honorarymember, Mr. Rahul Bajaj, and joinedTemasek Holdings.Manish had a fantastic run with investmentsin India. He had the full trust<strong>of</strong> the government <strong>of</strong> Singapore whichwas extremely demanding as an investor.But Manish surpassed its expectations.As the world’s economy almostcollapsed and in times when it wasvirtually impossible to think aboutraising money for investment in India,he and his colleagues raised over $500million for just that purpose.Truly a family person, Manish andSunaina had two sons and alwaysshared their children’s accomplishmentswith friends. Shailesh added thatManish was a second-generationRotarian.Following the introductions, PresidentNowroze Vazifdar conducted theformal induction ceremony <strong>of</strong> the twonew memebrs.But first he pointed out that boththe new members had already becomePaul Harris Fellows.He affixed <strong>Rotary</strong> pins to the lapels<strong>of</strong> the two new members and askedthem to “wear the <strong>Rotary</strong> pin alwaysand wear it with pride”.He also presented them with a copyeach <strong>of</strong> the <strong>Club</strong> Roster, Four-WayTest placards and other <strong>Rotary</strong> literature.Welcome to the <strong>Rotary</strong> <strong>Club</strong> <strong>of</strong><strong>Bombay</strong>, Anup and Manish.Office-Bearers'meetingsThe following are the attendancestatistics from July 1, 2012, toJune 20, 2013:Number <strong>of</strong> meetings held 48President Nowroze Vazifdar 46Nirav Shah 34IPP Paul George 31Shailesh Haribhakti* 3Sitaram Shah 46Hiren Kara 38Ishraq Contractor 5* From January, 2013Devi Thadani passesaway at 99<strong>Rotary</strong>ann Devi Thadani passedaway last week at the age <strong>of</strong> 99.President Nowroze Vazifdar said atthe last meeting that a letter <strong>of</strong> condolencewas being sent to Haso Thadaniand the bereaved family.CorrectionTHERE are two errors in the biodata<strong>of</strong> Ashok Gokal published on Page 4in The Gateway dated June 18. First,the name <strong>of</strong> his firm is “J.V. Gokal &Sons” and not J.V. Gopal & Sons aspublished. Second, the name <strong>of</strong> his elderson is Chetan, wrongly publishedas Cheta. Members are requested tomake the corrections in their respectivecopies <strong>of</strong> the <strong>Club</strong> Roster.At the lastmeeting(Held on June 18, 2013)ATTENDANCEMembers 89Visiting Rotarians 5<strong>Rotary</strong>anns 3Total 97Svc. box collection Rs. 1,700June 25 to July 1, 2013 THE GATEWAY, The Bulletin <strong>of</strong> the <strong>Rotary</strong> <strong>Club</strong> <strong>of</strong> <strong>Bombay</strong> Page 3
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