‘As in banking, there will be no loss <strong>of</strong> confidentialityif medical records are saved in electronic form’Continued from Page 2)What were the concerns about, andobjections to, adopting IT? The biggestfear was about loss <strong>of</strong> confidentiality.But if the widespread use <strong>of</strong> ITin banking had not raised concerns onthat issue, then ensuring the same level<strong>of</strong> security for health records wouldnot be very difficult.A few other fears were attached tothat about loss <strong>of</strong> confidentiality. First,people did not want it to be known onrecord that they had a condition suchas HIV, diabetes, blood pressure ormental problems because that couldaffect their chances <strong>of</strong> promotion atwork.Second, they feared that if informationabout these conditions becameknown, then they would be embarrassedor shunned by their friends, relativesand associates. This informationcould also be a major drawback in custodybattles with estranged spouses.Third, insurance companies wouldimmediately raise their premia because<strong>of</strong> the risk <strong>of</strong> these conditions.“But all these things can be takencare <strong>of</strong>,” said Dr. Rohini.She said hospitals were worriedabout the initial cost <strong>of</strong> HIT being high;but if they looked at the overall andall-round savings, then the cost wasnot so high.Worries were also expressed aboutconnectivity, hardware and so on. Itwas felt that there would be a need toset up computers here, there and everywhere.But this was no longer amajor problem because <strong>of</strong> improvedconnectivity and cheaper hardware.“But the real crux is this – who willpay for the HIT? This is botheringhospitals, doctors and everybody else.But let us see who benefits from it.The patients benefit, the insurancepeople benefit, the hospitals benefit.So what is the hitch?”Turning to electronic healthrecords, Dr. Rohini pointed out thatthe same HIT could be used for telemedicine.Already, Time magazinehad given a name to tele-medicine,viz., “heal-wire”. And more andmore people were using IT for deliveringclinical care. But therewere two types <strong>of</strong> tele-medicine, realtime or video-conferencing, and thestore-and-forward kind.Real time was a difficult proposition.But it required hardware, s<strong>of</strong>tware, thepresence <strong>of</strong> two doctors on the samelevel and in the same time zone. Moreover,when a video-conference wasover, there were no records.Under the circumstances, those usingthe web said that it was the bestway out because it didn’t require infrastructure.But that was not telemedicine.Increasingly, people were adoptingthe store-and-forward technology.Here, the patient didn’t have to goanywhere; his relatives gathered all theinformation and digitised it, whetherX-rays or angiograms. These digitisedfiles were then sent to experts, whetherin Japan or America; that person wouldsee it and also show it to other expertsand then collate the information andform an opinion.The advantage <strong>of</strong> this system wasthat it was cheaper, it didn’t requiremuch infrastructure and was quitequick.In India, most people rushed todoctors when they had a problem,nobody bothered about preventivemedicine. Information technologycould give a boost to preventivemedicine, too. If a man had a familyhistory <strong>of</strong> diabetes and if he kepttrack <strong>of</strong> his blood sugar levels, becausehe was collating his data, hecould note when his blood sugarwas going up and hence he couldtake steps to prevent the onset <strong>of</strong>diabetes. Thus, the cost to peoplewould go down if they detected diseasesearlier.What about rural health care facilities?Dr. Rohini said it was not possibleto build big hospitals in villagesbecause the population was dispersed.Besides, there were no facilities suchas cheap public transport for peopleto go to even the nearest hospital if itwas, say, five km. away.Optimum utilisation <strong>of</strong> rural hospitalswas made more difficult by thefact that few doctors were preparedto go there because (a) there was noincentive (b) there were few patientsand (c) poor infrastructure. In suchcircumstances, it was futile to expectdoctors to work wonders there. Butwith IT, those doctors could be betterequipped with proper guidance. Thiswould ensure “capacity-building” <strong>of</strong>doctors.The time had come for the Indiangovernment to make electronic medicalrecords compulsory at all governmentand private hospitals, at pathologicallaboratories and so on. Thiswould improve the outcome and reducethe cost.Even in a small country like Taiwan,when it was decided to give healthinsurance to all, electronic records wereprepared for each and every citizen.After that, a person could go to anydoctor in Taiwan and he would immediatelyget the person’s data and proceedwith treatment without duplication<strong>of</strong> X-rays, tests and other investigations.The country was thus savinga lot <strong>of</strong> money.New private hospitals in India haddoctors who were <strong>of</strong>ten not up to themark. IT could be used to train themand to improve their abilities.Of course, everything would haveto be customised for India becausethere was no point in taking up theAmerican system and applying ithere.Dr. Rohini pointed out that the AgricultureMinister, Mr. Sharad Pawar,had set up two mobile vans that regularlywent to every mandi inMaharashtra State. Each van had s<strong>of</strong>twarethat captured patients’ recordsand a staff member who did blood testsand X-rays. The information wasstored and the service <strong>of</strong>fered for a mereRs. 50.Of course, Mr. Pawar was doing allthis mainly to get votes at the time <strong>of</strong>elections, but this was another way<strong>of</strong> improving health care in villages andfor what was called the “capacitybuilding”<strong>of</strong> doctors.In conclusion, she urged membersto opt for those doctors and hospitalsthat stored records in an electronic formator those who would store andupload the data on a website for easyaccess by the patients concerned.Answering questions posed byMudit Jain and PP Arun Sanghi, Dr.Rohini said that she was using indigenouss<strong>of</strong>tware to store records inan electronic format.Besides, she also had tie-ups withexperts from all over the world whowere sent data for diagnosis or prescription.In this way, the best andlatest medical research was madeavailable to Indian patients.So far as costs were concerned,the charge for data entry and storagefor one year was about Rs. 1,200and Rs. 10,000 for a lifetime. Therewas no limit on data size and storage,Dr. Rohini added.Many people in India were opt-ing for video-conferencing becausethey felt that it was the way forward.Well done, Rohini. President Nowroze compliments Dr. Rohini Chowgule at the end <strong>of</strong> her talk. At right, she is inconversation with new member Anup Agarwalla, who was formally inducted along with Manish Kejriwal at thebeginning <strong>of</strong> the meetingJune 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 4
Welcome, Ambassador. Ramesh Narayan, the brain behind the pioneering ‘Bhavishya-Yaan’ project, greets the chief guest, Mr. Julio Ribeiro.District Governor Dr. Bal Inamdar, President Nowroze Vazifdar and Hon. Secretary Sitaram Shah join Mr. Ribeiro and others after the release <strong>of</strong> themonograph on ‘Spirituality and Leadership Practices for the Common Man’MONOGRAPH ON SPIRITUALITY AND LEADERSHIPHon. Secretary Sitaram Shah, who was a key figure in the compilation <strong>of</strong> themonograph on 'Spirituality and Leadership Practices for the CommonMan', makes the welcome speech and explains some <strong>of</strong> the salient features <strong>of</strong>the publicationIn a project devised and conceivedby the <strong>Rotary</strong> <strong>Club</strong> <strong>of</strong> <strong>Bombay</strong> withthe assistance <strong>of</strong> District 3140, a monographon “Spirituality and LeadershipPractices for the Common Man” wasreleased by former Ambassador, formerPunjab Governor and <strong>Bombay</strong>’s ex-Commissioner <strong>of</strong> Police, Mr. JulioRibeiro, at a programme at the NehruCentre on June 14.Among those present on the occasionwere District Governor Dr. BalInamdar, PDG Ghulam Vahanvaty,President Nowroze Vazifdar, Hon.Secretary Sitaram Shah, RameshNarayan and others.The four organisations involved inthe preparation <strong>of</strong> the monograph wereR.I. District 3140, the Chinmaya Mission,Kaivalyadham (Lonavala) and the<strong>Rotary</strong> <strong>Club</strong> <strong>of</strong> <strong>Bombay</strong>.The monograph contains 54 contributions(one <strong>of</strong> these by PresidentNowroze) and messages from theGovernor <strong>of</strong> Maharashtra, Mr. K.Shankaranarayanan, the <strong>Bombay</strong> UniversityVice-Chancellor, Mr. RajanWelukar, and the Vice-Chancellor <strong>of</strong>SNDT Women’s University, Pr<strong>of</strong>.Vasudha Kamat.The articles in the book describesome <strong>of</strong> the practices <strong>of</strong> national andinternational leaders. A few <strong>of</strong> themhave shared their spiritual and leadershipexperiences for the sake <strong>of</strong> thispublication.The monograph stresses the factthat spirituality and leadership are twosides <strong>of</strong> the same coin and that theyare strongly bonded by the edge providedby one’s evolving personality.It also points out that there is a continuousscaling up <strong>of</strong> an individual,from spiritual wealth to intellectualwealth, and from intellectual wealthto physical wealth (and not vice versa).Each article brings out a separateaspect <strong>of</strong> spirituality and leadershipand the reader will find many tips todevelop his multidimensional personalityto live in this vast world, wheregrowth and splendour is limitless.‘Spirituality and leadership are two sides <strong>of</strong> the same coin.’ President Nowroze Vazifdar, <strong>Club</strong> First Lady Niloufer (left) and Hon. Secretary Sitaram Shah chatwith a guest at the book release held at the Nehru Centre on June 14. Among those who can be identified in the photograph at right are Mr. Julio Ribeiro,PDG Ghulam Vahanvaty and Ramesh NarayanJune 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 5
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