Piloting the Design of e-Services Delivery Platform in Health Services: Technical Assistance Completion Report
sector: Health, Information and Communication Technology | country: Bhutan
Based on field study and survey, on a conservative estimate, this facility has helped at least two patients a day from making trips to the district referral hospital. Based on return, the savings, to patient of Tang BHU (basic health unit), of out-of-pocket expenditure annually, is about USD33,600. The intangible benefit includes (i) quality of data of patients, (ii) enhanced data analytics capabilities which will help in designing health policies specific to the locality, (iii) innovative solution for potential a scale up, (iv) patient’s access to a qualified doctor through virtual means, and (v) opportunity costs associated with productivity of resources.
This project piloted TV (television) white space as a last mile connectivity technology. The other forms of last mile connectivity such as leased lines, WiFi and Cellular can be evaluated separately and appropriate technology be selected depending on the context.
While ICT (information and communications technology) based solutions for public service delivery enhances efficiency, it has to be implemented in an appropriate size to leverage economies of scale. This pilot has provided insights into the implementation challenges of such an intervention, and benefits of e-Health mode of service delivery in remote locations. It also provided insights to operational requirements related to purchase and installation of internet services, and configuration of IT (information technology) enabled equipment and cloud services. The operational requirements are related to allocation of spectrum for TV white space component, working out memorandum of understanding with stakeholders and remote management of maintenance of equipment. In one instance, the remote maintenance did not work effectively and a site visit was required as well as replacement of equipment. However, as mentioned before, generally sustainability of e-health solutions lies in large-scale implementation of such innovations within a national e-health framework as the scale allows optimization of resources, efficiency, cost reduction, and sustainability.
Electronic records management, medico-legal, medico-ethical issues associated with such e-Health solutions, information security and data privacy associated with patient’s data are issues that need to be addressed within broader national e-health governance policies. Also, sustained solution can be achieved by involving private sector partners. For example, India’s primary health service delivery through e-health is implemented at some places by the private sector. However, before partnering with the private sector, it is important that a comprehensive e-health plan is in place and that health data is collected in a comprehensive national health information system and is not silo-ed. Further focused capacity building activities to the health professionals of the Government are required for sustaining efficient form of health service delivery.