Chronic Disease Management scene in India?
In India, a leading hsopital conceptualized the program to lead Outpatient chronic care market and to some extent, extend brand in outpatient care – By offering a comprehensive chronic care model. Here is the evolution of disease management in India:
1999 Patient specific information portal– Pure online model
2001 Online Wellness Channels – Pure Online model
2002 Branded Wellness Channels and Information Kiosks – Brick and Click model
2003 First Disease Management Program called “BreatheEazy” – Program to manage asthma.
2005 Second Disease Management Program called “Healthy Heart “ – Program to manage chronic Cardio Vascular diseases.
Role of Stakeholders in the program:
Pharmaceutical companies
• Patient education material
• Physician resources for treatment of Asthma and COPD; and co-morbidities
• Advertisement and marketing resources
• Sale of drugs at a discount
• Primary market research to identify program components
Healthcare Provider
• Program deployment
• Patient care
• Call center support
Physicians
• Patient care
• Education sessions
• Participation in camps (Corporate, school and community)
Patients / Corporate
• Receive care and adhere to program guidelines
• Feedback to call center
• Provide testimonials
IT/BPO companies
• Develop software for data management and health monitors
• Call center support
• Outcomes reporting and data analytics
• Presentations at key seminars – DMAA
Health Insurance
• No role as of now
• No data on actuary on out-patient care
• Out-patient care still not promoted by health insurance plans in India
Typical IT systems/modules involved in program:
The IT systems used in a DM program achieve 4 objectives:
• Program compliance
• Patient compliance
• Data analytics
• Reporting
The modules, which a typical DM system should have are:
1. Program management module – Scheduling visit, program health etc.
2. Call Center module – In bound and out bound
3. Physician module – PHR, Prescriptions etc
4. MIS – Reporting, data analytics, program support
Pros:
• Relieved patients – Testimonials, challenge camps, group session leaders etc
• Camps conducted for schools, corporates (Includes Infosys Hyderabad)
• Very effective database gathering model – Camps, advertisements, primary research, pharmacy coupons, referral centers etc.
• Outcomes presented at DMAA Annual 2003, 2004
Cons/Bottlenecks:
• Lack of health insurance
• Lack of focus on chronic care by leading hospitals – The focus still on critical care – big bucks!!
• Lack of physician support – Physicians in India doesn’t believe in team work compared to a group practice in US.
• One of the leading physician comment was “I do not want to loose my patient to the system. This is a good program, and it will suck in all my patients”
• Only GSK drug need to be prescribed , which limited the quality of treatment.
Going forward :
• In the US, DM programs are driven by Insurance companies to contain cost, control chronic conditions and reduce emergency visits. Health Insurance in India need to follow the model.
• As the cost of chronic care escalates, patients will realize value in DM program. Patients are happy taking SOS medications to preventive care (Salbutamol @ Rs.100 to Salmeterol/Fluticasone @ Rs.500 – Rs.1000)
• Encourage physician’s belief in team work to ‘lone’ care provider.
