Can the mouse get your CAT scan?

On one of his friendly visits to his neighbour’s house, Pune resident Sandep Tapaswi, 38, was shocked to find the senior citizen unconscious. “I had to rush him to the hospital, as his children stay in the US and Australia. And when the doctors started asking me questions about his health, I found myself clueless,” recalls Tapaswi, adding that he had to watch helplessly as doctors used up precious minutes to conduct a battery of tests on the patient to figure out his health condition.

This incident not only changed his life, it also made the computer engineer embark on a new career. “It made me realise how ignorant we are about our own medical details,” says Tapaswi. And that is when he decided to set up the website, arogyadarpan.com, which gives users access to their medical records at the click of a mouse button.

Medical goes digital
The website digitises all your medical records, right from your birth certificate to blood test reports, X-rays, and CT scan reports for a certain fee. Launched in January 2009, it has garnered 2,000-odd members since.

The concept of Electronic Medical Records (EMR), though at a nascent stage in India, is picking up across the country, especially in cities with a high concentration of net-savvy IT professionals. In the past two years, a plethora of websites offering to upload medical records have mushroomed in cities such as Mumbai, Pune, Bangalore, Chennai and Delhi.

“Healthcare records are not perceived as an immediate need. However, EMR is here to stay,” says Anand Anupam, founder and CEO of healthizen.com, a personal healthcare management portal, which was launched in January 2008 on a subscription-based model. “However, we changed that to a free model as an incentive to consumers. Today, the portal has six lakh consumer profiles online,” adds Anupam.

According to experts, such websites are especially popular among people living abroad, and whose parents are in India. EMR enables them to remain informed about their parents’ medical condition. A large proportion of users are working professionals in the 35-60 age bracket, who manage their account on the site themselves. The sites also attract pregnant women, or new moms who want to keep track of their baby’s vaccination, etc. Then there are people in the 20-30 age group, who are concerned about diet, exercising, lifestyle habits, smoking, alcoholism, etc, and use these sites as a resource for health-related tips. 

The site healthizen.com, for instance, apart from digitising medical records, also creates unique health profiles of individuals based on their EMR, recommends interventions, and even helps in healthcare decision-making. For example, if a 35-year-old male diabetic uploads his medical records, the system would recommend products such as a glucometer and sugar-free supplements, create a personalised diet and management programme, and send regular alerts and reminders for daily medications and monthly blood tests, which can be ordered to your home. The reports are then directly uploaded into your account, along with a diabetologist’s comment on it, explains Anupam.

Pune-resident Anuradha Sardesai, 33, registered with one such website a year ago, opting for a family plan, costing Rs1,000. “I started with the many free ‘tools’ that were available on their website, such as the calorie counter and BMI calculator,” recalls Sardesai.

She realised its real value when her husband, based in the US, was told that his cholesterol levels were very high. “We were able to show all the reports to our family doctor in Pune, thanks to our online account,” says Sardesai, who also keeps a record of her five-year-old daughter Sana’s immunisation schedule on the website and gets reminders on the date of vaccination.

“The website was useful during my pregnancy, as I was able to assess myself for health risks and now, post delivery, I regularly consult the website’s immunisation schedule,” says Manisha Puthran, 31-year-old Nerul resident. Radhika Raman, 35, chanced upon healthizen.com while surfing the web for information on diabetes. “I had the habit of forgetting to take my medicines. But now I get a reminder on my cell phone every day,” she says.

For 70-year-old Ramnik Shah, EMR proved to be boon. “I was diagnosed with three blockages in my heart and needed a second opinion from my cardiologist in Delhi urgently,” recalled the senior citizen who shifted to Mumbai recently. “All my son had to do was grant access to the account to the doctor in Delhi, who recommended surgery,” says Shah.

The future
People in the industry believe that EMR will pave the way for more allied healthcare services in the online space. Having recently found an investor willing to put in $2.5 billion, Shekhar Sahu, co-founder of the Bangalore-based healthcaremagic.com would know. “The initial plan was to create a live chat application that enabled people to connect with a doctor online,” says Sahu, who, along with his partners launched the website in January 2008, with three doctors working full-time. “Patients can consult a doctor by chatting with them in real time, for a certain fee,” he says, adding that the concept is very popular in Europe.

The portal now employs 45 doctors and boasts a doctor network 2,700 spread across the country. “We have around 3.5 lakh registered users, and globally, another three lakh users. The website sees 35,000 visitors daily, 40% from India and 60% from abroad,” says Sahu. Their next step is to provide EMR. The portal has also tied up with companies, offering electronic health-risk assessment for employees based on their medical records.

Another Bangalore-based website, healthshield.org, has also tied up with corporates, offering them a group discount on subscription. “For an individual, registering with the website costs Rs3,600 per year, but the rate is much lower when companies sign up for a group of employees,” explains Selvarajan.

The website’s health risk assessment tools have found takers, says Selvarajan. “We follow up with annual physical examination and laboratory tests for you and your family, and use advanced medical algorithms and an expert panel of doctors to assess if you are at risk for a disease and detect it before it becomes a medical emergency. If you are at-risk of any chronic ailment, we coach you on to handle it.”

The flipside
While storing your medical data online is a good idea, substituting a visit to your doctor with a phone or online consultation is definitely not, say physicians in the city. “With a population that is prone to self-medication, and where most drugs, including high-end antibiotics, are easily available over-the-counter, phone and online consultations should definitely be discouraged,” says Dr SN Acharya, general practitioner.

“I never encourage phone consultations, let alone online consultations. With medico-legal cases on the rise in India, just like in the US, it is too risky to prescribe any medication to a patient without conducting a clinical check-up in person,” says Dr Ashok Rane, physician. “However, EMR is a great tool that makes the job of doctors, particularly specialists and surgeons in hospitals, easier.”

Says cardiologist Dr VS Srikanthan, “Patients are quite terrified of invasive procedures such as coronary angiography, angioplasty, etc. Often they are not convinced by what the doctor tells them, and it’s easy for a consultant sitting somewhere else to independently review the data.” But he is quick to add that it would require “someone with a high level of experience to come to assess whether or not a patient requires a certain invasive procedure just by perusing the reports online.”

While the consensus on online consultations seems to be that they are best for second opinions, the fact remains they are not possible without EMR. So it might not be a bad to have all your medical records where your mouse can get them.
(Some names have been changed on request)