Parag Vora, an infotech professional from India, was strolling through a park one sunny evening in New York about eight years ago. An old man suddenly collapsed in front of him. While Parag stood there, stunned and wondering what to do, a group of teenage boys, who were playing baseball in the vicinity, rushed to the rescue.
Without panicking, one of them checked his pulse and followed it up with cardiopulmonary resuscitation (CPR), an emergency medical procedure for a victim of cardiac arrest. One of them rushed to call a nearby hospital's emergency number from a telephone booth. Within five minutes, an ambulance arrived and the patient was taken to the hospital.
Parag asked them how they had learnt to do all those things in such a situation. They answered there were computer discs and literature at their home explaining what to do in such situations. That made him think about the importance of emergency health education, counselling and general information.
Health experts point out that it will take decades for India to reach the level of health education and infrastructure in developed countries. Our per capita health expenditure is estimated at $23, which is only 6.1 per cent of the gross domestic production.
As against this, the per capita expenditure on health of developed and developing countries, such as the US ($4,499), Germany ($2,422), Canada ($2,058), the UK ($1,747), Mexico ($3,11) and Brazil ($267) are many times higher, according to an Assocham and PriceWaterhouseCoopers (PwC) study.
The English barrier
Half of India's population is illiterate and even with the remaining half, those who can read and write English constitute only a fraction. "Since most of the medical information available is in English, a large section of the population is unaware of the diseases and symptoms they are suffering," says C M Gulati, editor, Monthly Index of Medical Specialities.
While leaflets explaining the drug and its details are mandatory for drug sale in the US and UK, the same has not been strictly implemented in India. In Europe, even cutting of tablet strips is not permitted to ensure the patient gets basic information on the drug which he uses, he adds.
"Here, more than 90 per cent of doctors do not spend more than five minutes with an out-patient to ensure his hospital or clinic gets the maximum 'clients' within the working hours.
"In the west, teams of doctors diagnose diseases and it is up to the paramedics to decide which and what drug to be administered and at what doses. Then they educate the patients on the drug, its side effects and regularly monitors whether the patient takes the drug at the right time," noted a senior pharmaceutical executive.
"Doctors write only brand names and most of our patients are reluctant to ask questions to the doctors about the drugs they use. Making 'informed consent' mandatory and prescriptions in generic names instead of brand names are some of the basic simple changes we can bring in to improve the health information scenario in India," notes Leena Menghaney, a Delhi-based health-care activist.
Social confinement
So far in India, patient education, counselling and health tips are mainly confined only to social service offered mainly by health-care non-governmental organisations, corporate hospitals and pharmaceutical companies as a means to promote their products and services.
It has a big business potential in India considering the growth of the country and its 350 million-plus educated middle class families, says Parag Vora, director of Infoseek India.
His seven-year-old company, a health solutions content provider for doctors in India and abroad, is planning to pioneer various interactive health information tools in about ten regional languages in English and Hindi.
Health information solutions are already a big business in the west and there are large players in this segment, such as WebMD Health Corporation, non-profit organisation Healthwise, Adam Inc and the like, which together have a global business in excess of $300-500 million a year.
Most of these companies offer products that contain physician-reviewed texts, medical illustrations, multimedia and various interactive tools that provide highly effective health and medical education resources for the common man.
Healthwise, which is three decades old, claims that annually, over 100 million people make health care decisions with its English and Spanish resources.
Wrong info
However, even free floating information can go wrong. A study appeared in the British Medical Journal had noted that more than 80 per cent of health information available in the digital format were misleading and wrong, and were churned out by interested parties to promote their products, cautions Dr Gulati.
"Within a month, we will launch over 2,000 minutes of various multimedia interactive visual content on about 60 disease conditions and emergency health tips in both CDs and literature format. We plan to make available such products through malls, shopping complexes and other outlets, so that shoppers can pick it up at a price less than what they spend on a book or a music CD," he said.
For this, the company has invested several crores of rupees and a team of about 30 professionals, including physicians, content creators and IT experts are involved in preparing contents for the products.
"So far, about 4,000 doctors have volunteered to support us in this venture. We are also talking to a few non-governmental organisations for tie-ups," said Parag Vora.
The company also plans to popularise the products through a network of over 75,000 doctors in the country and by tying up with various non-governmental organisations working in the health and social sector.
He said it was difficult to estimate the size of the market in India and its potential since so far none has approached health information solutions as a business proposition in India.