In the UDHC model (de-identified open-online-patient-record), if we use Kaizala (HIPAA compliant) or similar rather than WhatsApp or Facebook with de-identified records, and publish case report in a normal format on a journal website, then also there will be resistance.
Kailzala being known as one of ideal HIPAA compliant methods, used at Narayana by Dr Devi Shetty sir and then, there can be similar issues as pointed for UDHC like,
- Why HIPAA in India?
- What if like WhatsApp like breach with Kaizala also or any other app used by those doctors in Narayana or other healthcare facility happens to breach security (which is not a rare thing)?
- Is the patient really understanding the privacy of data?
And more issues.
I only tried to discuss around UDHC for problems-solutions, anyone failed to suggest any steps to improve yet.
Even whatever system other telemedicine providers are using is much more vulnerable to security breach compared to WhatsApp.
For improvement, to prevent from any such breach we started taking an extra step or capturing pictures of already de-identified (paper) data (as we are not using secure dedicated devices).
Beyond this, the choices are to use better ways but get less engagement from a network of students and experts, or even less patient's benefits when better ways cost money.
UDHC have no financial benefits involved but social benefits are huge, eg. If 40 patients blogged and 40 students read and each did better for their 40 patients. The impact is better cared for 1640 patients by making 40 blogs (context-based research and education data for patient care) and here it becomes a rival which luckily for many telemedicine providers, haven't scaled (actually it have scaled but in an unstructured form on Reddit, Yahoo groups, Facebook groups etc.) But having a structure and privacy enabled makes UDHC strongest contender for all current money based telemedicine & education networks. (someday maybe Open / Decentralized AI models will also learn and do for more patients).
So the issue is like big pharma v/s generics. Big pharma buys all generics in the market and burns to sell their products at higher prices and they also stress/buy/kill the generics so they can close, many tried all the ways directly or indirectly for the social change.
Already many doctors in India are using communication technology in many ways with fellow doctors to learn and do better care for patients, but none blogging and none have standards so high as the USA or Europe because even our government is lacking that guideline and incentive/punishment to drive that in real practice and even resources in many cases of remote and rural areas where there is population who needs such tools most.
Overall we are doing the right things the right way and even corporate telemedicine providers too. Rest is about the market which makes some very worried and sad about patient privacy concern to extreme case scenarios and our legal responsibility rather than the real and much more important pain points patients and we (doctors and students) have.
For answers to above 3 questions, recently there is DISHA guideline so now we are also following that, a breach is always a risk for all and so we try best for that for not capturing a picture of identifiable data, we explain patients about their privacy and inform them about consent and let them choose.
Every system is Hackabkle.
Kailzala being known as one of ideal HIPAA compliant methods, used at Narayana by Dr Devi Shetty sir and then, there can be similar issues as pointed for UDHC like,
- Why HIPAA in India?
- What if like WhatsApp like breach with Kaizala also or any other app used by those doctors in Narayana or other healthcare facility happens to breach security (which is not a rare thing)?
- Is the patient really understanding the privacy of data?
And more issues.
I only tried to discuss around UDHC for problems-solutions, anyone failed to suggest any steps to improve yet.
Even whatever system other telemedicine providers are using is much more vulnerable to security breach compared to WhatsApp.
For improvement, to prevent from any such breach we started taking an extra step or capturing pictures of already de-identified (paper) data (as we are not using secure dedicated devices).
Beyond this, the choices are to use better ways but get less engagement from a network of students and experts, or even less patient's benefits when better ways cost money.
UDHC have no financial benefits involved but social benefits are huge, eg. If 40 patients blogged and 40 students read and each did better for their 40 patients. The impact is better cared for 1640 patients by making 40 blogs (context-based research and education data for patient care) and here it becomes a rival which luckily for many telemedicine providers, haven't scaled (actually it have scaled but in an unstructured form on Reddit, Yahoo groups, Facebook groups etc.) But having a structure and privacy enabled makes UDHC strongest contender for all current money based telemedicine & education networks. (someday maybe Open / Decentralized AI models will also learn and do for more patients).
So the issue is like big pharma v/s generics. Big pharma buys all generics in the market and burns to sell their products at higher prices and they also stress/buy/kill the generics so they can close, many tried all the ways directly or indirectly for the social change.
Already many doctors in India are using communication technology in many ways with fellow doctors to learn and do better care for patients, but none blogging and none have standards so high as the USA or Europe because even our government is lacking that guideline and incentive/punishment to drive that in real practice and even resources in many cases of remote and rural areas where there is population who needs such tools most.
Overall we are doing the right things the right way and even corporate telemedicine providers too. Rest is about the market which makes some very worried and sad about patient privacy concern to extreme case scenarios and our legal responsibility rather than the real and much more important pain points patients and we (doctors and students) have.
For answers to above 3 questions, recently there is DISHA guideline so now we are also following that, a breach is always a risk for all and so we try best for that for not capturing a picture of identifiable data, we explain patients about their privacy and inform them about consent and let them choose.
Every system is Hackabkle.
No comments:
Post a Comment