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IT for health

The Obama administration’s unprecedented $19 billion plan to promote the use of health information technology under the American Recovery and Reinvestment Act of 2009 serves to focus attention on an important emerging area in public health. If information technology can be harnessed to generate reliable and relevant health data from the ground up, the benefits for citizens, hospitals, and governments can be significant. The gains, to name just a few, would be better-targeted public health initiatives, accurate disease mapping, fewer patient visits to physicians, and, with privacy controls, sharing of data. Yet even in the United States, only about 10 per cent of hospitals and 17 per cent of doctors maintain Electronic Health Records, according to The New England Journal of Medicine. The U.S. stimulus package seeks to bridge the gap by implementing a time-bound plan that aims to create certification standards for records, and provides for incentives and penalties for doctors and hospitals to ensure compliance. The fundamental problem relating to electronic health data, however, remains. Even if governments are willing to allocate the substantial funds needed to create electronic health records, they face the challenge of building an interoperable system. In other words, all health data should be available in open formats that can be universally interpreted (as opposed to proprietary standards), and the platform should permit software programmers to innovate further by supplying the source code.

The solution to the problem of flexibility lies in free and open source software. India has already adopted open source approaches in administrative systems and education projects. This represents a good policy foundation on which to build a national eHealth system. It could, for a start, leverage the strengths of the large open source software community. The outcome would be a common electronic health platform covering clinical and administrative functions for government as well as private institutions, with full interoperability. What is more, the open source nature of the project is bound to attract software companies and communities of programmers to come up with innovative health applications. Some of this software will be free and others commercially distributed, but all fully compatible with the basic platform. There is also the potential of significant job creation. What is important is an empowered policy framework to achieve the goals. Cuba and Brazil have been working on open source health software development. India’s active participation in a consortium of like-minded countries can lead to much good all round.

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