Inspite of more than 60 years history of orthopedics in India we have not been able to define optimum and the current state of bone health in our population. We have not identified the factors responsible for poor bone health and evolve state and national level strategies to improve the bone health of the nation. The poor bone health affects the work potential and performance thereby reducing productivity and adds a tremendous musculoskeletal disease burden in late youth due to weak bones. It is not only a clinical burden needing treatment but also causes a huge loss of earnings/man-day.
Statistics on road traffic accidents
Road traffic accidents (RTA) are a growing problem worldwide accounting for around 1.2 million deaths and over 50 million injuries annually. It is expected that by the year 2020 RTA will rank third in the global burden of diseases.
It is obvious that RTA is evolving into the biggest threat for human survival in India. At present the deaths on the roads account for twice more than the death in India by the combination of all serious diseases like HIV, Malaria, Cholera etc all put together. Indian roads were at their deadliest in 2014 claiming more than 16 lives every hour on average. Over 1.41 lakh people died in crashes, 3% more than the number of fatalities in 2013. India accounts for more than 200,000 deaths because of road accidents, according to the Global Road Safety Report, 2015 released by the World Health Organisation (WHO). This coupled with occupational injuries and ailments plus joint problems in people over 50, assault and terrorism puts this number at an unmanageable level. While there have been several initiatives by the government, NGOs and various other stakeholders in terms of managing and mitigating the other serious diseases faced by the common man of India, orthopedic diseases are clearly ignored.
Impact of orthopedic problems on the poor
The poor and the lower middle class are affected the most by this situation. Poverty undermines health by restricting access to good medical services and healthy living conditions. The urban poor often are engaged in jobs associated with physical – formal or informal – labor requiring them to be mobile and active. Any orthopedic injury results in lack of mobility causing decrease in earnings creating an income shock leading to cyclical poverty.
The case for ortho digitisation
Surgeons in India want to improve the healing times in their patients while patients in turn are willing to spend money on technologies that work. Ultimately, identifying the optimal fracture healing technology for the Indian population is of significant interest to the health care community.
myOrthovalet, an initiative of myHealthvalet (cloud based application) by Hygeia e-Services Pvt Ltd aims to address this issue. Customised case sheets and templates enable specialists to capture pre-op and post-op parameters, based on which diagnosis and prognosis were made. This results in a set of standardized and systemic data for referencing future cases to determine the most appropriate course of treatment leading to reduction in cost of care. The evidence based rules derived from the myOrthovalet clinical Decision Support System (DSS) help decision-makers to gather and interpret information and build a foundation for decision-making.This will further grow to become an Artificial Neural Network (ANN) to predict and answer “what if” questions in a new situation related to providing customized care or in community medicine.
The follow-ups for the patient can be captured ensuring that the complete case file of the patient is available for future reference. The end result will enable the development of an orthopedic registry. For the patient, in addition to the more efficient/effective delivery of care it will facilitate better follow-up along with reminders and alerts for medicine intake and appointments leading to faster recovery with minimal risk of re-admission
myOrthovalet – Towards a healthier population
myOrthovalet aims to improve the quality of care by creating a robust healthcare service delivery process at three levels:
Patients: It helps better diagnosis and prognosis of care resulting in increased efficacy of treatment thereby reducing the chances of relapse and complications. The solution will enable the poor to reduce out-of-pocket expenses, revisions and DALY (Disability Adjusted Life Years). It also helps the patient access and avail health care services in any medical centre.
Doctors: It improves patient safety, mitigates risk and leads to improved quality of care focusing on creating a set of standards to treat patients, thereby reducing surgery time and medical errors while enabling them to have remote access to patient records.
Government hospitals: It allows hospitals to streamline their consumables, improve operational efficiency and plan infrastructure outlay.
Benefits to stakeholders
There is a pressing and imperative need to create a systematic and scientific health data base to understand the burden of musculoskeletal disease. This will help in deciding goals of the health needs of the region and country so that minimum basic orthopedic care to whole populations can be planned and the burden of patients in tertiary care hospitals can be reduced. myOrthovalet will collect information on all hip, knee, ankle, elbow and shoulder replacement operations as well as monitor the performance of joint replacement implants and the effectiveness of different types of surgeries, improving clinical standards and reducing costs, thereby benefiting patients, clinicians, device manufacturers and the orthopedic sector as a whole. The insurance sector also stands to hugely benefit by this approach. They can account for such factors as to whether the physician is using an EHR, antibiotic prescriptions before and after a procedure, the implant device used among others.
India is a country where the availability of know how and huge disease burden puts us in a commanding position to conduct multi center collaboration for orthopedic advancement through the use of technology and thus gives us opportunity for global leadership. The state of the art public and private hospitals can be used for medical tourism to provide cheap and reliable treatment to not only Indians but also to one and all throughout the world. The money thus generated could be used for further technological advancements and research and to improve the quality of health services provided in public sector. The orthopedic sector can create a revolution like the IT sector and become a world leader in orthopedic treatments.
“To keep the body in good health is a duty…otherwise we shall not be able to keep our mind strong and clear” – BUDDHA
- The Alarming Facts of Road Accidents in India – On behalf of Indian Orthopaedic Association Prepared by Dr S Rajasekaran, President-Indian Orthopaedic Association. Live mint: http://www.livemint.com/Politics/D04T9R6EADDF5aTS8RVIWI/Road-accidents-in-India-kill-more-than-2-lakh-people-WHO.html
- Orthopedics – Can India lead? Anil Kumar Jain Department of Orthopedics, University College of Medical Science, University of Delhi, Delhi -95, India. Indian J Orthop. 2013 Sep-Oct; 47(5): 435–436. doi: 10.4103/0019-5413.118196, PMCID: PMC3796913
- Indian Journal of orthopedics Bone and Joint day – India, Anil K Jainand Sudhir Kumar. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3796913/
- Will Orthopedic Registries Improve Joint Surgery Outcomes?Laird Harrison. http://www.medscape.com/viewarticle/858178_3.