My dentist Dr Kapoor is able to fix an appointment after I send an electronic request to him by WhatsApp. He uses a software to optimise his patient appointments and send me a message to confirm the time of appointment. On the day of the appointment his system sends a message to me confirming the time of appointment as a reminder. After the dental treatment, if any medicine is prescribed, I get a message with the name of medicine and dosage. This is only a tip of the iceberg. Internet has become a part and parcel of life. We are dependent on the internet, not just for information, but now there are a host of services that can be availed through it. This dependence is growing immensely. In the era being described as “Digital India”, it is important to increase internet penetration, but it is also important to improve the quality of internet services to be able to realise the goal of Digital India. Not underestimating the need for getting connected, which is undoubtedly the essential first step, quality of services cannot be ignored and is the necessary second step that needs to be taken.

In the interest of consumers, VOICE conducted a study to assess the impact of quality of internet services on internet users. Based on a sample of 52,000 internet users in 18 states, the study confirmed the impact of quality of internet service on various aspects of life which included education and research, development of rural areas, health and medical services, political and civic participation, women empowerment, shopping, travel and commuting etc. 

Health was one of aspects covered in the study, which found people increasingly resorting to internet for home remedies for alternative, quick and easy methods to address less serious medical issues. Many YouTube channels, Facebook pages and blogs are dedicated to providing home remedies and inspire users to adopt healthy lifestyles. There are videos available for exercise, yoga, meditation and what not. People who do not have time to go to fitness clubs, can now watch the videos and practise in the comfort of their homes. An added advantage is that they need not pay hefty fees to trainers. Hiccups not stopping, look for remedies online; baby is constipated, solution is available online; stomach bloated, having acne, dandruff problems, rashes, one can look online for remedies. Although for information on health related issues or home remedies could be accessed through articles, logs and other health related web pages; however, to have visual experience through watching fitness videos, live consultation and other via visual media, quality of internet becomes a primary issue. Every family is now consulting Dr Google on internet.

Internet has immensely contributed to the development of health and medical services and delivery thereof. People can now maintain and access medical records online. They can interact with remote doctors and medical professionals across the world. One can fix appointments online. Thanks to the internet, rural folks now have better access to health and medical services. Remote medical consultations have overcome inequitable distribution of medical resources. It has facilitated public health surveillance. Internet has dramatically reshaped the area of consumer health and public health. But the case of online consultation from a remote area with the doctor in the hospital handling the case of patient may not materialise, if the quality of internet is not ensured at both ends.

Not all consumer health applications require high speed and reliable internet connection. However, quality becomes a necessity when enhanced content needs to be transferred, especially in telemedicine consultations. Likewise, medical records and test reports can be uploaded from remote sites in advance of scheduled appointments which requires good quality internet in emergency situations. Also, remote monitoring devices require stable internet connection. 

The study conducted by VOICE found that 88% of the 52,000 respondents in 18 states believe that internet has an impact on health and medical services and the impact of quality of internet services on health and medical services was also reported to be quite high by these respondents.

There are many online portals such as Medicinenet, rightdiagnosis, WebMD etc., that patients use to diagnose medical conditions themselves, before visiting a doctor. Such portals provide health related information free of cost. Other platforms like Practo, MedIndia, Actozen, etc. facilitate online search for doctors and hospitals. Hospitals and doctors are strengthening online presence to make contact with prospective patients and to maintain a prolonged direct relationship with their patients. 

With the changing social and demographic conditions, the need for remote health care monitoring is growing, particularly for the elderly and the sick. Online portals like Health Care at Home, Homital, Portea Medical offer such services.

Growing mobile and internet penetration in India is opening avenues for low cost mobile based primary healthcare system particularly in remote and rural areas, where medical facilities are still scanty. Internet can facilitate the development of such systems, thereby providing rural folks access to better medical facilities. 

A recent development in “Health and Medical Services” is AmbuSens, a ubiquitous health monitor. Developed by SWAN group at the Department of Computer Science and Engineering, IIT Kharagpur, AmbuSens utilises wireless medical sensing and IT infrastructure and is a development in the field of IoT that enables patients and medical professionals to have instant access to real time medical data through the use of devices connected through internet to monitor the condition of patients in-transit. AmbuSens is a life saver technology, which would enable remote monitoring of patients in ambulance by the doctors at the destination hospital. The device is capable of wireless monitoring of various physiological parameters like ECG, heart rate, blood pressure and temperature. Such patients are monitored by ambulatory personnel and paramedics who have limited knowledge of the instant medical treatments or medical interventions that may be required. The condition of the patient in-transit is reported to the destination hospital by the ambulatory personnel and this information may not hold until the patient reaches the destination hospital especially when the journey is long. This can be a life saver. The technology uses wireless on-body sensors, cellular (3G/4G) and wireless technologies (wi-fi) and cloud computing. The technology is a boon especially for people residing in areas where patients have to travel long distance to developed areas for emergency medical facilities. The condition of the patient can be monitored by the doctors but imagine a situation when the connectivity breaks or the internet speed is too slow. Good quality internet is a pre-requisite for such technologies. Although, AmbuSens in future will work even with irregular internet connection; for now, to reap the benefits, reliable and high speed internet is a necessity.

The startup ecosystem in India is supporting projects like Portea, Netmeds, 1mg, Mfine, Curefit, Healthians, Mydermacy that are revolutionising the healthcare system. Given the burgeoning internet services and growing awareness among people, it is possible to access health related information, diagnosis, consultations, and better healthcare management and improved services instantly.

As internet proliferates, its success can be guaranteed with good quality of service delivered at every nook and corner of urban and rural India.

Prof Sri Ram Khanna is former Head and Dean of Department of Commerce, Delhi School of Economics, University of Delhi. Yukti Arora is Research Coordinator at Consumer VOICE and guest lecturer at University of Delhi.

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