By providing medical facilities free of cost, HMRI makes rapid strides in the health sector

By Team YS|11th Nov 2011
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HMRI

Hyderabad based non-profit organisation Health Management and Research Institute (HMRI) is supported by Piramal Healthcare and is a registered society under the Andhra Pradesh Registration of Societies Act 2000. It leverages state-of-the-art technology to bring healthcare to the doorsteps of the rural poor.YourStory.in speaks to Dr Balaji Utla, CEO, HMRI.

Why establish HMRI?

HMRI has three core beliefs. We believe that we need to work on the following factors to address India’s health challenges: universal access to health information, including triaging service, 24/7 from anywhere; universal access to basic health services within 3 km from the place of residence (this should include maternal and child health services, select long term conditions, and select acute minor ailments); and universal access to physicians and specialists to address at least 80 per cent of the morbidity rates. The second is that information and communication technologies can play a critical role in the improvement of healthcare in developing countries. As a result HMRI has worked on its approach centres on ICTs. Through leveraging ICTs, HMRI has created the world’s largest integrated digital health network. The third belief we follow is that no single institution can handle the burden of healthcare itself. Public-private partnerships are crucial to addressingIndia’s health challenges. In the past few decades, state and national governments have implemented various public health systems. HMRI works to supplement and complement these systems, inevitably strengthening them.

What are HMRI’s flagship programs?

Our core beliefs have translated into three flagship programs. The Health Information Helpline is a 24x7 health contact centre that provides medical and health advice, counseling services, directory information, and a platform to lodge service complaints against public health facilities free of cost. Mobile health services provides primary healthcare free of cost to habitations living beyond three kilometers of the nearest public health facility by deploying mobile health units. Telemedicine delivers specialty healthcare by connecting remote populations to high quality urban physicians through tele-medicine software and videoconferencing.

HMRI is trying to bringing about rapid changes in the health sector. Elucidate.

The 104 advice health information helpline is HMRI’s response to the challenges that Andhra Pradesh faces in addressing its minor ailment load. As of 2010, Andhra Pradesh faced an 18 per cent shortage in primary health centres (PHC) and a 65 per cent shortage in community health centres (CHC) (RHS Bulletin, March 2010). In 2007, when 104 Advice was launched, this shortage was greater. Andhra Pradesh has a 9 per cent fortnightly morbidity rate, of which six percent (or over five million illnesses) is due to minor ailments. HMRI estimates that this comes to a daily outpatient load of over 200 patients per PHC and CHC. This overburdens the health system, overworks doctors, and decreases the quality of care both for patients with minor ailments and with chronic diseases. 104 Advice set out to take on these challenges. By providing a free of cost call centre staffed by high quality and trained medical professionals, HMRI took on the issue of minor ailments thereby reducing the burden on the public health system. Moreover, by leveraging technology, HMRI was able to do this at a fraction of the cost of more traditional solutions (i.e. establishing additional medical infrastructure and hiring additional doctors and other medical practitioners). At its peak, 104 Advice addressed roughly 10 per cent of Andhra Pradesh’s minor ailment load.

When was this launched? 

HMRI launched 104 Advice Health Information Helpline in February 2007 in partnership with the government of Andhra Pradesh.

How does the entire process work? 

A caller dials 104. The call is picked up by a Health Advisory Officer (HAO). The HAO stores the caller’s demographic information and chief complaint to create a unique patient ID in HMRI’s software. If the patient calls again, the 104 Advice staff can access her or his record using this ID. After the registration process, the call may be handled in one of five ways - If there is an emergency, the call is automatically transferred to 108 emergency services or if the patient is calling for medical advice, the HAO uses a series of medically validated algorithms (‘yes’ or ‘no’ questions) and disease summaries in order to provide recommendations for treatment to the caller. The algorithms and disease summaries ensure that similar conditions receive similar treatment. If the HAO cannot respond appropriately to the call using algorithms and disease summaries, she or he will transfer the call to a Medical Officer (MO). If the patient is calling for counseling, the HAO will transfer the call to a Counseling Officer (CO). However, if the patient is calling for directory information, the HAO will transfer the call to a Health Information Officer (HIO) and if the patient is calling to lodge a complaint against a public health facility, the HAO will transfer the call to a Service Improvement Officer (SIO). When a call is transferred, the patient record is transferred to and updated by the responding officer. The service does not cost the patient more than just a phone call as 104 Advice does not charge any user fees.

How has the response been so far?

HMRI has received an overwhelming positive response from the public. With an average of 50,000 calls per day at its peak, 104 Advice received nearly 60 million calls since its inception in September 2011. This positive response has led HMRI to sign contracts and operate new health contact centres. HMRI launched 104 Sarathi, a 50 seat health contact centre inAssamin October 2010 and helped Aman Foundation inKarachi,Pakistanset up a 25 seat health contact centre. HMRI will soon launch a health information helpline in Rajasthan andMaharashtrain partnership with their respective state governments.

Who are the various stakeholders involved in the process?

In addition to HMRI, other stakeholders are the beneficiaries (callers) and the government of Andhra Pradesh. The government of Andhra Pradesh is the sole funder of 104 Advice. HMRI built up and established the initiative in such a way that it was successful and therefore it is in a position to be run by the government. Consequently, HMRI transitioned the 104 Advice Health Information Helpline to the government of Andhra Pradesh on September 30, 2011.

How does HMRI financially support itself?

104 Advice Health Information Helpline does not have a revenue model. HMRI provides services free of cost. Capital and operations expenditures are supported by the government of Andhra Pradesh.

Tell us something about your experience with NSIH?

NSIH gave us an opportunity to showcase our good work to the rest of the world. We also networked with other NGOs working with the same passion in the field of health, education, and capacity building. The national level coverage of NSIH winners provided HMRI with invaluable exposure acrossIndiaand helped us expanding into other states.

Go to www.hmri.in for more details!

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