USHA

Integrated Healthcare Accessibility and Monitoring Tool

Since independence, the focus of public health has been on rural areas. Delivery of urban healthcare services is a complex issue considering the fact that it requires the involvement and coordination of different stakeholders and tiers of the government. This has resulted in the neglect of systematic planning for health care infrastructure, service delivery for the urban population. The negligence shown towards Primary and Community Healthcare Centers (PHCs & CHCs) has resulted in lack of infrastructure and workforce to provide preventive, promotive, and basic clinical care. Thus, the lack of a reliable and updated system in healthcare exhibits poor planning and delayed action in healthcare provisioning.

Keeping the current scenario and upcoming challenges in mind and the need for digital intervention in urban healthcare system and service; the team intends to strengthen the role of the municipality as a healthcare service provider through the provision of an integrated accessibility and monitoring platform for better and informed healthcare planning and management in an urban area.

The project involves a community participatory approach to understand and analyze various on-ground issues and problems of different stakeholders. Mapping and gap identification of healthcare infrastructure and resources, predictive analysis of diseases and areas affected by them. The project has unique features such as

(i) One-Stop-Shop - for connecting citizens, healthcare providers, and the SPV, (ii) One-City-One-Platform - for monitoring and management of healthcare services, (iii) Online Healthcare Services – diagnosis, consultation, medicines, access to reports, grievance redressal, etc.

The urban population in India has increased at an annual rate of 2.7% during the last decade and it is estimated that by 2031, there would be about 600 million people living in urban India. Since independence, the focus of public health has been on rural areas. This resulted in the neglect of systematic planning for healthcare infrastructure and the delivery of comprehensive healthcare services for the urban population. The rapid increase in urban population due to migration, overburdened the urban infrastructure often, moving the poor into unhygienic settlements and risky environments making them more vulnerable to diseases and thereby increasing their need for healthcare which is neither within their reach nor affordable to them.

Due to negligence and lesser priority by healthcare providers (city administrations, district and state health departments, central government), PHCs & CHCs in urban areas, lack the infrastructure and workforce to provide preventive, promotive, and basic clinical care and provide accessible and affordable services to those who need it. The most persistent issue in healthcare service delivery is the lack of integrated primary and secondary healthcare systems in urban areas that have led to a limited resource utilization (limited infrastructure (physical and digital), human resources; for instance, pathology labs, crucial equipment, doctors, lab technicians, nurses, etc.,. There is also less outreach capacity in communities at ward and zone levels.

Although the city governments are trying to cope up with the crises in the health sector such as infrastructure, human resources, provisioning of health services within their best capacities, the problem persists due to a lack of coordination between different tiers of government and partial devolution of powers (74th Constitutional Amendment). Another major problem in healthcare provisions and response is the lack of dynamic data according to the increasing population and increasing impact of vector-borne disease outbursts.

The project has three objectives as follows:

• To integrate data with city layer mapping [health infrastructure (public & private), vulnerable communities, human resource, etc.)] using GIS/ICCC
• vulnerable communities, human resource, etc.)] using GIS/ICCC To design & develop an accessibility application for citizens and healthcare workers using technological intervention
• To provide an integrated platform for SPV/ULB to monitor and systematically plan for healthcare services

Gwalior Smart City was selected for the pilot of the project. The city was selected to be part of the Smart Cities Mission in its second round. Three main criteria were identified to choose the pilot city: a functional Integrated Command and Control Centre, a functioning and digitally equipped healthcare system. Gwalior fulfills all three criteria. Moreover, the city was interested in the project to be implemented in the city as well as at the district level. The city was also working on a COVID-19 dashboard during the commencement of the project, which created an opportunity for the pilot.

• Enhanced accessibility for the citizens to avail various healthcare services
• Provision of better healthcare resource management tool to the city administration and healthcare providers
• Empower city administration to systematically plan for its healthcare infrastructure
• Improve decision-making for the deployment of preventive and curative care to city administrations
• Facilitating the integration of health data and geospatial data with ease

Healthcare Provider Interface: Through this product, health workers can record the geo-tagged digital data from the community and the providers can gain better outreach in the community. The app will capture the geotagged location of the survey point. The survey points with the location of the healthcare worker will be marked and shown in the dashboard as well. The app provides contact tracing opportunities through contact surveys, lab testing reports, and status as well.

Smart City SPV Interface: is an integrated monitoring platform for data visualization to be used by the authorities. The dashboard will provide an overview of the health provisions within the city according to the locations. The platform will also be used to track disease, contact tracing, identify the cause of the rise in diseases or cases in a specific area. Additionally, the platform will also help in, tracking and tracing the healthcare worker, monitoring their location, and rectifying the data captured by them. It will also help different departments to analyze the problems and issues that need intervention by them. It will capture health infrastructure disposed to cities. The tool will help the city administration, healthcare departments, and bureaucrats to make an informed decision to fight city-level health crises.

Health is a multi-dimensional sector, which is governed by multiple agencies in an urban area. It is important that the end-user of the service should be involved in the process of providing any solution to the sector. Thus, moving forward the team intends to develop an interface for the public, where a citizen can book appointments with the public health facilities, consult doctors online and also get their lab test reports while also incorporating data for different interdependent departments of public health provisioning to analyze a real-time and holistic situation at the ward level. The application has the potential to conduct a comparative analysis of various cities. The project involves all possible stakeholders of the healthcare system and hence can be replicated and scaled up to any level of governance system or for any disease surveillance.