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Adoption of technology in Orthopedics

The case for digitization in Orthopedics

@myHealthvalet

myOrthoValet

2016

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Contents Introduction ........................................................................................................... 2

Statistics on road traffic accidents ......................................................................... 2

Impact of orthopedic problems on the poor .......................................................... 2

The case for ortho digitisation ............................................................................... 3

myOrthovalet – Towards a healthier population ................................................... 3

Benefits to stakeholders ........................................................................................ 4

Conclusion ............................................................................................................. 4

The people behind the venture .............................................................................. 5

myOrthoValet

2016

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Introduction 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.

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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.

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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.

Conclusion India is a country where the availability of knowhow 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

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References:

i. 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 ii. 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

iii. Indian Journal of orthopedics Bone and Joint day – India, Anil K Jain and Sudhir Kumar.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3796913/

iv. Will Orthopedic Registries Improve Joint Surgery Outcomes? Laird Harrison.

http://www.medscape.com/viewarticle/858178_3.

The people behind the venture Ranjit Kovilinkal is an entrepreneur, marketing specialist and teacher/coach. His experience is

across IT, consulting, education and social enterprises. He has more than 16 years of corporate,

teaching and entrepreneurial experience in India, the Middle East and Singapore and is a CEG

and IIM-A alumnus. He is currently a mentor cum educator at CIIE and NEN and a practicing

Psychotherapist, teacher and choreographer. https://www.linkedin.com/in/ranjitkovilinkal

Gowtham Raj Viswanathan is an entrepreneur, product and finance specialist. His experience is

across the Banking and IT industries. He has more than 16 years of corporate experience across

India, Middle East, Singapore and Malaysia. Gowtham is an AC Tech (Anna Univ) and IIM-A

alumnus.

Dr. Singaravadivelu is one of the leading orthopedic surgeons in Chennai and acts as our

Advisory Board Member.

For more information, pls mail to ranjit@hygeiaes.com