The public sector healthcare structure of Pakistan can be revamped through a digital revolution by moving away from voluminous paperwork. Advocates of digital healthcare project the success of health care such as data base storage, usage of drones to transport medicines to patients in remote or inaccessible locations, creating applications to track patients, research applications, modern analytic machines and implants besides numerous software applications integrating healthcare systems in the developed world. Economics plays a persuasive role as cost cutting in terms of personnel and infrastructure and sustainability as well as ease of replications and an enhanced outreach. We in the Pakistani healthcare system tend to lose sight of basic facts those being non availability of computer hardware and software adapted to our cultural and economic sensitivities for the bulk of patients and the daily disruption of power outages especially in the rural areas and towns. Not to mention how to deploy the health industry workers becoming redundant the cost effectiveness of which needs to be worked out as well. Theoretically speaking the digital healthcare revolution would take digitization to extremes by automating industries with the spin off or unwelcome effect of invasion of privacy of not only the patients but hospital staff too by accessing their personal health in a domain accessible by many tiers of healthcare. In Pakistan with weak firewalls and pirated software cyber attack of healthcare network systems may result in “Health leaks “. Pakistan continues to lag in the world of technological innovations and advancements although not in terms of usage of social digital media which has little to do with content based development.
Relatively speaking digital healthcare transformation has been a success in the Western world not only ensuring that a patient’s health history is electronically accessible and multiple health sites provide information, diagnosis and suggest required treatments. Yet in Pakistan we should not loose sight of the abysmal healthcare standards, standardization, regulatory and enforcement issues, shortage of health practitioners adept at digitally based technology with accompanying costs involved in transforming a manual and disconnected system into a nationally seamless integrated health care system. Constitutionally the federating units are not on one page with each other which does not augur well for such health initiatives. The fact that Pakistan is one of the most populous country in the world exposes any digitally based initiative to scepticism as it could lead to a further increase in the unemployment rates in Pakistan. To remove any doubts Pakistanis ranked 125thin terms of human capital development as categorized in the Global Human Capital Report 2017 one of the indicating factors of which are extremely low literacy rates .If we link literacy rates with allied social and developmental skills then useful and focused collaboration with digital technology and maintenance of infrastructure does not present a rosy scenario. The narrative so far is discouraging yet we have to identify the systemic and inherent weaknesses to move forward in research and advancement in health care which can be made possible through improving the quality of health education conjointly with a workforce equipped with digital skill sets.
The fact that Pakistan is one of the most populous country in the world exposes any digitally based initiative to skepticism as it could lead to a further increase in the unemployment rates in Pakistan
In May this year a gathering of persons relevant to the health sector addressed health priorities affecting the world. In the lead philanthropist Bill Gates advocated for combating the menace of women dying on a daily basis from childbirth attributable causes. Ideally speaking health experts agree that it implies investing in efficiently functioning, coordinated and digitally integrated health care systems with one end of the spectrum being the community based clinical setting and the other end being specialized health care units in District headquarters hospitals. Equity in health is contingent upon eliminating structural disparities with fault lines extending alongside vulnerable populations as well as gender or cultural profiles. What we in Pakistan tend to lose sight of is that through utilization of predictive technologies available digital data can in the long term drastically cut down on routine and reoccurring health costs. In Pakistan we could focus on maternal mortality rates, prevalence and timely intervention of persons suffering from disability, non communicable disease morbidity conditions all of which lead to an increased incidence of economic burden on the state. Rehabilitation would markedly alleviate suffering, reduce caregiver burden and make such individuals productive citizens of Pakistan. Merely importing persons from international health organizations would not serve the purpose as person to person Pakistan’s health practitioners are academically at par with donor assembled teams. No doubt digital data and its utilization in consonance with the World Health Organization’s comprehensive strategy on digital health complemented by survey enriched data enabled initiatives can contain epidemics and save costs on reoccurring health campaigns. The adage a healthy citizen is a productive citizen cannot find more conviction then in Pakistan. Persons with disabilities in Pakistan are invariably neglected and perfunctory efforts made at their inclusive education and mainstreaming ultimately adding to social welfare costs of the state and health equity takes the back seat. The emphasis remains on epidemics and communicable disease which make sensational headlines yet non communicable diseases including, renal, cardiac ,cancer and stroke with millions dying annually in Pakistan do not attract the attention of international donors perhaps as the countries funding the donor agencies are concerned to the extent of communicable diseases which may be contracted by the citizens of their countries. It is time Pakistan’s health community wises up as we ingratiate ourselves for mere dole outs while million perish in Pakistan annually due to lack of awareness campaigns, timely intervention and rehabilitation and mis directed funding priorities. The recently inducted team at the Health Ministry advocated for a Health tax on tobacco consumption, ostensibly to treat individuals who ironically acquire diseases from tobacco consumption, and even received congratulatory accolades from WHO but the initiatives faded for inexplicable reasons.
The writer is PhD In Rehabilitation Sciences