Our country has many medical needs and the use of Information and Communication Technologies (ICT) for health (eHealth) has a potential to improve the quality of healthcare delivery and reach the unreached. The eHealth based delivery of health- related services can involve remote clinical participation.
We strongly believe that health and access to healthcare is one the fundamental needs of human beings. With a population of 1.26 billion,
India has 1 doctor to 1700 people. There is a scarcity of the human resources in healthcare services in country and
there is a projection of shortage of 600,000 doctors. India faces a severe shortage of specialities
both for its rural and urban services. Seventy percent of the posts of specialists (surgeons,
physicians, paediatrics, gynaecologists, etc.) at the community health centre (CHCs), which
provide minimum specialist services to villagers are lying vacant.
Though the progress of Health indicators is progressive since independence but it is not as expected. Infant mortality rate (IMR) has dropped from 150 to 50 (a threefold reduction), the maternal mortality ratio (MMR) declined 10 folds from 2000 to 200 per 100,000 live births and the life expectancy at birth has gone up from 31 to 65 years. Sixty years ago the total number of physicians was 47,524, with doctor population ratio of 1 to 63007. Currently there are approximately 840,130 registered medical practitioners in the country. Overall doctor population ratio is 1 to 1700 which shows an improvement. The number of Primary Health Care centres has increased from 77 in the first plan (1995) to 23,887 in 2011. The burden of Noncommunicable diseases is on rise in India. In 2005, 53 percent of all the deaths were due to NonCommunicable diseases and expected to increase to 67 percent in 2020. With all the positive improvements in health indicators of India, we have to remember that as a country we have not achieved Millennium Development Goals – 2015. .
Noncommunicable diseases require continuous medical care complemented by long term support from healthcare services. Health financing is one of the building blocks of health systems. Health systems, ideally, should be financed in a way that people can use healthcare services without financial hardship. In India, 71 percent of the healthcare is financed through outofpocket payments by households at the time and point of healthcare use. In 20042005, almost 65 percent of households in India had to incur out of pocket payments for healthcare. Out of pocket payment is the primary barrier to access healthcare services in India and this leads to significant impoverishment among those who use the services. In 2004, Berman et al., reported that approximately 6.2 percent of Indians fell below the poverty line due to out of pocket payments for healthcare; a greater proportion of them for outpatient care (4.9%) than inpatient care (1.3%), while expenditure for medications constituted the greatest share (71.2%). In most of the cases people with chronic conditions are likely to incur higher out of pocket payments for outpatient care, as they need periodic outpatient visits and regular medications on long term basis. Such expenditure may impoverish and even push them below poverty line.