Interoperable telemedicine and more
Open Network for Health Services
The Open Network for Health Services is designed to create a network enabled by open protocols that connect healthcare providers, patients, and other stakeholders. Its primary purpose is to facilitate the discovery of available healthcare services, appointments, and resources, streamlining the patient journey.
With every passing day, more and more services are becoming digital, often powered by private platforms that have disrupted traditional service providers. Strong network effects and hence concentration of data with these few large players is a pattern we see. Closed-loop marketplaces are the norm. Apps are not interoperable and all the individual businesses have to solve all parts of the transaction cycle, i.e - discovery, ordering, fulfilment & post fulfilment.
While an aggregator-led model (where both service providers and end users are onboarded to the same platform) seems to work, it does not scale beyond a point. Besides, large aggregators often adopt business policies that are advantageous to neither the service provider(seller) nor the end user.
Data in silos, predatory monopolistic practices, lack of scale and exclusion of certain population segments - all indicate a need to shift the approach from a “platform” to a more“network” approach. Imagine trusted, low-cost, decentralised transactions and at scale - this is what open networks aim to achieve!
In healthcare, we need to access many services - booking a doctor's appointment, ordering medicines/lab tests online, booking the nearest ambulance in case of an emergency, and consultation via telemedicine are just a few of these. Normally all these services are in siloed apps or platforms. If a patient uses app A and their doctor uses app B, they can only consult the doctor if both are on the same platform. This creates monopolistic practices, and a lack of scale - all resulting in exclusion.
What if we could create a network and use open protocols to access any good or service on any platform? The patient can now use app A to consult their doctor on app B and this creates an open network of health services- This also implies that not all apps have to solve demand and supply individually. Now the user-side apps can be then customised to their demographics - for low digital literacy, people speaking local languages etc. and will still solve for care - which is very powerful.
In developing economies, there’s often diversity in terms of language, income group, location and culture, digital literacy, access to phones/ digital and more. One (or two) solutions do not fit the needs of all. For example, it’s a very common practice for governments to launch “the national telemedicine app” to improve access to care for impoverished sections of the population. While, it’s a great effort this will not scale for all of society, neither all the caregivers nor care seekers. Fundamentally, what an open health network does is unbundle the user interface from the service providers, while connecting them both, eliminating the need to aggregate both sides. There can be many user interfaces - solving for differently abled sections of population, low tech literate sections, old people etc - all having access to the same service providers (doctors, pharmacists, labs ..)
This approach is also advantageous for the service providers as they have more choice in terms of who they choose to work with, are in control of their (digitally signed) transaction data (which they can use to get access to loans) and now have access to almost whole of the population.
The same network can be extended beyond patients to providers. Healthcare facilities can discover their service providers through this network and solve for any resource gaps. For example, a primary care centre can discover and use a cloud diagnostics service, and idle ambulances and give their patients better care.
Other functions like online dispute resolution, contracting, and regulations can be layered on the network. This network can interact with open other networks for fulfilment of allied goods and services.
How can various stakeholders benefit from an open network of health services?
For patients 😷
Discover any healthcare service or good - Check the availability of beds/ procedures/ equipment at a hospital, discover & consult a doctor (via telemedicine), order medicines online, book an ambulance, discover nearby vaccination camps and many more!
For healthcare facilities 🏥
Be discovered by consumers of the services they provide by uploading their service catalogue to any of the network applications.
Discover any service providers for any ancillary service - Ambulances, Cloud diagnostics etc
For healthcare professionals 👩⚕️
Be discovered by consumers of the services they provide by uploading their service catalogue to any of the applications - without being on multiple apps.
Key considerations in designing an open network for health services :
Solving for trust: Design should solve for trust by verifying all the network participants and making this service available to all other participants
Separate data package exchange from user experience allowing for multiple implementations: The design should allow for multiple manifestations of the end user-facing layer across form factors, connectivity, devices etc. For example, the same network should be accessible via a smartphone, feature phone, USSD etc.
Special focus on multilateral dispute resolution and grievance redressal: The network/ protocol design should also leave provisions for multi-party dispute resolution and mediation.
Open specifications allowing for interoperability: Standardised open specifications for information exchange between any two participants irrespective of technology or medium of exchange.
Decentralised: Should support a network among the end-user/participants with no centralised intelligence; the intelligence, influence and control are distributed to the end-users
Layered design: Should allow for higher-level applications to be built via unbundling the whole process.
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