MediQ: Elixir to Medical Management

AIIMS Delhi, March 31, 2012 11:30AM, NRD and I were looking at multiple gigantic queues -- Queues to get appointments to doctors of their concerns, or to get some sort of medical help. What even more surprising was, that some of these guys were queued for more than 8 hrs – since 3AM!

Varanasi, Dr Hatwal, known expert of Thyroid related problems. He has a unique system. Patients write their name on a paper and put it under the brick. A Friggin Brick! The brick is not guarded by anyone. On a windy day, an innocuous lift of brick, to put one’s paper-slip, can just literally blow everyone else’s application. Come on doctor, you can do better. He wouldn’t hear, or at least pretended not to.

Saraswati Heart Care, Allahabad. I call in from Varanasi to get an appointment, three days in advance. I can’t. I will have to come to the hospital – be physically present there in the morning to get the appointment; which, the receptionist says, wouldn’t be much trouble as everyone does that. I, be assured, will get the appointment for the day.

In India, we are use to of queues. Starting from our college days – queues for fee deposit, queues for admission, queues for food, queues for enquiry, queues for deity, and queues for shitting – literally. While some queues are cut short by advent of information technology (IT), most of them are not. The queues – that are solved by IT, are mostly profitable entities for upper/medium upper classes – movie tickets, club tickets, air tickets, train tickets… off the top of my head.

Why can we not have a universal queuing system for medical/doctors’ appointment and patients’ history keeping? Let’s call it MediQ (yeah, I have googled and this domain name is not available and already owned as a firm’s registered name.)

The Story: I like to think in stories. So, let me tell you a story of a Mr. Hardbody. Hardbody did not have a healthy life as most stories’ protagonists do; but he is a smart person. For last three days, he had this chronic pain in his eyes. So he requested an appointment to his eye doctor from his smart phone which turned out to be a week ahead. He thought he could wait. But suddenly the next day, he had so excruciating pain that he just looked into MediQ for the nearest available eye doctor with closest open appointment, reserved it. It was in next 30 min, a 7 min drive from his home. The doctor made some temporary relief to Hardbody but suggested a surgery as soon as possible. Hardbody called his insurance agent who sympathetically declined that the particular procedure was not covered in the insurance, sorry. Hardbody will certainly loose a major fortune if he paid for the bills. So, he searched for the lowest cost surgery over MediQ. It turned out to be a doctor in India. He looked at the recommendations for that doctor, and talked to the patients who had recently undergone through the surgery by him. It was a good deal, affordable including flight costs and little tourism. He requested the doctor in India to look for his case, over MediQ. Doctor promptly replied, since all the reports from pathology and previous doctor were automatically available to the doctor. Hardbody packed his stuffs and left. He had gone through surgery successfully. The doctor, looking at previous history of Hardbody on MediQ, figured out that some medicine’s causes him acidity, so he prescribed the alternatives. MediQ analyzed the post-surgery medicines were available in stores in nearby Hardbody’s house. Hardbody came back home happy. Posted a review of the surgery and provided his rating for the doctor over MediQ. He can be found in MediQ discussion groups with people having similar issues. And his history is updated in MediQ.

Fundamental Requirements: These features are the core of the idea. It can’t be compromised. MediQ must

1. reliably manage appointments
2. be free on the patients’ end

Functions:

1. People can make appointment to doctors via internet, via smart phones, or via SMS
2. There is going to be only one appointment list. So, any appointment made by calling the doctor, or by going physically to the clinic, or by any means that is not mentioned in #1, has to be entered in the MediQ by the operator/receptionist.
3. On unavailability of slots on request date and time, MediQ should automatically suggest the closest available appointment schedule.
4. MediQ should also manage cancellation of appointment by the doctor or by the patient.
5. MediQ should manage doctors’ schedule, so that it does not allot appointments on the doctor’s day off.
6. MediQ should be able to make two way communications between doctors and their patients so that patients can be communicated about the upcoming appointment X hours ahead, or a sudden cancellation by a patient should push the candidates behind, one slot ahead, or an emergency request shot up to top priority irrespective of its position in the queue.

Roadblocks:

1. Like any new system, doctors – specially, the government hospitals, the biggies, would not embrace MediQ with open arms. So, we need some ground work done beforehand, in convincing people.
2. Awareness – people should be aware of the system so that they can request appointments by themselves; ask for appointment number when appointment made by physically going in or over phone call.
3. Funding is a minor roadblock, but it is as real as it gets.

Nice to have:

1. Medical History: MediQ should manage patients’ history.
   
2. e - Clinic: Things that do not require patients to be physically present to doctors can be taken care over MediQ. This includes upload of reports, and suggestions by doctors.
   
3. Integratability: This is revolutionizing. An integrated system which is hooked with pathology labs, emergency systems, medical stores, various doctors and research centers, and with people having same form of illness.
   
4. Sociable: MediQ creates a society of people connected over internet. People can talk with others with same symptoms; doctors will have millions of case studies to go through.
   
5. Location tied – Location Free: A search will get you to nearest available doctors and closest available appointment slots to them. You can get medical expenses that might cost for a surgery anywhere on the globe. So, if you find that your insurance does not cover laser eye surgery, and it costs a fortune to you in USA, while the same treatment with equally good doctor in India is much cheaper (including your air ticket) – just make an appointment.