|LETTER TO EDITOR
|Year : 2022 | Volume
| Issue : 2 | Page : 197-198
Living in 'Digital India'
Department of Medicine, KG's Medical University, Lucknow, Uttar Pradesh, India
|Date of Submission||23-Feb-2022|
|Date of Decision||12-May-2022|
|Date of Acceptance||13-May-2022|
|Date of Web Publication||29-Aug-2022|
Dr. Harish Gupta
Department of Medicine, KG's Medical University, Lucknow - 226 003, Uttar Pradesh
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Gupta H. Living in 'Digital India'. J Med Evid 2022;3:197-8
'Be a yardstick of quality. Some people aren't used to an environment where excellence is expected.'
–Steve Jobs (1955-2011),
Co-founder and Chairman of Apple Computer Inc.
Kalyani et al. assess challenges in application of Online Registration System (ORS) in health care in India in their original article published on 28 December 2021 in the Journal. They made a survey of patients in outpatient department of their tertiary care hospital, collected answers of the posers, compiled its data and then got their results published here. This survey provides us an insight into the way our masses use digital tools, their habits and interests, challenges faced in the process and their surfing pattern. Correlating with socio-demographic profile of the patients, we can derive useful data to view emerging trends.
Table 1 of the article shows that male patients comprised 70% of the population, whereas census data show that proportion to be near 50%. To the best of my knowledge, this pattern denotes our patriarchal society. When it comes to availing tertiary care health services, males can gather wherewithal to do so and women are left behind. That is the reason behind seven male patients visiting the Apex Institute when only three women could. I urge our policymakers to address this gender divide and apply some policy measures to rectify the injustice, for example, free registration or partial fee waiver for female patients visiting the hospital.
Another glaring feature of the study is that when it comes to qualification of the sample population visiting outpatient department area at the hilly terrain, all the patients have at least higher secondary qualification. Census data show total literacy rate to be 79% there. What may have been happening at the background is that educated – that too highly ones – are able to make use of digital tools and avail the services. While public services are run by taxpayers' money, it is duty of our elected representatives to approach the last man standing in the queue. However, what is apparent here is that persons having less than higher secondary schooling are not able to avail these services. Therefore, our administrators should devise some innovation to reach out to those who are not experts in this area. Corona pandemic is teaching us that no one is safe unless everyone is safe. As communicable diseases do not know any barriers, treating educated (and people with means) is as much necessary as the other deprived half. Lack of inclusivity is an area of concern for us today.
Census data also indicate that the state has 70% of rural population versus 30% urban ones. However, when the authors conducted a random survey at a teaching hospital, a higher percentage of urban population was visited and ratio is reversed. In my opinion, two factors may be operational here. First, rural folks simply could not reach there due to logistical challenges. Or second, they reached the hospital despite several barriers but could not get included in the study. In either scenario, if the rural population does not get represented in a random survey, we need to make corrective steps to balance the equation.
Table 2 of the survey results indicate that the random sample makes the maximum usage of their electronic devices for social networking to make connections. Our policymakers need to look into the data carefully. Instead of erecting big, elegant and costly hoardings – which are vulnerable to fall during strong winds – time has come to educate the masses on social networking sites through virtual tools. We need to put our eggs on that basket where population pays its attention to.
Another point which needs to be pondered about is its reasoning. Is it so because when a user uses social networking site, the application is more user-friendly, but when she comes on the web page of the ORS of a hospital, perhaps she faces some difficulty? If that is the case, we need to design our web page in a way that generates more virtual traffic. Crucial points where a new user gets stuck, should be scanned and the bottlenecks should be fixed. The point I want to emphasise is that when a consumer has a device and can surf the web, all the challenges in front of her for smooth operation of hospital system should be carefully looked into and resolved appropriately and in a timely manner. Lest we may lose in competition.
When the authors draw a conclusion that they (our software engineers) should redesign ORS as per feasibility of patients, one starting point may be to ask them that how it is so that a larger proportion of them use social networking sites but not those belonging to the hospital. The poser may throw up some interesting, bewildering and humbling responses.
When authors draw a conclusion that in their study, majority (of the sample population) were educated and employed males, we need to pause for a while and think why it is so. If people from all the walks of life are not visiting us, our students may not observe full spectrum of illnesses prevalent in our society. Disease belonging to the poor, women and the uneducated may escape their attention. Moreover, it is possible that in the long run believing these groups – and their illnesses – -to be insignificant, may not become their area of interest.
As we know, skewed research generates less than optimal results, all the attempts should be made to include everybody in our safety net.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Kalyani CV, Arora G, Chao H, Kaur HD, Kaur H, Malik H, et al.
Challenges in application of online registration system in health care in India. J Med Evid 2021;2:209-12. [Full text]
Saikia N, Meh C, Ram U, Bora JK, Mishra B, Chandra S, et al.
Trends in missing females at birth in India from 1981 to 2016: Analyses of 2·1 million birth histories in nationally representative surveys. Lancet Glob Health 2021;9:e813-21.
Guterres A. Global Leaders Agree on the Challenges Facing Humanity – Why Can't We Agree on Action? United Nations General Secretary. Available from: https://www.un.org/sg/en/node/261832
The Editors of The Lancet Group. The Lancet Group's commitments to gender equity and diversity. Lancet 2019;394:452-3.