Healthcare and the Fourth Industrial Revolution

The main goal of e-healthcare is to provide fast medical care to remote patients from specialist doctors through telephone or mobile.

Domestic and foreign expert doctors' advice can be taken at home through teleconference, video conference, or online. E-healthcare brings all types of health care to the doorsteps of everyday people, providing medical advice, arranging specialist doctor appointments, arranging tests at diagnostic centers, ensuring easy availability of rare medicines, and making familiar people aware of health.

You are using an intelligent wristband that tells your pulse rate, heartbeat, stress level, how long you walk, and measures your weight. These are the contributions of IoT devices. IoT devices can also monitor health and activate emergency notification systems remotely. Bangladesh has already made a lot of progress in the health sector, such as reducing the under-5 mortality rate, availability of effective drugs against HIV, and increasing the TB cure rate through drug detection and direct supervision of children under five years of age. In addition, Bangladesh has made significant progress in reducing poverty rates, reducing the number of underweight children, increasing primary school enrollment, reducing infant and maternal mortality, improving immunization programs, and reducing the incidence of infectious diseases.

The hassle-free healthcare app offers online doctor video consultation, e-prescription, and emergency healthcare. You can install the healthcare app on your smartphone very easily. And directly talk to the doctor on the video call. Health care can be taken quickly by starting the app and clicking the doctor option on the homepage to get the doctor's serial from the healthcare app. Click on the category for which the specialist will see the doctor. Now click on the preferred doctor, click on the 'book your appointment' button, select the chamber, select the patient type, select the date to see, select the time to see the doctor, enter your problem, and submit the appointment. If the doctor's fee is scheduled, you will be taken to the fee payment page, and after selecting how to pay the cost, the appointment will be confirmed. The doctor's appointment was effortless.

The fourth industrial revolution is giving a new dimension to world civilization. The process and potential of this revolution are already being widely discussed worldwide. The discussion is going on in our country, too. Through this discussion, the Hon'ble Prime Minister and his advisor on information and communication technology are working tirelessly to create awareness among the people and make Bangladesh suitable for leading the fourth industrial revolution. The fourth industrial revolution is the fusion of physical, digital, and biological spheres. Here, physical is human, biological is nature, and digital is technology. It becomes difficult to separate these three. What is the result of this? What kind of changes in society? This results in intellectualization, human-machine interfaces, and merging reality and virtuality.

Now, if we are to prepare for our fourth industrial revolution, we need to teach emotional intelligence, physical intelligence, social intelligence, and contest intelligence into their heads. Then, we can all prepare for the fourth industrial revolution in the future. But what will be created in the future is unknown. There are a few things we can do to prepare our generation for this unknown future. Information is a powerful element of civilizational change. Since the dawn of civilization, man has been eager to spread his experiential knowledge. The invention of paper and ink and the printing press made the human desire for information dissemination a reality. The technological upheaval of the Fourth Industrial Revolution is everywhere.

This revolution is causing considerable changes in the world of thought, product production, and service delivery. People's lifestyles and the nature of the world are changing drastically. Perpetuates the wall of difference between the biological, terrestrial, and digital worlds. Artificial intelligence, robotics, the Internet of things, virtual reality, 3D printing, genetic engineering, quantum computing, and other technologies are a revolution. The scale of this revolution, technology-based modernity, and its associated complex system have also faced a significant test of the ability of the governments of the world. Especially when the government is committed to inclusive development with everyone in the light of Sustainable Development Goals and SDGs, 'leaving no one behind'. Sustainable development, reducing inequality, safe work, responsible consumption, and production are key challenges to implementing and achieving the SDGs.

In our country, citizens can get free health advice from doctors working in government health centers through mobile phones. That is why one mobile phone has been given to each district and upazila hospital in Bangladesh. You can also use this service. Arrangements have been made to publicize these mobile phone numbers locally. Some doctors receive the call of this mobile phone 24 hours a day. Local people can call these mobile phones and get free medical advice without visiting the hospital.

As a result of the introduction of this service, free medical consultations from government doctors have been created for all the rich and poor living in villages or remote areas. There is no need to delay seeking medical advice in the dead of night, for urgent needs, or due to distance. There is no need to risk mistakes or wrong treatment by visiting the doctor. Treatment that can be done at home does not require a visit to the hospital.

There is no need to go to the upazila or district hospital for treatment, available at the village community clinic. Again, for a complex disease that requires urgent treatment, it is possible to get advice to go to a big hospital with just one phone call without wasting time wandering here and there. Busy people can consult the doctor at the beginning of the disease. As a result, the possibility of disease complications is also significantly reduced.

Many patients come to the outpatient departments of government hospitals in the country. It is, therefore, difficult to consistently provide quality services with limited manpower and medicines. Many patients will consult doctors at home when mobile phone health services are widely promoted. As a result, the pressure on the hospitals will be reduced. Then, it will be possible to provide good treatment to incoming patients with limited manpower and resources. Patient satisfaction will also increase. Mobile phone health services will also be extended to community clinics.

High-quality telemedicine services are available in hospitals of different levels nationwide, and more hospitals will join soon. As a result of the launch of this service, patients admitted to hospitals at upazila and district levels can consult doctors of specialized hospitals using modern telemedicine methods.

Besides, web cameras have been provided in each upazila hospital, district hospital medical college and institute hospital. As a result, an opportunity has been created for patients admitted to upazila-level hospitals to consult specialist doctors working in specialized hospitals of the district and capital. Mini laptop computers with web cameras have already been provided to community clinics. Laptops are being delivered to all union health centers and community clinics in the country. These mini laptops have a wireless internet connection. Laptops are used to provide telemedicine services. For those patients who need to consult a doctor, arrangements are made to consult the doctor of the Upazila hospital by starting a video conference. As a result, there is a shortage of doctors in community clinics. Various health awareness information on healthy living, safe water, sanitation, nutrition, etc., is also being distributed easily. The health information repository of rural people is also being updated with this laptop.

About 5000 unions in Bangladesh manage union information and service centers. These centers provide quality services to the local population using ICT equipment at a nominal charge. ICDDRB has a state-of-the-art artificial intelligence-based method of diagnosing diabetic retinopathy using tele-ophthalmology technology called 'CARA'. 'Bondstein' has been using intelligent tracking through IoT devices to prevent the leakage of medical question papers for four consecutive years. Aleek, Intelligent Machines, Desh AI, BrainStation 23, and some other initiatives are working on IoT, Virtual Reality, and Artificial Intelligence on a small scale.

The potential role of verifiable national identity cards in Bangladesh's e-healthcare delivery is an obstacle to its success and must be overcome. We can take a cue from India's Aadhaar project, which is recognized as the world's most extensive biometric ID system, the Aadhaar card. It provides a unique identity number through which all will be provided health services, pension services, and many other social benefits. This identity can be compared to Bangladesh's distinctive national identity card facility.

If identity cards can be verifiable, they can become a crucial component of e-healthcare delivery. We can leverage our technological systems to address this unique identity's technical aspects and challenges. One concern regarding NID and other databases is data privacy. However, the examples of successful e-healthcare services in Estonia, Botswana, Thailand, and Korea can inspire us.

About 2 billion people worldwide are deprived of much-needed social services due to a lack of unique IDs. A global unique identity is very much needed for achieving social and economic benefits and gender equality. Most of the people who do not have identity cards are women, and they are lagging behind in terms of development and services. We must consider overcoming the political and economic problems of using a unique identity.

62% of healthcare providers are knowledgeable about e-healthcare, and 59% have a positive attitude towards it due to the lack of electronic systems in current healthcare in Bangladesh. There are not enough laws to prevent cybercrime in the healthcare sector.

In our country, we must also work with a unique identifier for every patient. Information should be stored in the database so patients can access any work anytime. Again, if there is a database and a unique identity system, it is necessary to ensure the database is not hacked.

The National Identity Card of Bangladesh was created specifically to ensure voting rights. The election commission does not want to take responsibility for making it usable in other cases, so there is no substitute for government policies or laws to ensure its multiple uses.

Service providers and receivers are reluctant to adopt the technology. Service providers hesitate to use technology to store data as it is bureaucratic and time-consuming. There are currently no privacy breach issues in the database. However, many government organizations have to come together to solve the various problems of this identity, and the order must come from the highest level of the government. E-health services will become popular quickly if joint efforts of both public and private sectors are required to work on verifiable unique identity cards in e-health services.

Written by Hiren Pandit

Bio: Hiren Pandit is an essayist and researcher

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