A Special Issue On Understanding Digital Health: Challenges And Opportunities

INTHISISSUE

NEWSLETTER

PageNo.2

LatestHealthITNews

PageNo.5

UnderstandingchallengesinDigitalHealthcareadoption

andusageinIndia-CMEEInitiative

PageNo.9

OverviewofDigitalHealthCare-Global

Scenario

PageNo.3

InnovationsinHealthcare-NationalandGlobalprospects

PageNo.7

RoundtablediscussiononDigitalHealthcare

deliveryinIndia

PageNo.10

OverviewofDigitalHealthCare-

NationalScenario

PageNo.4

Challenges&OpportunitiesofDigitalHealthcareDelivery:Importantresearchinsights

PageNo.8

UnderstandingtheusersentimentinDigitalHealthcareservice

deliveryinIndia

PageNo.14

MessagefromtheCMEE-Chair

1

Volume5,SpecialIssue1 March,2020

MESSAGEFROMTHECMEECHAIR

PROF.SATYABHUSANDASH

ChairpersonCMEE

Dear Readers,

It gives me an immense pleasure to bring the newsletter of Centre for Marketing in Emerging Economies “Aspecialissueonunderstandingdigitalhealth:Challengesandopportunities”. The special issue delineates the national and global scenario of Digital health care, latest innovations, few research insights undertaken in digital healthcare implementation. The special issue covers CMEE's initiative to study categorization of digital healthcare across the hospitals of India. Further, outcome of the roundtable discussion focusses on the barriers and recommended solutions for delivery of digital healthcare solutions. We �ind there is requirement of rigorous research to understand the challenges in adoption and usage of digital healthcare across hospital administration, nurses, doctors and patients.

Technology has always played a crucial role in healthcare innovation, and this will be no different in the future. Most of

the innovations in healthcare has been focussed on the development of state-of-the-art digital healthcare facility

encompassing new diagnostic procedures, therapies, drugs, or medical devices. Healthcare demand in emerging

markets is growing due to the growth in aging population. Considering the fact that limited research has been taken up

in technology adoption in healthcare in India, CMEE is in the process to undertake a large study exploring the state of

art of technology adoption and associated challenges in digital healthcare delivery in India.

I am thankful to the participants of the roundtable discussion, Consortium of Accredited Health Organizations (CAHO)

for organizing the round table discussion. I extend my sincere gratitude to all the participants of the hospital

administration, doctors and nurses who enriched our understanding of various categories of digital health care service

delivery across hospitals of India. I earnestly solicit the co-operation and contribution of all the interested academia

and healthcare industry representatives and medical professionals to join hand with us in our march towards research

on digital healthcare in India.

To see past events of CMEE and know all the updates please . click here

Hopeyoulovereadingitasmuchwelovedmakingit.

Prof Satyabhusan Dash

2

De�ining Digital Health……

“broadly de�ined as the use of

information and communications

technologies (ICT) to improve

healthcare services . An increased 1

use of ICT in health care sector

is promoting the quadruple aim

of enhanced patient experience,

reduced cost, improved population,

health and improved clinician

ef�iciency . Healthcare systems 2

vary from country to country,

with a common goal of providing

quality care for both patients

and the healthcare professionals.

The urgent need is to provide an ef�icient,

e c o n o m i c a l a n d e ff e c t ive h e a l t h c a r e .

T h e evo l u t i o n a n d d eve l o p m e n t s s u c h

a s d i g i t a l h e a l t h r e c o r d s , t e l e h e a l t h

a n d a r t i � i c i a l i n t e l l i g e n c e ( A I ) h a v e 3

led to better health outcomes and reduced costs .

Digitalhealth

recordsTelemedicine

Arti�icial

Inteligence

ADOPTIONRATEOFDIGITALHEALTHTECHNOLOGY(2015-2018):-GLOBALOVERVIEW

• More accurate and up to date data about the patients

• Used by 76% health professsionals.

• Enables 24/7 consultation and care

• 61% health professionals use telehealth

• Assists through clinical decision in personalized treatment plans to patients.

• 46 % use AI

FUTUREOF

HEALTHCARE

FocusonpreventionandwellBeing

Interoperabledataandplatforms

Consumerengagement

andempowermentInteroperable

DIGITALHEALTHCAREADOPTIONANDEXPERIENCESI t i s wo r t h to n o te t h e i n c re a s e i n t h e d i g i t a l h e a l t h to o l u s a g e (like telemedicine & wearables) among consumers i .e . , from 80 % in 2015 to 87% in 2017. A report on Transforming Healthcare experiences based on 15,000 individuals and 3,100 healthcare professionals in 15 countries explores digital health care impact on the patient and healthcare

4providers See more

“IdreamofaDigitalIndiawherequalityhealthcarepercolatesright

uptotheremotestregionspoweredbye-healthcare”ShriNarendraModi,PrimeMinisterofIndia

3

OverviewofDigitalHealthCare-NationalScenario

The technology adoption in health care sector has gained prominence in India, with efforts from both public and private sectors. India's healthcare sector is expected to be $280 billion in size by 2020, workforce in the sector is expected to be at 7.4 million in 2022.

6

InitiativesbytheGovernment- The government has launched several initiatives such as Digital India and Aadhaar in some cases with support from the private sector. MoHFW has started various e-Gov initiatives in Health care sectors in India, the division is named as e-Health division. The e-health initiatives will deliver better health outcomes in terms of access, quality, affordability, lowering of disease burden and ef�icient monitoring of health entitlements.

ValueCreationbyHealthcareInnovationstopatients&ConsumerTransition5

Transforming an individual's healthcare experience via

tech based tools needs an engrained understanding of

the consumer's preferences.

As a matter of fact, engaged and discerning consumers

exert greater in�luence on health systems and drive new

business models. New entrants from industries such as

retail, telecommunications, technology and wellness and

�itness are exploring new opportunities.

lower healthcare

costsValue drivers

for Digital Health

Innovators

Enable health Data

ownership

Improve Access to care

Empower Pa�ents

Democra�ze informa�on

SeveralinitiativesbyGovernmentofIndiaare7

e-hospital Mitaan e-Aushadhi

S e r v i c e s l i ke o n l i n e registration, payment of fees and appointment, online diagnostic reports, c h e c k i n g o n t h e avai labi l i ty of blood online, etc.

A virtual assistant for A N M w h i c h p r o v i d e s reminder services i .e . , job charts , work plan & budget monitoring at their �ingertips-initiative byGovernmentofRajasthan

A transparent system of procurement, storage & distribution of drugs, supplies & equipment at reasonable competitive rates implemented by the GovernmentofGujarat.

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HealthcareInnovationsStart-upsinIndia

A rapid growth in GDP, smartphone penetration and half a billion citizens under the age of 25, have paved the path to Digital health start-ups which are trying to overcome India's health care challenges.

Start-up like provides platform to doctors in Practo9

highlighting their practice reach target patients and increase revenue by offering online consultations, Lybrate

10 provides platforms addressing care accessibility through telemedicine and transparency. LiveHealth

11

aggregates patients' medical/health records, data, doctors' reports and test results for constant and convenient access.

BIGDATAandMhealthIntegrationforIndia12

Need of the hour is to implement technology in the rural areas where healthcare infrastructure and resources are not avai lable . mHealth devices combined with big data could increase rural health and lead to an accessible, cheap and ef�icient healthcare system. The major metabolic risk disease (heart attack and stroke) can be identi�ied by continuously monitoring and updating the patient's data.

Latest Health IT News

5G has an important role to play in solving the worst health outcomes, due to its ability to support millions more devices at speeds up to 100 times faster than 4G read more

Boston Patient Experience Symposium Attracts Star Power for Tech ImprovementTalkIFEBRUARY10,2020

Technology and a shift to value-based care have �inally put patients at the forefront of their healthcare journey. And as the industry continues to put health in the hands of their patients, it is important to collaborate on best practices and next steps. read more

Kick-startingtheHealthcareTransformationwith5GIFEBRUARY17,2020

EmergingGapsinhealthcaresystemofIndia(seemore)8

Hospital bed density in India has stagnated at 0.9 per 1000 population since 2005 (WHO laid guidelines of 3.511 per 1000 patients' population).

Nearly 80% of healthcare spend in India is out-of pocket 0.65 doctors per 1000 population, 1.3 nurses per 1000 population. (WHO guidelines: 1 doctor per 1000 population & 2.5 nurses per 1000 population Only 295 million out of over 1 billion people are covered by insurance

5

Breaking down the barriers to AI Adoption in Healthcare I DECEMBER 30, 2019

Arti�icial intelligence (AI) is taking over the world—or so it seems. According to a recent reportby PricewaterhouseCoopers, healthcare industry advances in AI, including variants like machine learning (ML), will contribute signi�icantly to an economic boost totalling $15.7 trillion Read more.

IndiatohostBRICSDigitalHealthSummittoboostdigitalhealthcareIINOVEMBER15,2019

India will host a on innovative solutions to a healthy lifestyle that will BRICS Digital Health Summitseek to integrate digital technology with . healthcare informatics and diagnostics read more

State,ICMRBangaloretoinkpactforcancerregistryIIFebruary04,2020

Soon each and every case of cancer in the Rajasthan State will be registered as the health department is planning to sign an MoU with the Indian Council of Medical Research., Bangalore, which will provide a software to the health department to register each case of cancer. Read more

TechnologyaidingthetreatmentofMitralRegurgitationIIFebruary14,2020

Mitral valve repair surgery using this technique has been used in over 100,000 patients from across the world, improving outcomes, and restoring their normal quality of life. From occluders for closing heart defects to pacemakers that can detect sleep apnea, medical intervention in cardiac care has come a long way. Read more

The government has mooted an ambitious plan to introduce interoperable electronic health records (EHR) based on consent which will enable all citizens to access their h e a l t h re c o rd s w i t h i n � ive c l i c k s . Read more

At Children's Hospital Los Angeles, we creativelysolve problems using the limited resources we have. This is a trait we share with our fellow safety net hospitals and our special charge for caring for patients and families living with c h a l l e n g i n g i n d iv i d u a l c i rc u m s t a n c e s . Read more

GovtplansAadharbaseddigitisedhealthdatavaultIIJULY16,2019

HowChildren'sHospitalLosAngeles'StaffiscreatingchangethroughinnovationsIINOVEMBER29,2019

6

INNOVATIONSINHEALTHCARE-NATIONALANDGLOBALPROSPECTS

Apple' s Researchapp: What does itwant your healthdatafor?IINovember18,2019

Apple has of�icially launched its research app, which iPhone and watch users can download from the App Store to take part in health studies. Once users have downloaded the app, and opted in to sharing their information with the studies, their hardware will collect data that will be used to inform the trio of studies. Read more

NewAlgorithmshowspromisetotreatchildhoodcancerIIJanuary08,2020

Using a computer algorithm, researchers have identi�ied a promising new treatment for neuroblastoma- a form of cancer in children, which occurs in children, which occurs in specialized nerve cells in the sympathetic nervous system and may be life-threatening. Read more

Government'sgoaheadfor4medicaldeviceparksIINovember10,2019

The government has given approval for setting up four at AndhraPradesh, medical device parksTelangana, TamilNaduand Keralawith a view to support and provide Make in India initiativeworld-class products at affordable price for treatment. Read More

Kerala:SreeChitradevelopsalowcoststentgraftIIFebruary20,2020

Sree Chitra Thirunal Institute of Medical Scienceand Technology (SCTIMST) has developed

and its delivery affordable aortic stent graft system for the treatment of thoracic aor�c aneurysm

Read More.

7

ChallengesandOpportunitiesofDigitalHealthCareDelivery:ImportantResearchInsights

Smar tphone apps f o r cancer :Acontentanalysisofthedigitalhealthmarketplace.

The interactive nature of smart phone apps offered users to upload photos, post updates, exchange information with peer. While limited number of cancer apps supported tracking appointments medications, side effects and chronic pain.

DigitalHealthIIVolume6;1-7II2020

Smart healthcare: Challenges andpotential solutions using internetofthings(IoT)andbigdataanalytics

Digital health-care systems that leverage EHRs and use technologies such as IoT and big data are expected to seamlessly connect patients and providers across diverse health-care systems.

PSUResearchReviewII1-7II2019

HealthcareRobotics:QualitativeExploration of key challengesandFutureDirections

The present study elicited the perspectives and experiences of stakeholders from various international settings to bring together knowledge and deliberate on potential future challenges of implementing and optimizing robotic applications in health care settings.

JournalofMedicalInternetResearchIIVolume20II2018

NarrativeReviewforexploringbarrierstoreadinessofelectronichealthrecordimplementationinprimaryhealthcare.

The study highlights an urgent need of health providers to create an EHR implementation roadmap, establish teamwork with the participation of end users, select and prepare leadership, provide user training to operate the system and also prepare support to maintain and promote the system. Among the developed countries a lack of familiarity with the new technology is a common barrier among healthcare staff.

HealthcareInformaticsResearchIIVolume25(3)II2019

The effect of digital technologies adoptioninhealthcareindustry:acasebasedanalysis

The present study highlights the case of MSD Italy the management model including (a) providing health organizations with primary care services, (b) social assistance and (c) social health for patients enrolled in these tele-monitoring programmes. The study also highlighted few barriers like big data management, patient's resistance to use of technologies for indifference.

BusinessProcessManagementJournalIIVolume24;1124-1144II2018

The utility of wearable �itness trackers andimpl i ca t ions for increased engagement :Anexploratory,mixedmethodsobservationalstudy.

A comprehensive evaluation of how the wearer interacts with the device had a positive impact o n h e a l t h . S i x s p e c i � i c e l e m e n t s i . e . , attractiveness, monitoring, feedback, privacy protection, readability and gami�ication explains the health empowerment of the wearer

DigitalHealthIIVolume6;1-12II2020

8

StateofArtFacilityforHealthCare

OnlinePayment

CMEEinitiativestounderstandchallengesandopportunitiesinDigitalhealthcareadoptionandusageinIndia

CentreforMarketinginEmergingEconomies(CMEE),IIMLucknowNoidacampus conducted a study to understand the challenges and opportunities in Digital Health care adoption and usage in India. A preliminary qualitative interview was done with hospital administration and medical professionals (doctors and nurses) of few leading hospitals in Delhi/NCR to adopt technology in their healthcare ecosystem. An attempt was made to understand (a) the level of awareness and adoption of various digital technology in their respective hospitals (b) their current and potential usage of digital technology and (c) barriers and facilitators in adoption of digital health technology.

Further, on the basis of digital usage of various services we found that the digital technology activity can be categories into 6 broad activities.

ElectronicMedicalRecordandPatientInformationGuide

OnlineAppointmentsandConsultation

(Patient contact information, Emergency contacts, Insurance info., Physical Vitals, Past and future medical facility appointments, Medical progress and surgical notes, Billing information, Discharge summaries and treatment plan)

Find Doctors (with schedule) /Departments, Book Appointment/Health Check up, Quality Care at Home, Tele Health/Telemedicine, Online expert online

ServiceExcellence

Patient Feedback and Medical Query

Max Myhealth, My Fortis Doctor, BLK Doctor App, Aakash Patient Portal

MobileApplications

Smart OPD, voice-modulated integrated operating theaters, Da Vinci Robotic System and Integrated PACS Deployment- AIIMS

9

on

Organized by

Centre for Marketing in Emerging Economies (CMEE)

& Consortium of Accredited Healthcare Organizations (CAHO)

ND22 JANUARY, 2020 ND22 JANUARY, 2020 ND22 JANUARY, 2020

CAHO SECRETARIAT CAHO SECRETARIAT CAHO SECRETARIAT

Dr Amit RajCardiologist, Plexus

Cardiac care,

Rajkot, Gujarat

Mr. Prashant MishraManaging Director

at BMJ Publishing Group

for India & South Asia

DR. DK GuptaFelix Hospital ,

Noida

Dr Vibha JainDeputy General Manager-IT

Max Hospital, Gurgaon

Col Binu SharmaSenior Vice President

Nursing Services, Columbia Asia Group of Hospitals, India

President Infusion Nursing Society India, US Af�iliate

Mr Mohan Krishnan

CMEEGoverningBoardMember,

ExSeniorVPKantar

ModeratoroftheRoundTableMeet

at

Ms. Arti SinhaCEO& Founder-

WayU Health

Dr Rajiv JanardhananDirector Amity Centre

for Vascular Biology,

Amit University

Ms Parthvee JainVP-Operations-

Max Super Speciality Hospital

Vaishali

Head-Market Access &

Partnerships-Innovatio Curis

Dr Gaurav Aggarwal

Dr SB GogiaDirector-DH India

Founding Fellow of IAHSI ,

President- SATHI

Dr V K SinghManaging Director

Innovatio Curis

Prof Satyabhusan DashProfessor IIM Lucknow

& Chairperson CMEE

Prof Moutusy MaityProfessor- IIM Lucknow & CMEE

Governing Board Member

Dr Vijay AgarwalPresident

CAHO

“Round Table Discussion on Barriers and Recommended Solutions for effective delivery of Digital healthcare services”

10

Mr Mohan Krishnan, Governing Board Member-CMEE, facilitated the discussion by emphasising on global digital healthcare in becoming important in the recent years. He highlighted that the most considerate points were- a) Digitalization challenging many fundamental questions in healthcare, b) The way digital health is being delivered and its movement from reactive to proactive, c) Disruptions in digital healthcare are individuals centric and d) Importance of digital healthcare for universal coverage.

The speakers brainstormed their ideas on the following topics-

* De�ining the contour of the Digital Health * Major Buckets of Digital Health * Barriers and recommended solutions * Areas to Deep Dive in Technology Adoption in Healthcare sector

De�iningthecontourofDigitalHealthinIndia

DrVijayAgarwal- Fusion of technology with biological functions to create innovations. It can also be de�ined as mixing the earlier technologies and giving rise to disruptive solutions adhering to simplistic solutions.

Mr Prashant Mishra- Cultural transformation of how digital techniques provides digital & objective data accessible to care giver as well as patient is leading to an equal level of play between the doctors and the patients.

Dr Vibha Jain- Information at the �ingertips, digital health is moreover the sharing of the information between the clinicians, hospital administration and patients.

DrSBGogia- Digital Health care is a term that originated from the term e-health which in turn came from telemedicine/telehealth. It is in line with the changing emphasis from sickness to the wellness."-

Dr Gaurav Aggarwal -Simpli�ication of healthcare operations from complicated ones.

DrDKGupta - Digital Health care is affecting the healthcare ecosystem that includes the patient care, hospital operations and clinical operations. By digital health our main motive is to improve the patient experience, quality health care and patient safety.

DrRajivJanardhanan- The perception of digital health is not only to identify the disease burden but to also improve strategies for early detection of vascular disease (like cancer) so as to improve the clinical prognosis of patients. It can help to post the data of patients in remote areas to the physicians at varied locations.

DrVKSingh- Need of the hour is to understand the scope and idea of Digital health in the year 2020, and understand the emerging focus areas of digital health care from the achievable and grew able point of view.

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MajorBucketsofDigitalHealth

DrVijayAgarwal- Digital health can be bucketed into (a) Mobilebasedapplications(b) Portals/websites (c) EHR/EMR(d) Innovations(e) Education&trainingprogram.We have developed digital health platform where a range of tools in the digital health spectrum is available, the platform is privately secured. EHR is one of the digital health care tool adopted in India and experts having knowledge and experience of implementing EHR should focus on writing a preamble of EHR. The training in health care also includes training in �ire safety.

DrGauravAggarwal- The bucketing of technology adoption in health care should address how does digital health care provides accessible health care like (a) Health tech based on emergency accessibility(Innovative methods in digital health care) (b) Health tech based on routine accessibility (Mobileapplicationsand Telemedicine/ tele health for quality health care in remote areas) c) Health techbasedon hospital management (EHR/EMR) and d) Health tech based on providing diagnosis/consultations.

-WayuMD is a mobile application developed for doctors and has helped in behaviour Ms.ArtiSinhachange of the patients, and improved patient care by providing an easy-to-use connected platform. It has been bene�icial for the patients undergoing a long treatment period (in case of patients with chronic disease) as with the help of the WayuMD applications they can be engaged, get remote care and monitoring and provide valuable data to doctors to help in the treatment process.

Mr.PrashantMishra- Innovations are happening in private as well as in the government space. For instance, getting an appointment in AIIMS was a nightmare but the online registration system is facilitating doctor's appointment at much ease.

DrRajivJanardhanan- Digital health is an early diagnostic tool which will have a positive impact in the work of physicians by addressing each minute problem.

Dr.SBGogia- Through creating a routine in the chain management and using AI for summary creation will simplify the process for the stakeholders. Best form of Telehealth and Telecare is a sharable EHR/EMR and its creation should be in routine and painless for doctors.

Col.BinuSharma -Adoption of EHR is poor in small cities and also its adoption is pretty slow among the doctors. There has to be an improvement in the whole gamete of designing the EHR. It should be designed in continuous supervision of doctors from different stream for its better adoption.

-EHR/EMR is being followed at our cardiac program. For each and every patient in the DrAmitRajoutpatient department, history taking, provisional diagnosis and vital signs is maintained by the physician assistant. The med-tech is connected to software and is assessed by physicians in a hardcopy. Same method is being adopted in the ICU, where the day to day progress notes and nursing notes is maintained by the physician assistant.

Dr.DKGupta- Digital Health care is affecting the healthcare ecosystem that includes the patient care, hospital operations and clinical operations. By digital health our main motive is to improve the patient experience, quality health care and patient safety. Further it also helps in optimizing the promotors processes and their cost effectiveness. As a result, the outcome is great for patients, promotors and also in the terms of the revenue.

Ms.ParthveeJain- InnovatioCuris is also addressing this learning by focusing on used cases of AI in the health domain. How can we address the cyber security threat? InnovatioCuris with the help of CAHO has developed a Cyber Help Desk helping people encountering several issues and how they can be resolved with the help of expert's opinion.

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BarriersandRecommendedSolutions

Col.BinuSharma- Adoption of EHR is poor in small cities and also its adoption is pretty slow among the doctors. There has to be an improvement in the whole gamete of designing the EHR. It should be designed in continuous supervision of doctors from different stream for its better adoption. There is a need to adopt a standardized structure recommended for EMR/EHR.

DrVijayAgarwal- The biggest challenge is there is a lack of registry and lack in comparison of the functionality of EHR.

DrSBGogia- The main problem lies in identifying which data needs to be uploaded and classifying what is important Arti�icial Intelligence assists only the process but a human brain will sort and con�igure what is important and bene�icial. Through creating a routine and using AI for summary creation will simplify the process for the stakeholders. Basically the Information technology system is all about the input and output devices processing and connectivity of methods. The main issues lie in identifying where does the information enters into the system and once it enters, how does it integrates with the rest. The speaker emphasized that the biggest roadblock is the user adoption of the healthcare information technology in general.

ProfMoutusyMaity- Expressed her concerns on Data security and data privacy in health care and raised questions on how are the doctors coping with the mismatch in data occurring due to interpretation by the software.

Prof Satyabhusan Dash- Elaborated the presence of a scanty information related to health technology in the public domain. How the available digital technology being adopted by our nation is creating value be�itting the patients/consumers with its tangible and intangible bene�it.

- Data privacy in maintaining the data in hardcopy is much riskier than maintaining Dr Amit Rajthe digital data. Data recorded digitally is protected by passwords and is accessible to only few physicians. Additionally, there is a cross veri�ication and cross reviews between the doctor's prescription and the prescription interpreted by the software by the physician assistant curtailing mismatch and any confusion.

AreastoDeepDiveinTechnologyAdoptioninHealthcaresector

DrVijayAgarwal- FocusonMobileHealthApplications- Collating information about the available mobile applications, a step further would be auditing these applications. A review of apps and segregating it on the basis of their segments and bene�its.

Mr.PrashantMishra- Evidences from the local case studies- One should have the grassroot level of understanding in usefulness of applications to the person concerned. There is a need to generate local evidences/ publish the data and further also demonstrate how these applications are making animpact. Supporting the top most agendas and concerns around quality of care and patient safety, one should come up with simplistic ways of what worked and what did not work in the local case studies of digital studies.

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UnderstandingtheusersentimentinDigitalHealthcareServiceDelivery

Snapshotofalargestudytounderstandusergeneratedperceptionofusingtheservicesofdigitalhealth care undertaken by Centre for Marketing in Emerging Economies, IIM LucknowNoidaCampus.

ResearchTeam- Prof Satyabhusan Dash, Dr Shalini Kumari, Mr Avinash Jain.

An attempt was made to analyse the user feedback of the Max My Health application developed by Max Health Care Group. Sentiment Analysis and Topic Modelling techniques through R software were used to derive the insights of 204 users of the applications. The analysis derived emotions of the usersassociated while using the application and 9 topics emerged at the end of the analysis. Moreover, the sample study concludes the positive response of the users in using the application while few users were dissatis�ied with the service and were having dif�iculty in adoption of the application on the daily front.

PositiveandnegativesentimentsThe users posted real time messages about their opinions on a variety of topics discussed current issues, complained and express positive sentiment for the use of app of Max Hospital. The users felt relaxed as their time was saved, they could book appointments at their own convenience. Few words associated with positive sentiments are excellent, easy to use, outstanding and facilities on �inger. The app helped in availing quality health care at home. While it was also easy to �ind doctors in different department. On the other hand, users also reported few roadblocks which disinterested them in using the app. Few users reported the app to be extremely buggy as a result they faced problems in booking appointments. Further, topic modelling reveals some important topics which emerged out of the user feedback on the app and they are described in the below section.

Sentiments Wordsassociated

Negative(48%)

Positive(39%)

worst experience, error message,bugs, crashing, single star, extremely buggy, money making, terible app, poor response, complaints, too slow, no OTP, impossible, terrible , unjusti�ied, fraudulently, waste of time, poor service, frequent updates

facilities on �inger, useful, helpful, excellent, easy to use, nice facility , easy appointment,a w e s o m e , o u t s t a n d i n g , wonderful app, convenient

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TopicsofdiscussionamongtheusersofMaxMyhealth

Online Lab Reports and e-prescription-Reports were uploaded late, once uploaded it was not organised, users had to spend a lot of time in �inding their latest reports. Few users faced problems in downloading the e-prescription.

ConfusingUXandUIToo frequent updates and too much error while accessing the application, problems in updating pro�ile (user name, date of birth, adding new family members, creating new account).

LackofCustomerSupport Despite of raising concerns and feedbacks, few users complained that their issue were not resolved. Hospital administration also refused to help.

MedTecError

The online payment gateway was not working, update suggestion even if the app is updated, family members were removed automatically from the pro�ile.

NewGraphics&DesignRecent modi�ied version was not user friendly, b o o k i n g p ro c e s s wa s to o c o m p l i c a te d , application kept crashing.

BookinganappointmentLogin issues, lack of con�irmation whether the slot is booked, majority complained that they booked something and got something, problems in OTP generation, no option for booking an appointment with a radiologist.

DataSecurityConcernsThe users reported the software as too buggy, they were also concerned about their data as the basic reports were not maintained properly.

LackofclarityinbillingcycleUsers reported inappropriate and hiked prices of few tests, few complained about less clarity in billing.

User'sExpectationfromtheapplication a) Providing drop down menu of available specialities in the hospital. b) Filling last name of the patient should not be made mandatory (as few don't have last names) c) Direct Hotline numbers for individual centres within the facility. d) Additional documents can be uploaded by the patients themselves e) Direct communication with doctors through app or text message at the time of emergency f) Reports like ECHO, MRI, Digital X ray should also be uploaded in the report section

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deliveryatacademicmedicalcenters.InHealthcare(Vol.2,No.1,pp.9-13).Elsevier.

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integration:promisesforhealthcaresysteminIndia.BMJHealth&Informatics,26(1).

Formoreinformation,Kindlycontact

CentreforMarketinginEmergingEconomiesIndianInstituteofManagementLucknow

NoidaCampusB-1,Sector-62,InstitutionalArea,Noida-201307,UttarPradesh,India

Phone:01206678483,9654250130,8826280997CMEEWebsite:http://iimlcmee.org/IIMLWebsite:https://www.iiml.ac.in/

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