Tag: Virtual Healthcare

09 Apr 2016

Experiment in remote, virtual care – Michigan to Sri Lanka


Last year, I went to Trincomalee on the east coast of Sri Lanka to volunteer at Grace Care Center, a wonderful orphanage and center for elders run by a friend and colleague Naresh Gunaratnam, MD from Ann Arbor, Michigan. I was part of a small group – we were mostly alumni from University of Michigan (from medicine, law, finance and business backgrounds) and one from Texas. Naresh suggested that we experiment with remote healthcare delivery/ management by rolling out enki EHR at the Center.

When an eye-camp was organized, we went through documenting medical charts of children from Grace and nearby orphanages electronically on enki. It was an interesting start because in a very short amount of time, we trained five or six senior kids at the home to start using the EHR. Two kids captured BMI, another documented demographics, and one girl Karthika (in the picture) who was training to become a dental assistant entered all the medical information. Each resident at the home had a paper medical chart documented previously by doctors volunteering/ visiting from University of Michigan. Over 2-3 days, the children and their local teachers entered all the information they had into enki – including medical data of the elders at the center.


A few months later, when I was in Ann Arbor, Naresh called me over one Saturday morning to watch a group Skype call. I saw 3-4 medical students in their respective homes, elders from Grace in Sri Lanka participating in a remote medical consultation under Naresh’s supervision. Someone who knew Tamil (the local language) would ask patients questions and translate – about pain, symptoms, behavior and so on. Then there would be a discussion amongst the group with Naresh asking the students probing questions. There were often references to previously documented electronic records of the patients. During an hour+ long call, one patient after the other received medical care remotely from Ann Arbor to Trincomalee. Everything was electronically documented in enki EHR. It was very satisfying to see remote healthcare delivery in action on a software that we created.


This morning I was pleasantly surprised to be copied on an email that the students were mailing each other – it said ‘enki training video in Tamil’. One or more of the medical students from UM made a basic video on how to document medical records in enki EHR in the local language, Tamil. Here’s that video.

Professor C.K. Prahalad (from whom I learnt anything I needed to learn from a business school – all outside of class) often used to talk about weak signals that would give a glimpse into the future – these usually amplify over time and become dominant trends. I remembered him this morning. On the face of it, the experiment in Sri Lanka may seem like a simple video conference, followed by documentation of patient records, training of medical students and localization of a software program. But it gives a peek into the future of how medical training could be imparted and how healthcare could be delivered – remotely, virtually, without regard to location, perhaps on demand. Electronic health records are really not an end in themselves – they are simply the building blocks that would allow for treating patients anywhere, anytime with the aid of data.


Further reading: Update on remote healthcare delivery from Michigan to Sri Lanka