This article is different. It is not about trying any software but a need we felt very recently. The issue was that how does one find help for homecare. It is not something for which one has any plans and it is not something which is a regular requirement. However, it seemed to me that a service using information technology with the involvement of healthcare providers could be immensely valuable. I was reminded of a startup in Bangalore I had read about some years ago. Google search by a trial and error of keywords led to Babajob.com.

Hiring from the informal sector

It is a fascinating concept for placement of people in the informal sector. It was a pleasure to see that babajobs.com is still operational and in more cities than just Bangalore. However, the focus has changed somewhat from the original goal of connecting the informal workers with well-off households needing help - http://www.techsangam.com/2011/04/27/a-monster-in-the-making-the-babajob-story/

Firstly, they realized that it’s easier to hire someone into a work environment than a home environment. There also are more businesses hiring informal workers than households. Most of Babajob’s growth has come from businesses

My recent experiences led to the need for intermediaries. Since the need is immediate, there is little time to explore or verify the antecedents of the intermediary and you can easily be misled. The critical pieces of information like reliability, punctuality aside from the skill set are just not available. A glib talker is at a distinct advantage. I would have preferred the intermediary to be a web site. The use of ratings on the web sites like ebay acts as a self-disciplining force.

A second fact emerged that the intermediary or the middle-woman need not be fair paymaster. While you may even pay advance, there is no assurance that the actual service provider gets paid in time. Holding on to payments seems to be a way of ensuring that the caregiver continues to work with the intermediary.

It is desirable that the doctors or the hospital provide some options but they also lack enough background or information to suggest any option with any confidence. More often than not, there advice is also by word of mouth, possibly of their patients.

As our society also ages, the need for such services is bound to increase. We found that there seem to be a fairly large number of people involved in this activity in Chandigarh, which seems obvious since it has the reputation of being a city for the retired. Were such a service available, family members sitting in Bangalore or Silicon Valley could organise care even if they could not rush home.

Consulting a Doctor

I know just one person who visits a doctor with remarkable frequency. In most cases, the visit to the doctor is delayed until the agony is worse than the agony of going to a doctor! Something does not seem right. An article in http://techcrunch.com/tag/medlion/ led to http://www.medlion.com/. The motivation for the MedLion service is a reaction against health care becoming very expensive because of medical insurance. However, a significant fact mentioned by Techcrunch is:

Like many direct primary care practices, they find more than half of their patient interaction is via electronic means, as they aren’t forced by reimbursement rules to have a patient come to their office for something that could be done simply over phone or email. We want to be available for our patients whether they are in the Bay Area, Bali or Boise.”

Perhaps, a visit home by a physician is no longer an option. For critical cases, hospital may be the better option but in many cases an email, sms or a brief discussion over phone or a video call may be adequate to decide the best course of action. Perhaps it can help us move towards the ancient Chinese system of rewarding doctors.

Doctors in Ancient China were paid only as long as their patients were healthy. As soon as the patient fell ill, payment to their doctor stopped. China Medicine has a tremendous emphasis on the preventative aspect of medicine. (http://www.wholebodybalance.com/acucpuntureflu.htm)

Given the penetration of mobile phones and increasing density of smart phones, I hope some physicians in India start a similar model. The use of open source model for the applications will make it far easier for the concept to spread.

You should be able to communicate with a doctor rather than follow the advice of a commercial which was banned: “You know something is going to be wrong with you but you don't yet know what it is. Take X and kill it before it hits you!”