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How Chronic Disease Costs could be prevented: A Jile Health User's Story

On 25th March, I published an essay titled: “There is no substitute for the Problem first mindset, our banking regulators deserve respect!”. In this essay, I highlighted our mission to make healthcare affordable for the bottom 90% of Indians, emphasizing a thoughtful approach, one community at a time. I presented a diagram illustrating the comprehensive healthcare journey from birth (day 1) and even proposed that day 0 should be included in this healthcare continuum, extending to the edge of the Healthspan. Frankly, at the time of writing this essay, I had no idea how the healthcare outcomes were super interconnected. Of course, after discovering the framework to identify the root causes of human medical conditions/diseases - we knew human health is connected. However, one of our recent user encounters was a different level of realization. And this essay is an insight from one of our users.

Let’s get started…

Sunanda Ji, a 55-year-old mother of two (both under 20), with a monthly income of approximately INR 35,000, sought my advice concerning her health. She had a few medical records and had been informed by her doctor that her eyesight problems were linked to her diabetic condition, warning that without treatment, she might permanently lose her eyesight. Sunanda Ji and I live in the same apartment complex in Patna, Bihar, India. At this point, it was common knowledge among our neighbours that I work in the healthcare sector. Consequently, I shared a link to the Jile Health app via WhatsApp and encouraged her to install it, sign up, and create an ABHA account. I requested her to attach her health records. Remarkably, Sunanda Ji had diligently maintained physical copies of her health records for many years, including prescriptions and paper-based medical bills. I wished that every Indian could safeguard their health records as meticulously as she had.

I requested Sunanda Ji to simply click all of her past medical records so I could review all and uncover the root cause of the provider statement. This is a beautiful part of the Health Stack (ABDM) a user who can use WhatsApp can also create ABHA and link their Health records. Our AI engine is not live, it will take some time therefore we reviewed all her health records on our local computer. Here are the surprising parts that we discovered through uploaded past and present Health Records

  • There was no deficiency in key health vitals and nutrients, including Vitamin A, Vitamin C, Vitamin E, Vitamin D, Omega-3 fatty acids, and zinc, which could be responsible for her eye issues.

  • Sunanda Ji is a non-smoker hence no problem with contract formation - one of the potential root causes of eye issues.

  • A normal blood pressure for the past many years - except for occasional highs.

However, blood glucose has been on the rise for the past many years. In 2019, from her body checkup report, we got to know the blood glucose (Random) was 94 mg/dL (this is in the biological range: 70 to 100 mg/dL). This is one of the mistakes most of the providers made, 94 mg/dL in 2019 was in the biological range however on the edge of pre-diabetic, no? And almost all providers in India don’t even care to nudge patients that their Blood glucose is on the edge.

And no timely, attention led to the pre-diabetic condition in 2021, and we discovered through Sunanda Ji’s diagnosis records of heart disease. The blood glucose (Random) crossed 100 mg/dL - 106 mg/dL. Here also, since the diagnosis reports were for the purpose of Heart diseases, the provider ignored the pre-diabetic condition.

According to her current eye diagnosis reports, her blood glucose (Random) is in the diabetic range - 134 mg/dL. And seems her blood glucose crossed the diabetic range last year (2022) and hence she is experiencing an eyesight issue. This diabetes leads to eyesight problems called Diabetic Retinopathy. One of the most common eye problems caused by diabetes is diabetic retinopathy. Diabetic retinopathy is a condition that damages the blood vessels in the retina, the light-sensitive tissue at the back of the eye. This can lead to blurry vision, vision loss, and even blindness. Frankly, I was a bit shocked and worried because this means - in the next 5 to 7 years India will have 350 million+ visually impaired people (How?).

According to the National Blindness and Visual Impairment Survey (NBIA) 2019, there are an estimated 62 million visually impaired people in India and according to the Indian Council of Medical Research (ICMR), there are an estimated 101 million people with diabetes and 136 million people with prediabetes in India. See there is a danger of one-third population having some form of eyesight problem in the next 5 to 7 years. This is an alarming problem for the economy and people living in our country, no?

In the past 12 months of our journey, this is the first time we encountered such interconnectedness of two chronic diseases. And if there is one, in the coming time we might discover more. But let’s look at this problem from the availability of eye care professionals. The World Health Organization (WHO) recommends that there should be one eye care professional for every 10,000 people. This means that India would need about 1.3 million eye care professionals to meet the WHO's recommendation. However, as of 2023, India only has about 130,000 eye care professionals. This means that there is a shortage of about 1.17 million eye care professionals in India.

It is evident that upgrading our physical infrastructure to accommodate this growing demand or producing such a vast number of eye care professionals is unrealistic. Nor can this problem be solved by creating INR 20,000 yearly packages, as I have observed in the solutions offered by most Healthtech companies. This leaves us with one viable option: the framework shared by us. This approach becomes especially crucial when addressing healthcare problems on a massive scale for India's bottom 90%—a population of 1.2 billion.

Imagine if healthcare providers had alerted Sunanda Ji about the potential implications of her rising blood glucose levels. Technically, it would have cost nothing to diagnose the risk of Diabetic Retinopathy. Today, Sunanda Ji might not be facing the prospect of spending a substantial sum for treatment and ensuring a comfortable final phase of her life. Such an outcome would have been nearly impossible just a few years ago. However, today, we have both science and technology at our disposal to tackle this and many other healthcare problems at an affordable price for India's bottom 90%—1.2 billion Bhartiya…

We have been working on Jile Health for more than a year, I started Jile Health after facing a personal problem with a mission to make healthcare affordable for the bottom 90% of Indians. We have worked silently for the past 12 months and believe - what we have constructed will make Healthcare affordable for the bottom 90% of Indians - 1.2 billion Bhartiya. To explain what we are building we have created loom pitch videos. You can find part 1 of the video pitch here. And if you find part 1 interesting, contact us - we shall share part two.

Thanks for reading, please share this in your network if you find it useful. I shall see you all the next week


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