The program has several interconnected components in the form of promotion of health grid, ambulatory devices and tools for analytics, ANS research, clinical assessment tools, and training courses.
Technology, including Information Technology (IT) has immense potential to transform health care especially in a developing society like India. Compared to some other sectors like banking/finance and travel which have benefitted immensely through IT, IT’s penetration in health sector has remained low which is attributable to lack of appropriate ecosystem. Grid architecture is a promising methodology to aid in building a decentralized health care infrastructure because it encourages an ecosystem development culture. It is envisaged that the Grid will foster not only connectedness of various stakeholders (viz. clinics which form the bulk of care giving in urban and rural areas, labs, devices, pharmacy, paramedics, homecare, in-patient services, patients and their families) but will enhance quality of services through implementation of practice guidelines and dissemination of health education. The grid will provide infrastructure for health surveillance & clinical research, thereby guiding policy formulation and rapid response to emerging public health challenges, and would contribute to effective implementation of insurance and publicly funded initiatives in health care.
The Center strives to bring together technology developers/industry and medical experts to create the health grid through a novel model of open platform and content contribution by the stakeholders and low cost/high sustainability factor that eliminates entry barrier and permits masses to join the grid which is its true purpose.
The Center has built agreement with technology developers, has been interacting with various medical associations and institutions ranging from general practitioners to super-specialties, and medical colleges to NGOs for content development, and has been advocating the approach to potential stakeholders/sponsors. The endeavor has proved very fruitful with the number of associations and other stakeholders joining the grid swelling by the day.
Ambulatory devices & tools for analytics
Advances in medical electronics have paved way for miniaturization of devices, which in turn has opened new vistas for several research and service applications. Bio-medicine has found a new ally in mathematics to derive greater insights from the data beyond the traditional statistics, especially time series analysis that paves way for predictive analysis and prognostication. The Center advocated development of Ambulatory Polygraph (multiple physiological/vital parameters assessment) that started as a requirement for the ‘Indo-German Collaborative Research on Neuroscience of Yoga’ for making measurements during activity. Collaboration with industry resulted into delivery of first of its kind Ambulatory Polygraph device and sophisticated bio-signal analysis software incorporating various time, frequency, and non-linear mathematical measures.
Making use of the ambulatory technology, Center conducted path breaking ‘process research’ on ANS modulation and Yoga, which has high significance for therapeutic application of yoga. Elaborate information of this research is found under the heading ‘Indo-German Collaborative Research: Neuroscience of Yoga’. The Center is looking at extending this technology for supporting various evidence based, monitored, and outcome oriented health care applications that include rehabilitation (cardiac and others), prevention and health promotion programs, and homecare.
ANS (Autonomic Nervous System) is integrator and controller of key physiological processes, and disturbance of ANS rhythm is associated with several diseases of public health importance, the list ranging from obesity/Metabolic syndrome/Diabetes, Hypertension and heart disease, to smoking, sexual dysfunction, psychological stress and neuro-psychiatric disorders. The dysfunction has been mapped even in infective conditions/sepsis, and pregnancy complications. Considering its diagnostic/predictive /prognostic promise, the Center is working on two levels to promote ANS research:
(a) Facilitation of ANS Research through provision of training and through promotion of ‘Central Lab’ approach to provide analysis facility
(b) Researching on new mathematical approaches to address the challenges in the current HRV measurement approach
The Center aspires to take forward the work of the HRV Task Force of the European Society for Cardiology and the North American Society of Pacing and Electrophysiology (1996) on “Heart rate variability: Standards of measurement, physiological interpretation and clinical use”.
Clinical Assessment Tools
The Center endeavors to fill the gaps in availability of clinical assessment tools for the conduct of specific epidemiological and clinical research, and also for application in clinical services.
• CBM-SQ (CBM Screening Questionnaire) exemplifies one such development to facilitate rapid screening of psychological health issues in various clinical and community populations. An ICMR research on psychological health of spouses of persons with HIV/AIDS is employing CBM-SQ with ultimate aim of translation into better services.
• Starnberg Scale is a clinical assessment tool for assessing the muscle action (degree of contraction/relaxation) during yogasanas. The tool has good biometric properties and has both research and training application.
• Official translation of PANSS, SCI-PANSS and IQ-PANSS in Marathi & Hindi languages (2007-2009) in association with PANSS Institute, USA & MHS.
• Official translation of MATRIX (Cognitive assessment battery) in Marathi.
Best Poster category at International Conference of Basic and Applied Physiology – Ahemdabad , December 2012. Circadian Variation of HRV in Healthy Young Adults: A novel Minimum Activity Protocol. Leena Phadke, K.M. Dandare, Sanjay Phadke, Aniruddha Joshi, Monika Gavali, Amit Inamdar.