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Building a Caring Healthcare System

  • Through a phone and web-based patient feedback system, Mera Aspataal (My Hospital) helps policy-makers and decision-makers regularly monitor central and state government health facilities. Image courtesy USAID/India

 

The Mera Aspataal application developed by USAID/India helps collect feedback from patients to establish a responsive and accountable healthcare system.
 


Regular feedback from patients is critical for health facilities as well as patients. Even though many health facilities have designated boxes or physical forms to collect suggestions and complaints, the system is often not efficient enough to assess how the facility has responded to the patients.

 

Patient feedback accurately reflects key quality components like better health outcomes, adherence to clinical guidelines and positive communication between patients and healthcare providers. Moreover, feedback on health services empowers the patients by making their voices heard and engages them in making the healthcare system more accountable and responsive to their needs.
 

With this goal in mind, the Indian Ministry of Health and Family Welfare partnered with the United States Agency for International Development (USAID) to develop a dynamic solution that would be simple, intuitive, secure, inclusive and can be quickly scaled across different healthcare facilities and settings.

 
The result of this initiative is Mera Aspataal (My Hospital)—a phone and web-based patient feedback system that uses an open-source platform. It is a breakthrough application through which policy-makers and decision-makers at the national and state levels regularly monitor the central and state government health facilities respectively, using patient feedback data.

 

“Studies across the globe have reported that patient feedback could help improve the quality of health services and health outcomes, foster healthy competition among the providers, and enable patients to choose health facilities,” says Arvind Kumar, senior advisor strategic partnerships, USAID/ India.

 
While designing the application, several other names like Meri Awaaz (My voice), Hamari Awaaz (Our voice), NAVIHAAN (Network for Awakening Voice of India for Health Advancement) and PAVAN (People Action and Voices for Advancement) were considered. “But the final decision on the term Mera Aspataal was taken by the Ministry of Health and Family Welfare,” says Kumar.

 
During the pilot phase from August to December 2016, the application was tested in 99 public health facilities across 14 states. Mera Aspataal is integrated with the online and manual patient registration systems at health facilities using a multi-channel approach. It uses platforms like SMS, outbound dialing, mobile app and a web portal to collect feedback on aspects like provider behavior, waiting time, cleanliness and the cost of healthcare services. The responses are automatically computed into a patient satisfaction score.

 

The integrated health facilities share demographic data like mobile or landline numbers of outpatients and inpatients with Mera Aspataal on a daily basis. The next day, an SMS is sent to the patients, soliciting their feedback on the services availed in terms of “very satisfied,” “satisfied,” or “not satisfied”. Patients who are not satisfied receive a call for the collection of information about the reasons behind their lack of satisfaction with the services received. Healthcare facilities that do not get a good score are asked to report on the actions they have taken to address the issues. This leads to greater accountability and improvement in patient satisfaction.

 

Keeping in mind the diverse profile of the Indian population, Mera Aspataal has been designed in a multilingual format.  Currently, it is available in English, Hindi, Tamil, Telugu, Kannada, Khasi and Gujarati.

     

The project was transferred to the Ministry for Health and Family Welfare in 2019. As of June 2021, it has expanded to 8,156 hospitals, including 7,443 public and 713  private empanelled hospitals in 28 states and 8 union territories. Mera Aspataal has reached out to 99 million people, out of which 6.4 million responded to the request for feedback.

 

There are plans to upgrade the initiative to further help the government take appropriate decisions for enhancing the quality of healthcare delivery across public facilities and improve the patients’ experience. In the days ahead, Mera Aspataal is expected to be an important tool in establishing a patient-driven, responsive and accountable healthcare system in the country.

 

Ranjita Biswas is a Kolkata-based journalist. She also translates fiction and writes short stories.