We spoke again with Samar (first interview here), to see if some of the ideas and insights we got from him were translated into prototypes the right way, and get a more in depth look into his prescription behaviour, amongst other feedback.
Across the clinics he works for, some have up to 70% illiterate patients, being in mostly low-income areas. Even in these areas, people tend to have smartphones, but patients more than 40 years old mostly use them for making calls.
We talked to him about the way he prescribes and what he exactly writes down both in the patient record and the prescription itself.
“Patients forget their ID number and the card, so then there is no record to use in the consultation. If patients don’t bring their card, it delays the process”
Samar spends a lot of time writing the patient record, besides capturing the name, age and sex, he also captures the family relations, complaints (symptoms & tests) and signs (diagnosis). He says a 'normal' doctor (RMP) would instead make you do tests to make money, he would not look for the diagnostic signs.
To examine, he uses 7 keywords to make sure he hasn't missed anything significant. They are sleep, appetite, bowel, bladder, menstrual, last childbirth, contraception. He says it doesn't take much times and it allows him to paint a complete picture of the patient.
He often writes about the illness on another piece of paper, as the older people need to be able to tell their kids what’s wrong (i.e. their blood pressure) so the kids can bring them the right medication and find the right instructions in terms of dosage.
On the concept, he tells us:
“This works along with my conscience, usually [in my consultations] it’s a pressure for time”
Pressure for time means he can’t counsel the patients as much or share the reason why he’s prescribing, he knows its going against his conscience.
On the fact that Smart Prescriptions might provide warnings:
“It would make sure that I am not missing anything when prescribing to my patients”
“When the patient pesters for an antibiotic but the warning says if a fever is just there for 3 days, i would rethink my decision”
When we provide a lot of information to the patient, Samar told us:
“I’m a bit fearful that when it’s all written down, doctors will spend less time, it shouldn’t reduce the interaction between doctors and patients"
“Putting gas in a bicycle would be better”
He likes the idea of the petrol-diesel, but thinks its not exactly accurate, he believes it's like using the wrong antibiotic for something that actually needs a certain kind of antibiotics.
“People here don’t play with cubes”
He doesn't think that in India people would be convincible by abstract metaphors, he believes the concept of antibiotics needs to be explained very plainly.
He already uses numerous apps to keep himself on top, UpToDate, RefRx and Curofy being a couple ones.
“We have to renew our license every 3 years, you need 100 CME points”
He was reluctant at first, saying it would require time, but it being connected to CME points made it more appealing for him.