Social Health: Treatment, Rehabilitation, and Palliative Care

Every patient should get healthcare under the UHC scheme covering primary, secondary, tertiary healthcare, rehabilitation, and palliative care equally, free or without more spending that may become a burden on savings and push them below the poverty line.

In the case of a patient who has a chronic disease, addiction to drugs, or disability cases, the service provider will refer the patient to a rehabilitation center. The rehabilitation will attempt to restore, maintain and maximize their physical strength, function, motion, and overall well-being by addressing the underlying physical issues to be able to become independent in his day to day activities so that they efficiently participate in learning, earning, and living a meaningful life role as the breadwinner of his family.

Public and private sector service providers and NGOs may establish rehabilitation centers at the doorsteps of the community and operate them by using standard rate lists of treatment, procedure, and services. They also root all claims to relevant insurance companies as per the same clinical and claim adjudication processes described below for their sustainability.

Palliative care is specialized medical care for patients living with severe diseases. This type of care is provided by a specialized team of specialists, doctors, and paramedics who work with other doctors of the patient to provide relief from symptoms and stress of illness to improve the quality of life for both patient and his family. Most tertiary care hospitals can provide palliative care to patients in many developed and developing countries. Still, the need is to develop adequate national policies, programs, and training on palliative care for public and private sector service providers’ health professionals on an urgent basis to provide healthy life to the patients and their families.

Digital development and artificial intelligence is the basic need of each service provider because no one can maintain, monitor, or evaluate accurate medical and financial records of each patient manually and cannot avoid fraudulent and malpractices in day-to-day operational processes. These operational processes are known as care management processes.

We are entering into a technical phase of UHC called digital development and artificial intelligence. The technical phase consists of setting up standards, business rules, lookups, empanelment evaluation criteria (EEC), and the development of logical data models for family/household data and flow charts of all operational processes for beneficiaries, service providers, and complaint management. This technical phase consists of the following steps.

STEP – 1

STEP - 2