Riding into the digital wave - Telehealth, artificial intelligence, cloud computing, digitally mediated diagnostics, consumer facing health applications, interactive interfaces are some of the key terms in today's health IT sector^*1. The outbreak of covid-19 and measures to contain individuals within their home although proved a major challenge initially has been both a boon and a bane to the healthcare industry particularly for the growth of the health technology industry.

Digitalizing the care ecosystem began with converting paper based medical charts to online libraries of medical information thereby making accessibility and availability to medical assistance faster than ever before.

To create access to your care provider online through a personal channel of communication via messaging or video call is the need of the hour reducing the burden on human resources at the hospital and also proven successful^*3

Research shows that "Remote management is possible for many patients that are seen in primary care and hospital outpatient clinics. Moreover, this type of management can still be delivered by healthcare workers that are quarantined after infection or exposure. Telehealth tools have also been suggested as a form of electronic personal protective equipment (PPE) that can be used by acute care clinicians to evaluate hospitalised patients while avoiding physical proximity^*2." Barriers that existed pre covid to take healthcare systems entirely online were shattered by the pandemic and opened a glass ceiling for a new kind of medical encounters from the comfort of your home through the telehealth module^*2.

In the post pandemic era, the shift from crisis management to more sustainable healthcare delivery services that make the most efficient use of digital health systems like Agastha with its myriad of features offered is explicable. Electronic Health Records offer a 'secure system that properly preserves data security and patient privacy'. They have transformed the way 'clinical care' is serviced in hospitals with numerous benefits for care seekers thereby reducing wait times, giving them quicker access to their provider but challenges like with any system persist.

Electronic Health Records and the current population health scenario

An online medical chart that brings together a dashboard of services like scheduling appointments, managing progress notes, e-prescriptions and laboratory results tracking and also a personalized messaging channel between doctor and patient, doctor and nurses and administrative team alike is the primary use of EHR today^*4.

Healthcare is a multi-dimensional system that collects large amount of data on a daily basis from across the spectrum. Care professionals gather information from the patient across various levels as listed below^*5:

1. Primary: first point of consultation
2. Secondary: acute care requiring skilled professionals
3. Tertiary: advanced medical investigation and treatment
4. Quaternary: highly uncommon diagnostic or surgical procedures

Going forward, technological advancements with machine learning and artificial intelligence capabilities allows an additional feature to operate as a supportive decision-making tool to extract more meaning from the large data available. Electronic medical records have been in the market and adding value to healthcare operations since early 1990's and until now have been used in practices and clinics in developed countries. The widespread use of online care systems particularly in countries of large population since the pandemic, which nudged the health systems to reduce human interaction to the minimum made EHR systems a popular choice across the globe.

"The impact of decision support systems goes beyond medication prescribing. Early research suggests that electronic prompting can improve preventive care for a variety of conditions, ranging from the reception of Papanicolaou smears to the administration of the influenza vaccine" ^*4

Over time other kinds of clinical data get added into the system like medications & prescriptions, imaging and laboratory examinations, other personal and private data. Large amounts of information get collected and spun into the algorithms to derive meaningful information and predict a suggestive mode of care^*5.

A study on the impact of big data and the contribution of EHR's highlights that "EHRs enable faster data retrieval and facilitate reporting of key healthcare quality indicators to the organizations, and also improve public health surveillance by immediate reporting of disease outbreaks. EHRs also provide relevant data regarding the quality of care for the beneficiaries of employee health insurance programs and can help control the increasing costs of health insurance benefits. ^*5"

A software like this enables standardisation in data in the real world and serves as "efficient storage and sharing units" of health information with limitations of lack in data diversity and is very homogenous^*6.

The reservoir of information available in EHR's is vast and the biggest challenge with this information is that it has not been collected for research purposes and hence is very heterogenous in nature^*7. Information collected from a wide variety of healthcare organizations across the globe is an exciting data analytics forecfield but considering the robust nature and lack of qualitative definition to the data with only quantity reduces its potential considerably.

In conclusion, there are large amounts of raw information available and to classify them into context and use them productively incorporating the efficiency of health technology software that provide AI/ML capabilities as a value add is a starting point from small niche and specialty practices to large healthcare organizations.