Indian Healthcare is Ready to Embrace a Tech-enabled Future
By Chandni Mathur
The delivery of healthcare services in India will see varying degrees of technology in place across the value chain even in the post-COVID-19 world.
As the COVID-19 case count flashing on headlines becomes more sobering by the day, healthcare experts, policy advocates, and care providers are left pondering the same questions: How did we get here? What technologies and tools can we leverage today to come out of this situation? How do we design a better healthcare system that will be resilient yet flexible enough to respond to similar situations in the future?
The Pandemic is Crippling the Healthcare System
The shortcomings in India’s healthcare system (not enough beds per unit population, inadequate number of graduating medical and nursing professionals, and the growing disparity between access and affordability of quality care in urban versus rural centers) were often highlighted but never exposed as ruthlessly as during the pandemic. Government hospitals are running on full capacity and are extremely overcrowded with the influx of COVID-19 patients. Private hospitals saw a decline in elective surgeries and occupancy levels to just 40% by late-March as compared to pre-COVID-19 occupancy levels of 65-70%, according to media reports. Patients with chronic diseases have delayed treatments because they have been unwilling to leave their homes. This can add to the country’s overall disease burden and increase complications in the future. Faced with an imminent surge of COVID-19 cases, the Indian government roped in private hospitals to manage the pandemic. The intricate relationship between healthcare outcomes and economic growth is now evident, elevating healthcare to the highest priority in terms of public policy and private sector participation. The virus has reached some of the most remote parts of India where healthcare services are the poorest and most inaccessible. Managing this extent of the spread requires immediate attention.
Stirring the Change
A seismic change in India’s healthcare system design has been underway with the central government expanding healthcare coverage through Ayushman Bharat. Its success is predicated on lowering prices as the first step (hence, the efforts to cap prices on selected drugs and medical devices such as stents). Improving healthcare outcomes will require a quantum leap in efficiencies: perhaps the only silver lining amidst the pain being witnessed is that this pandemic could mark an inflection point in the deployment of complex health technologies across the value chain.
As policymakers scrambled to issue enabling telemedicine practice guidelines, healthcare providers (from general practitioners to large diagnostics and tertiary care hospital networks) are looking to leverage digital health tools to engage with their patients virtually from appointment bookings, screening, and diagnosis to post-care management and adherence. India has witnessed the transition to telehealth, a revolutionary feat considering the hitherto dependence on face-to-face consultations.
A case in point is Practo, a platform that aids communication between patients and providers, which witnessed a sixfold increase in virtual consultations from March to May 2020; 80% of interactions were first-time telemedicine users and 44% of customers live in non-metro cities, according to Practo. Other companies, such as mFine, DocsApp, 1mg, and Lybrate, are also facilitators of this paradigm shift. Justified privacy concerns aside, the speedy design and deployment of the Aarogya Setu contact tracing app showcase the will and willingness of authorities to leverage existing tools in its fight against COVID-19 in the short term and in reimagining India’s healthcare ecosystem for the future.
Building Blocks for a Transformation in the Indian Healthcare Story
The redesign of India’s healthcare system should start with a dissection of the failures of the past. Healthcare and education are areas where perhaps India’s size, scale, and diversity have historically proven to be an insurmountable challenge rather than an opportunity. Policymakers must lay the foundation for a digital future. India’s limited resources would be better utilized not towards building more physical infrastructure to augment bed capacity and exponentially increase trained manpower, but by leveraging emerging technologies such as artificial intelligence (AI), cloud computing, Big Data analytics, and remote patient monitoring tools enabled by next-generation ICT infrastructure (i.e., 5G and Bluetooth 5.0). Robots will find more applications.
Home healthcare services have helped reduce the burden of chronic patients on hospitals by offering more complex ICU-like services to the terminally ill. They have emerged as the best approach to bridge the gap in hospital infrastructure and started to move up the healthcare value chain. Remote monitoring devices and smart wearables integrated with a patient’s health records have catalyzed this shift of care from the hospital to the home. In addition to supporting the growth of home healthcare services, the Indian medical insurance fraternity will use smart wearables for continuous health and wellness tracking to create new insurance plans. Patient portals that encourage patient-reported outcomes will gain credence as clinical evidence of advantages become more apparent in the Indian context. This will be of use when designing care pathways and encouraging patient engagement. Virtual assistants based on natural language conversational interfaces and AI also hold strong promise in the Indian context for information dissemination, screening, triaging, and home-based monitoring. Tele-consultations will experience continued usage. Omnichannel care delivery models (a mix of face-to-face and virtual consultations) will become more prevalent.
The pandemic has forced patients, payers, and most importantly healthcare providers to accept technology. The delivery of healthcare services in India will never be the same again, with varying degrees of technology in place across the value chain even in the post-COVID-19 world.
Technology vendors will reap the benefits of this massive opportunity but must ensure the quality and accuracy of their digital solutions and be flexible in managing the variability in demand.