The last few decades witnessed the unfolding of a telecom revolution in India. From a very low base in the 90s, the mobile penetration today is greater than 90%.No one could have predicted this huge transformation in the telecom sector. The healthcare system in India is following a similar pattern, changing more than ever before. Driven by economic, consumer and legislative forces, the pace of change is only going to accelerate in the years to come.
The next decade will see the unfolding of even bigger a transformation in the healthcare sector in India. This transformation can be accelerated, and will have a greater impact, if the products and solutions developed, leverage existing and emerging technologies judiciously.
With a growing population of 1.38 Billion, the healthcare challenges are unique when compared to other countries, given India’s demographics. Here are some reasons:
- There is a shortage of clinicians and healthcare facilities. These are also unevenly distributed between urban and rural India. Wherein~70% of the population live in rural India they are served by only ~30% of the doctors.
- The private spend is high at 70%, however the government expenditure on healthcare is less than 2% of the GDP.
- At 65%, the out of pocket spend is high,when compared to other countries. However, this will change in the coming years, given the recent launch of Ayushman Bharat.
- The high inflation in healthcare costs (~15%), will result in the cost doubling over the next five years if not addressed.
- There is a lack of available metrics on productivity and the quality of the care, as less than 2% of the hospitals are accredited.
- There is an early onset of chronic diseases, like high blood pressure, cardiovascular diseases, cancer, diabetes, and chronic pulmonary diseases in younger people across the country. New infectious diseases like Covid-19 are only adding to the existing burden.
These challenges together are exerting an immense pressure on the healthcare system,which is currently stretched to its limits.
To address these challenges conventional approaches alone will not suffice. New innovative approaches leveraging technology are required. The healthcare startups and the manufacturing sector will have to play a key role in this journey. In addition to increasing the GDP spend on healthcare, it is imperative to improve the efficiency and productivity of the clinicians and the existing infrastructure. Increasing the awareness among people on healthy living needs more focus. Through appropriate government regulations, all the stakeholders in the healthcare ecosystem need to be made more accountable for their actions.
Leveraging existing and emerging technologies can help develop solutions that can address the country’s healthcare challenges.Technologies like Cloud computing, Healthcare IoT, 5G, Artificial intelligence, Robotics, Drones, Augmented Reality (AR), Virtual reality (VR), 3D Printing, Blockchain etc. can have a huge impact on the solution if used judiciously.
But there are some common mistakes that need to be avoided:
- Using a technology just because it is cool, without evaluating the broader impact
- Usability, quality and ease of maintenance not being built into the solution
- Inability to integrate the solution seamlessly with existing systems
- Implementing a point solution without understanding the big picture
- Sometimes multiple technologies might need to be used together for maximum benefit
- Just automating existing workflows without making any changes that may be required
A classic example of things having gone wrong,is in the implementation of Electronic Medical Records (EMR) in several hospitals in India. Digitization of patient records is required to improve the productivity of the hospital staff and to provide doctors with the required patient history, for an accurate diagnosis and treatment of the disease.However, this improved productivity is many a time offset with the non-intuitive user interface of the EMR systems, which results in the doctors spending enormous amount of their valuable time in data entry, rather than treating patients.
Some of these systems which are home grown are not interoperable with the existing systems in the hospital which entails an additional cost to integrate with new systems.Another common issue is under-engineered infrastructure (Servers, PCs, Network, etc.). This slows down the solution and contributes to an indirect loss of productivity of users. Sometimes mistakes made are too late to be corrected because of the huge sunk costs involved.
In order to maximize the impact of a technology-based solution, it is imperative to take a holistic view of the problem, be clear on the end objective and do a thorough evaluation of the accruing benefits and pitfalls.
An evaluation of the quantifiable impact for one or more of the attributes in the questions below can help in the decision-making process:
Does the solution –
- reduce the cost of care?
- improve the quality of care?
- improve the productivity of the healthcare provider?
- improve the quality of life of clinicians?
- lower government spend on healthcare?
Adapting indigenous solutions in combination with global solutions localized for India is required to effectively address the healthcare challenges in the country. Point solutions invariably will not yield the best results. An end-to-end platform-based solution approach is required. The government, private sector and startups need to work closely together to make this happen.
If used appropriately technologies like Artificial Intelligence, 5G, Cloud Computing, and Healthcare IoT, have a high potential to maximize the impact(please see the above Table).An improper design and implementation of a solution, could have an adverse impact on the problem. The common mistake of using a technology just because it is cool should be avoided.If required, current workflows should be modified to maximize the strategic benefit from the solution.This may entail an initial investment to design and implement the solution, and train the users.
For technology-based solutions to be the panacea for the healthcare challenges in India, it’s imperative that the solutions are end-to-end and strategic in nature.
(Srinivas Prasad is Founder and CEO of Neusights and the views expressed in this article are his own)