Revolutionizing Healthcare: The Impact of AI and Telehealth on Patient Care, Quality, and Access

CXOToday has engaged in an exclusive interview with Dr. Arjun Kalyanpur, Founder CEO and Chief Radiologist of Telerad Group.

1. What are some specific applications of AI in the healthcare sector, and what benefits have these applications brought to patient care and medical research?

Some of the areas where AI provides benefits in healthcare are related to:

1. Screening for detection of diseases of public health significance: For example, AI algorithms have been developed and trained to detect findings of Pulmonary TB on chest Xray, and Breast cancer on mammography (such as MammoAssist AI developed by our team at TeleradTech).
2. Early diagnosis: In Radiology algorithms such as NeuralAssist developed by our team at TeleradTech are used for the detection of bleeding in the brain in the setting of head injury and stroke. Similarly, AI algorithms have been reported to differentiate benign from cancerous skin lesions in Dermatology, as well as detect early degenerative changes of the retina and several other eye diseases in Ophthalmology.
3. Treatment planning: AI solutions such as IBM Watson have been used to help develop or optimize treatment protocols for patients with cancer.
4. Monitoring of diseases and Outcome prediction: In patients with chronic diseases such as Diabetes, or those on homecare monitoring, AI can be used to detect changes/trends in metabolic parameters which can predict the risk of hospitalization or a negative clinical outcome.
5. Workflow/operational productivity: AI has been used to help shorten imaging duration in MRI while at the same time preserving the quality of the image, enabling more efficient scheduling. Further AI in the form of virtual assistants and chatbots can be used to reduce waiting time for primary interaction with patients with their healthcare providers.
6. Healthcare data analysis: AI algorithms can be used to analyze medical records to ensure quality of the data recorded. The use of AI in analyzing healthcare billing patterns has been found to be of value in fraud prevention, which adds an economic benefit.
7. Drug Discovery: AI algorithms have been found to be of value at multiple stages in the drug discovery cycle.

2. Can you elaborate on the technology-driven transformations in healthcare delivery in India and how these advancements are improving healthcare access and quality?

Technology-driven transformations in healthcare delivery in India include:

1. Telemedicine/Teleradiology – especially following the COVID pandemic, during which the Indian Government legalized Telemedicine, this has become a mainstream process causing a paradigm shift within healthcare. Teleradiology in India has been present for two decades but is only recently starting to show explosive growth related to increased penetration and acceptance. Teleradiology and Telemedicine allow populations of remote areas the opportunity to tap into the best healthcare expertise that the metros have to offer.
2. E-learning- Given the significant scarcity of physician educators, the use of E-learning allows for the extension of the educator’s classroom into a limitless virtual environment opening access to a nationwide pool of students. Our RadGuru educational portal provides an online learning resource for postgraduate students across the country.
3. AI- As discussed AI is the new frontier in terms of transformational technology in healthcare, impacting every aspect of healthcare delivery.
4. Medical devices- As an example, the use of handheld portable X-ray units can potentially transform areas such as TB detection by increasing reach and access.
5. Robotic Surgery- In areas such as prostate surgery, precision robotic arms enable highly controlled and bloodless surgeries. Recovery time is also typically shortened.

3. How has telehealth addressed the challenges of physician shortages and burnout, and what role does technology play in making this possible?

I will focus on Teleradiology, given my specific focus on this innovation. Teleradiology affords a myriad of benefits in terms of addressing physician shortages.

1. It allows for distributing workload equitably within a group of radiologists, which is a great productivity boost.
2. A hospital or diagnostic centre does not need to hire a radiologist at each site – one radiologist can cover multiple centers.
3. Night to day conversion- By placing the radiologist diametrically across the globe from the hospital the night shift is converted to a day shift.
4. Workflow efficiency and productivity- Teleradiology lends itself to tech innovation and process improvement, i.e., a constant effort to boost productivity.
5. Reduced need for commuting. In crowded metros, and today’s desire for Work from Anywhere, this feature is of great value.
6. Work-life balance, family time- The ability of young mothers to work through a home-based teleradiology system helps them achieve both their career as well as parental objectives.

4. Could you provide insights into the journey and growth of Teleradiology Solutions in the field of teleradiology services?

TRS was started in 2002 in the guestroom of our home in Whitefield, Bengaluru. Our first project was with Yale University, our alma mater. There was a growing need for emergency teleradiology services and work came pouring in. Joint Commission accreditation followed in 2005.  A contract was signed with the Ministry of Health, Singapore to provide services to the island country – the first-time healthcare was outsourced from Singapore. We moved to our own campus in 2006, with Nandan Nilekani cutting the ribbon at our inauguration and inspiring us to one day be reporting for every country in the world. We won America’s Best in KLAS award. And then expanded globally, today we service 20 countries. Along the way we started TeleradTech, to promote indigenous AI-enabled Teleradiology software development.  To give back within India, we set up a not-for-profit Telerad Foundation, which provides free teleradiology reporting to charitable hospitals. The privilege of serving 20 countries allows for an extension of the impact of our services. Our new set-up in the Andhra med tech zone in Vizag is our gateway to work with our Indian government, something we are keen to do.

5. What are some key aspects of Teleradiology Solutions’ business operations on a global scale, and how have they adapted to different healthcare systems and regulations worldwide?

Our forte is providing quality Emergency Services to US hospitals through a global pool of Teleradiologists. In addition, we also provide services to Singapore – These are General Outpatient/Polyclinics managed by the National Healthcare group where we have been able to help reduce the reporting time from 3 days to an hour.

India/Africa –24/7 services based on the need.    In some cases, this has been through Government partnerships as in the case of our Tripura project.

Middle East – We have been providing services for several years in Saudi Arabia to the Johns Hopkins- ARAMCO group of hospitals, and more recently to the HAMAD Group in Qatar via a Ministry of Health tender that we won in Qatar.

In every case, we ensure to meet the local regulatory compliances through reporting by appropriately certified radiologists (American Board certified, UK FRCR or Indian trained) depending on the specific requirement.

6. In the context of telemedicine and teleradiology, what emerging technologies and trends do you see shaping the future of healthcare, both in India and globally?

AI integration – Exciting new technology which can transform quality and efficiency reporting and analysis.

VR/Structured reporting– This allows reporting of scans to be done much more efficiently.

Subspecialty Teleradiology– There will be an even greater need for subspecialist teleradiology reporting going forward, given the shortage of subspecialists.

Remote Area – access to high-quality healthcare for rural areas using telemedicine and teleradiology is a necessity and a growing trend, in some cases through public-private partnerships.

Screening – TB, Cancer – The combination of a large-scale screening program for diseases like TB or breast cancer combined with Teleradiology will greatly increase the impact of these programs and help control these diseases.