Getting Ready for the Digital Era in Healthcare

By streamlining processes and addressing traditional challenges, technology is bringing a sea of change across sectors. And healthcare is no different as it witnesses a push to make the move from paper-based to electronic health record systems. All the companies are getting digitally transformed into an automated network in the healthcare region. By going digital, healthcare is able to move beyond the brick and mortar constraints of traditional medicine by using a new technological infrastructure to ensure more efficient service delivery.

“Digital healthcare space can offer a change in near future for the population, which is a growing need for a progressive nation like ours,” says Amit Munjal, Founder & CEO, Doctor Insta.

Technology is making inroads into every aspect of healthcare and addressing major challenges. From using tablets and iPads to accessing patients’ records to using telemedicine to expand reach to rural communities, technology has extensively and intensely impacted healthcare today and is already shaping how it will look in the future. In fact, there has been a tremendous increase in demand of telemedicine alone, both nationally and globally. This sector has been growing at a tremendous pace, and will touch $280 billion by the end of 2020, according to Statista.com.

Digital improvements

Human health has improved exponentially in the last decade primarily due to unbelievable advances in digital technology. “Today, we have more health information – and misinformation – at our fingertips than any generation in history of humankind,” says Prof. K Ganapathy, Director, Apollo Telemedicine Networking Foundation. Digital technologies are being used to improve the training and performance of health workers, and to address a diversity of persistent weaknesses in health systems. Harnessing the power of digital technologies is essential for achieving the Sustainable Development Goals, including universal health coverage and the other “triple billion” targets in WHO’s 13^th General Programme of Work. Such technologies are no longer a luxury; they are a necessity. At the 71^st World Health Assembly, WHO’s Member States requested a global strategy on digital health. This first WHO guideline establishes recommendations on digital interventions for health system, strengthening and synthesising the evidence, for the most important and effective digital technologies. It is a matter of justifiable pride that individuals from India have been selected to be on the WHO Roster of Experts on Digital Health.

Amit Munjal, Founder & CEO, Doctor Insta

While the government is increasingly encouraging digitisation with initiatives such as Digital India and Aadhaar, the private sector has launched numerous mobile applications, telemedicine tools, and innovations centres throughout the country

While globally, the healthcare systems are adopting to the new information handling systems, India is catching up with the new rules and regulations for technology development in healthcare logistics. “Use of drones is a very good example here and it requires ample amount of digitisation as the delivery systems go autonomous,” says Rishabh Gupta, Co-Founder, Redwing Labs, a drone service company operating in multiple states.

Digitisation enables centralised database containing all aspects of patients’ health, which in turn reduces the risk of medical errors. The digital campaign by the Government of India has seen huge acceptance, a major initiative that demonstrates the power of eHealth, which is a part of Digital India program of the government. With concepts like ePharmacy, eDiagnostics, eInsurance, eReferrals, this program would provide a robust ecosystem support to the patients and service providers alike with access to information— anytime, anywhere. The database of health records is further expected to be linked to the Aadhar number of citizens.

With this initiative, getting an OPD appointment, lab reports and blood availability in any government hospital becomes easy. Patients can skip the hassles of registration and other formalities by merely identifying themselves through the Aadhar number. Further, they can select hospital and department, select date of appointment and get the same through SMS.

Prof. K Ganapathy, Director, Apollo Telemedicine Networking Foundation

Professional training in health informatics is necessary to break the fear of technology and the resistance to change

“The biggest impact from healthcare digitisation is going to really come from the growing role of Artificial Intelligence (AI) in healthcare, rapid acceleration and adoption of cloud services, and data analytics as it redefines the dynamics of digital healthcare industry,” says Dr. Subhasish Sircar, Founder & CEO, Health Vectors.

Factors driving growth

The current technology penetration, growing and young population, progressive economy, and blossoming healthcare industry are all responsible for the increased demand in digital healthcare.  

“While digitisation brings in new business avenues for stakeholders, for the general public it brings an ease in communication with doctors, provides online prescriptions as many of them don’t get time to attend doctor meetings,” says Sankalp Gupta, Consultant, Innovation M, a leading technology company.

Ultimately, it is beneficial to the patients at large. The factors that are driving growth in this area are the proliferation of technologies, mandate by organisations and the government at various levels and also by the realisation that there is so much to be gained via digitisation. The participation of doctors and patients will be the key factors that drive this. The solutions that are created should be immensely engaging and very easy to use.  “The price of technology coming down with time also provides the necessary impetus for growth,” points Dr. Sircar.

Dr. Subhasish Sircar, Founder & CEO, Health Vectors

The biggest impact from healthcare digitisation is going to really come from the growing role of Artificial Intelligence (AI) in healthcare, rapid acceleration and adoption of cloud services, and data analytics as it redefines the dynamics of digital healthcare industry

Some of the other factors driving growth include accountability, responsibility, demand, quality, affordability and product availability 24/7. Wearables or portable devices allow better monitoring of patients resulting in less acute episodes and better disease management.

Vivek Srivastava, Co-founder & CEO, Healthcare at Home says, “Data can predict/suggest diagnosis, reduce errors using AI or otherwise, hence leading to better outcomes.”

The global concept of providing Universal Health Coverage is a tremendous impetus to drive growth in deployment of digital technologies. Today, we can test for diabetes, HIV and malaria on the spot, instead of sending samples off to a laboratory. 3-D printing is revolutionising the manufacture of medical devices, orthotics and prosthetics. Artificial intelligence is being used by Ayushman Bharat to make available solutions to a humungous problems covering 500 million. Machine learning is helping us to predict outbreaks and optimise health services. Contact, continuous, financial, universal and effective coverage for millions requires digital technology.

Major gains

Healthcare digitisation has a major advantage of handling and transmitting information with high accuracy. However, we need to make sure that the systems are safe from any kind of unauthorised access. With mobile phones breaking the one billion mark in India (40% or more entry level smart phones), prioritised digital health interventions can be made accessible via mobile devices. These include birth, death notification via mobile devices, stock notification and commodity management, telemedicine, digital tracking of patients’ health status and services, health worker decision support and provision of training and educational content to health workers via mobile devices.

While under telemedicine, we can attain cutting down of consultation time, deployment of digitalisation to maintain patient records, use of smart devices and health monitors for quick and effective diagnosis, use of genomics for personalised treatment, and use of mobile apps for health education.

Vivek Srivastava, Co-founder & CEO, HealthCare At Home

Privacy and consumers being duped are some of the things to be taken care of on the road to digitisation in healthcare

mHealth is particularly relevant in a low resource setting area. Poor management, insufficient training, infrastructural limitations, and poor access to equipment and supplies will be major challenges. Though costs are rapidly plummeting introduction of Digital Health in suburban and rural India where it is required the most pre supposes availability of funding. “Revenue generation alone will keep this self-sustaining. Developing a business model is probably the greatest challenge,” Prof. Ganapathy says.

Although the healthcare sector is seeing a giant leap in providing services to the consumers, it has still not been able to expand its footprint in rural areas of the country. Around 75% of the rural population is struggling with insufficient infrastructure and technological awareness, while here lays a huge opportunity for healthcare technology players to contribute. Privacy and consumers being duped are some of the things to be taken care of on the road to digitisation in healthcare as pointed out by Mr. Srivastava. If data protection and data privacy issues are not properly handled, it could lead to misuse of the information and could be used against the subject. Especially, data privacy issues, if not handled carefully, could lead to widespread distrust and misuse. For example, people could be denied health insurance based on past health conditions that are fully cured currently and have no known future health constraints, whatsoever. 

Contemporary business avenues

The complexity of the problem itself provides new business opportunities for technology providers in healthcare. Developing culture sensitive language specific health content in a digital format, providing information that is aligned with recommended health practices or validated health content would be a major business opportunity. There cannot be a bigger business opportunity than identifying and making available hundreds of digital applications, using ICT systems and communication channels that facilitate delivery of myriads of digital interventions and health content for 13 billion people. 

Rishabh Gupta, Co-Founder, Redwing Labs

Use of drones is a very good example here and it requires ample amount of digitisation as the delivery systems go autonomous

Leadership and governance, strategy and investment are the buzz words. Developing future ready interoperable standards, services and applications is a huge opportunity. India can be used as a test field and a ready to go to market, customised products can be introduced almost anywhere globally. “From online appointment booking to tele-consultation, patient management systems, online pharmacies, in-home healthcare, genome-focused R&D, consultation in alternate medicine, and cloud-based health information systems, the new age telemedicine players cater to a wide range of healthcare needs,” Mr. Munjal says. The Internet and smart phone penetration are on all time surge with the introduction of 4G and 5G, but the digital health market is growing at snail’s pace while seeing an upswing in recent times. 

When business is transformed from one model to another model, it will always see a change, which can be a disaster or a benefit for technology vendors who are catering to these companies to get a business on a large amount. “There is a great benefit of digitisation in the healthcare systems. The need assessment, medical resources acquisition, and medical products traceability etc., all becomes easier through digitising the processes,” Mr. Gupta says. All the businesses related to these services can take advantage of the secure way of information sharing through digital platforms. 

Digitisation also leads to generation of huge amounts of data daily. Wading through this data and extracting health value and also business value for various stakeholders is a big job. The various technology providers in healthcare understand this need and are focused in delivering this value, sometimes in real time. The intersection of medical knowledge, information technology and data science is where the technology providers would bring the most value. For example, a company like Health Vectors can actually tell a hospital, very objectively, how many of the subjects who walked into their hospital would need further evaluations and further procedures etc. even before the person leaves the hospital. Technology providers can thus not only provide opportunities for further engagement for patients, but also provide opportunities for the healthcare provider to increase their top and bottom line. The obvious fallout of all this is that digitisation would lead to significant reduction in the cost of care.

Government support

India’s National Digital Health Blueprint (NDHB), released by the Government of India, outlines its vision for moving forward with a major health digitisation program that will affect millions of citizens. Data scientists, researchers, academics, and activists around the country have also responded to this adoption and change. Although slow, the changes are easily discernable in all public and private healthcare institutions in India today. “The Digital Information Security in Healthcare Act (DISHA) is a firm first step taken by the Indian government in the long journey to securing the healthcare data of patients in India”, says Dr. Sircar.

As the previous models in the healthcare logistic systems fails to provide solutions to the current problems, government is ready to adopt to the digital technologies, which have the viable solutions. eHealth landscape is rapidly changing universally. The digital divide is rapidly reducing. Developing countries no longer have to follow the advanced countries, they do not even have to piggy back. They can leap frog.

While digitisation brings in new business avenues for stakeholders, for the general public it brings an ease in communication with doctors, provides online prescriptions as many of them don’t get time to attend doctor meetings

– Sankalp Gupta, Consultant, Innovation M

India in the next few years probably will be pole vaulting. NITI Aayog is already working on identifying eHealth trends, opportunities and emerging challenges. “Professional training in health informatics is necessary to break the fear of technology and the resistance to change,” Prof. Ganapathy says. The adoption of a e Health policy to define the vision and action required, the development of a funding framework and mechanisms to develop ICT infrastructure for provision of eHealth services, are mandatory at a national level. Securing public and professional confidence in information governance arrangements, and privacy and confidentiality measures in holding and processing sensitive health information electronically, needs to be addressed.

“While the government is increasingly encouraging digitisation with initiatives such as Digital India and Aadhaar, the private sector has launched numerous mobile applications, telemedicine tools, and innovations centres throughout the country,” Mr. Munjal says. The three segments of digital technologies that are helping transform the face of healthcare in India are M-health, remote diagnosis & telemedicine.

Road ahead

Digitalisation of healthcare allows for care beyond the bounds of the hospital and into the limits of home. With the increasing number of patients demanding health care services, often the infrastructure falls short. And hence, healthcare providers are now increasingly shifting towards remote monitoring services like telemonitoring and IoT connected wearables. According to a study conducted by Assocham, India’s telemedicine market, which has been growing at a compounded annual growth rate (CAGR) of over 20%, is slated to cross $32 million mark by 2020. As per a report, only 2% of doctors are available in the countryside for 68% of the population. India requires 600,000 to 700,000 additional beds for the next 5 to 6 years, telling of an investment prospect of 25-30 Billion USD. Digital health care space can offer a change in near future for the population, which is a growing need for a progressive nation like ours. “The current market place is an ever evolving place and so current businesses need to adopt to the changes in the systems quickly and reliably,” says Mr. Gupta.

Digital Health is an all-encompassing term which includes Information and communication technology, telehealth, eHealth, mHealth, artificial intelligence etc. There is no limit for deployment of digital health. We are in a stage of transition. All transition periods offer great opportunities. We should however never ever forget that “a fool with a tool is still a fool”. We should not be swayed by the hype and the pressure exerted by MNC’s. Today there is a real danger of solutions being developed first and then problems be searched for, so that they can be used. Technology is a means to an end and not an end by itself.

Currently, the health data collected is not of good quality. Systems operate in silos and are not integrated. The current need is to understand the challenges of collecting quality data and address those challenges by creating systems and policies, and by setting up IT infrastructure to enable the collection of quality data.

At the 71^st World Health Assembly, WHO’s Member States requested a global strategy on digital health. This first WHO guideline establishes recommendations on digital interventions for health system, strengthening and synthesising the evidence, for the most important and effective digital technologies. It is a matter of justifiable pride that individuals from India have been selected to be on the WHO Roster of Experts on Digital Health. This will be a booster to digital health in India.

Final word

The digital transformation of the Indian healthcare industry is not just starting – it is already underway. However, it will need a considerable amount of strategising and planning to put a method to this madness. All the stakeholders need to embrace open systems that allow for sophisticated analysis of multiple streams of data and the development of customer-centric services. They must be able to view processes as end-to-end flows rather than discrete handoffs, embrace more risk, move at higher speeds, and engage in innovative partnerships. Also, the consumer demand for digital-health services and applications is stronger than ever. Research suggests that almost 70% of patients between the age group of 18-65 would prefer digital health monitoring over conventional ways of measuring health parameters.