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How technology can play a pivotal role in addressing India’s healthcare challenges?

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If India is to realise its goal of Universal Health Coverage (UHC), it is imperative that technology and healthcare talk to each other seamlessly. An insight by Manoj Kapoor, VP – Product Engineering and Data Services, Optum, elaborates

With a population of 1.3 billion scattered across urban and rural India, the country poses a unique healthcare challenge. According to a report by the United Nations, 75 per cent of all healthcare infrastructure including medical specialists and doctors are concentrated in urban areas where only 27 per cent of the Indian population live. Added to this is the fact that private hospitals and quality healthcare are limited to urban areas. While on the other hand, around 716 million people that make up the remaining 72 per cent of the population stay in rural areas with a chronic lack of primary health care facilities.

One of the most pressing challenges for India is to offer world-class care at affordable rates to all its citizens. In 2011, (the latest data available) the country’s hospital bed density stood at 0.7 per 1,000 people, which is significantly lower than the World Health Organization (WHO) guidelines of 3.5 beds per 1,000. In such a scenario, technology is the only tool which has the potential to bridge this gap.

Is technology the answer?

If India is to realise its goal of Universal Health Coverage (UHC), it is imperative that technology and healthcare talk to each other seamlessly. The good news is that change is here. Technology is all pervasive and is helping address the unique challenges of India in terms of accessibility, affordability and quality. Though at a nascent stage, the rate of adoption is rather fast and given the size of the healthcare sector, the resultant scale and impact can be immense.

According to the Indian Brand Equity Foundation (IBEF), the Indian healthcare industry will grow from $160 billion in 2017 to $280 billion by 2020. And, technology will clearly be the backbone of this growth story. Adoption of Electronic Health Records (EHRs) is key to improve care, reduce errors and bring about cost efficiencies by streamlining the clinical care processes to improve outcomes. New age cloud-based solutions and mobile apps that seamlessly integrate provider and patient interactions will further boost the adoption of EHRs. Needless to say, the data gathered through EHRs, over a period of time, can help in further refining the analytics models to improve clinical outcomes.

With increasing awareness of health and wellness issues, patients will soon start playing a major role in the overall process of care. Already, consumerism of healthcare is driving many of the new age apps dealing in prevention and continuous monitoring of health. Artificial Intelligence enabled recommendation engines are helping consumers make choices that they never knew they could make. A high degree of personalisation and care has been made possible through the use of technology. This is the need of the hour since chronic diseases are on the rise as is the demand for personalixed care depending on the illness and psychological make-up of the patient.

Changing role of medical insurance

The Insurance Regulatory and Development Authority (IRDA), is now allowing coverage of OPD in some cases, while the National Health Protection Scheme (NHPS), is poised to fundamentally change healthcare for the masses. Cashless will be the new norm in the next five years for many procedures. Digital payments and automated microfinance will fundamentally change the way we pay for care.

As medical Insurance penetration increases in India there will be a need to create a national-level medical transaction clearing house, based on Blockchain and AI, with cascading multi-level payments and settlements, could be a game changer. The clearing house will offer real-time healthcare transaction processing services over the Internet with a highly secured connection and state-of-the-art internet architecture that speeds up deployment and minimises costs associated with claims submission, claims tracking, clinical data exchange, and follow-up.

As per the Ministry of Health and Familiy Welfare of India, development of 50 technologies had been targeted in the FY16 for the treatment of diseases like cancer and tuberculosis. The government is also emphasising on eHealth initiatives such as Mother and Child Tracking System (MCTS), and Mother and Child Tracking Facilitation Centre (MCTFC). Indian companies are increasingly engaging in mergers and acquisitions with domestic and foreign companies to drive growth and gain access to new markets.

Technology trends

Technologies like Artificial Intelligence (AI), automation, and the Internet of Things (IoT), have percolated to almost every aspect of healthcare today. For sake of clarity, let’s look at some of the potential applications of these two technologies: (i) AI (including automation, machine learning, deep learning), and (ii) IoT.

Applications of AI

The unique power of AI is that it not only complements human skills but significantly expands the scope of human activity. Some of the AI-related technologies include among others, natural language processing, intelligent agents, computer vision, machine learning, expert systems, chatbots and voice recognition.

Data management of health records is one of the most widely used applications of AI and automation. Robots collect, store, re-format and trace data to provide faster and seamless access to it anytime, anywhere. AI is also deployed to perform certain repetitive tasks like analysing laboratory tests, X-Rays, CT scans and data entry. AI-based apps can be used to provide medical consultation based on personal medical history and intelligence gathered through analytics.

The process of drug creation can also be supported by AI-powered programmes which can significantly lower the costs of developing pharmaceuticals through traditional clinical trials. Precision medicine is another application of AI wherein AI-powered body scans can spot cancer and vascular diseases early and predict the health issues people might face because of their genetics.

Applications of IoT

In healthcare, IoT is all about unleashing the power of connected devices and sensors that are widely used in the sector. In 2008, the number of connected devices exceeded the population on this earth. By 2020, 50 billion connected devices are expected to be present on earth. The IoT revolution will be a result of replacing disconnected objects with connected ones and making these objects more intelligent and context-aware using sensors.

IoT can also be used to derive valuable insights from data derived from foetal monitors, electrocardiograms, temperature monitors or blood glucose levels. Smart IoT devices can provide the required health information remotely and lessen the need for direct patient-physician interaction. In a world of IoT, different distributed devices will gather, analyse and communicate real-time medical information to open, private or hybrid clouds, making it possible to collect, store and analyse big data streams in several new forms, and activate context dependent alarms.

In healthcare surveillance as well IoT can play a major role. It can help in early detection of health problems. It can also help in integrating data collected from tests instantly, monitor the condition of the patient, and then relay that information to the doctors and staff in real time thereby improving the efficiency of the overall healthcare system.

The future prescription

In the future, India will witness a complete spectrum of the healthcare ecosystem wherein small clinics will co-exist with home healthcare and large sophisticated hospitals. The trend is pointing towards more and more homecare, ambulatory and emergent care services outside of the hospitals. The focus is also shifting towards a preventive approach from a curative approach.

Personal IoT-based health monitoring devices will change the way we track the health of individuals. Technologies like Blockchain will soon redefine how we populate and maintain EHRs, and how we link them to other services like payments and insurance, among others. AI will increasingly assist physicians, health workers and caregivers in triage, diagnosis and treatment.

Ingestible pill monitors, bio stamps, nutrition sensors, AI doctors, and 3D printing will be common applications in the healthcare sector in due course of time. It is likely that AI doctors will outperform human physicians in diagnostic challenges that require a quick judgment call, such as determining if a lesion is cancerous. 3D printing will impact replacement organs, exoskeletons, casts and beyond. The opportunities are endless.

With technology increasingly becoming an integral part of the healthcare sector, the obvious question that arises is whether machines will eventually take over the doctor’s role? We often hear about the fear of the so-called “technological unemployment.” While one school of thought believes automation could spell the end of doctors, the other side argues that the fear psychosis is mere hysteria generated due to several misconceptions, largely based on an overestimation of AI’s uses and abilities.

The answer perhaps lies somewhere in between. Machines might never replace physicians entirely but will surely take over much of his/ her work including some of the decision-making power. It will not be a matter of AI versus physicians, but one of AI plus physicians. The power lies in working in tandem to derive more value. This is the reason some companies refer to AI as “Augmented Intelligence” which essentially suggests that the main purpose of AI is to enhance products and services, rather than replace the humans that offer them. In an ideal world, machines and humans will co-exist to create a better and healthy tomorrow.

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