[Kurukshetra November Summary] Technology and Innovation in Healthcare – Explained, pointwise

Introduction

The COVID-19 pandemic presented an unprecedented challenge to the healthcare system all over the world. It made evident the inadequacy of the the healthcare infrastructure. Due to the overburdened system, social distancing norms and the fear of infection, may life-saving surgeries and transplants were postponed. This has driven healthcare providers to embrace technology in healthcare services delivery along with innovation systems to continue provision of services to the patients in such crises.

Technological Progress and Digitalisation of Healthcare

Healthcare is slowly moving from healthcare facilities, focusing on patient facilities (homes) and technology is driving this transition. Fear of COVID-19 infection boosted virtual counselling through telemedicine. Tele consultation has received increased acceptance among doctors, patients, insurers, and others in the wellness ecosystem.

In 2020, the Ministry of Health and Family Welfare (MoHFW), NITI Aayog, and the Board of Governors of Medical Council of India (MCI) issued the Telemedicine Practice Guidelines enabling medical practitioners to provide healthcare using telemedicine. It has helped in democratisation of the provision of health services.

It has also helped bridge the urban-rural healthcare gap by providing super speciality support to tier 2 and tier 3 regions, making life easier for people in rural and remote areas. The Indian healthcare system has witnessed a paradigm shift in ensuring quality healthcare delivery to citizens in the last decade. Increasingly, the technology has been leveraged for better reach and patient care.

The application of digital technologies including Artificial Intelligence (Al), Machine Learning (ML), data analytics, Internet of Things (loT), cloud computing, and robotics is increasing in each facet of the healthcare system.

Geographical Restrictions

More than 65% of India’s population resides in rural areas. Access to timely and quality healthcare is lacking in rural India. Healthcare services in the country lean heavily towards urban areas. Due to limited infrastructure and the poor availability of qualified health professionals in rural areas, residents often travel long distances to receive specialised treatment in cities. This results in waste of time, energy and resources of the poor rural residents.

Emergence of Digital Healthcare in India

Interoperability is the ability of systems to be able to communicate with each other and make use of the information obtained through each other without any restrictions. It is common in sectors like banking and finance. Its usage is independent of an individual’s location. Interoperability of systems is missing in the healthcare sector. The Electronic Health Records (EHR) of people are not easily available or communicated within doctors, hospitals, pharmacies, etc. due to constraints like security, permission, cost, and platform etc. This results in the decline of good quality healthcare available to all.

Phones and other modes of communication are insufficient in providing enough information to doctors to completely analyse their patient’s condition and undertake diagnosis and advise prescription. Also, the amount of healthcare-related data generated is humongous (big data). It is impossible to keep track of every patient’s medical record at all times. A lack of awareness and healthcare for all citizens add on to the existing problem. This creates hurdles in ensuring platform of interoperability in the Indian healthcare system.

The Ministry of Health & Family Welfare (MoHFW) notified the EHR standards for India in September 2013. Revised EHR Standards were notified in December 2016. The review report by the Ministry of Electronics and Information Technology (MeitY) titled ‘Adoption of Electronic Health Records: A Roadmap for India‘, highlighted that Government hospitals and dispensaries have very little ICT infrastructure, with only some major public hospitals having computers and connectivity.

In the light of the COVID pandemic, the National Digital Health Mission (Ayushman Bharat Digital Mission) was launched in 2020, under the implementation of the National Digital Health Blueprint. It seeks to create a single repository of medical records of all citizens. Under this, every Indian will get a unique Health ID under the National Digital Health Mission (NDHM). The Health ID will contain information about every test, disease, medicine, and associated reports of a patient which can be accessed by an authorised person from anywhere across the country.

The Union Government has been working on developing digital modules and registries. The mission has been rolled out in 6 union territories (UTs) across the country. 3 key registries of NDHM namely Health ID, Health Professional Registry (HPR), Health Facility Registry (HFR), and digital infrastructure for data exchange have been developed and implemented in these UTs. INR 45 crore has been released to the National Health Authority (NHA) for implementation of ABDM. Till March 2022, a total of 20,97,55,222 Health IDs (ABHA Number) have been created.

Source: Kurukshetra November 2022, mygov.in

A comprehensive EHR would be beneficial to rural patients as it would include patient’s health problems, their lifestyle and habits (like blood-pressure monitors). Genomic data can also be added to the EHR, including certain drugs that may or may not match the patient’s genome. Genomic data can help in: (a) Allowing a doctor to know if a specific type of drug will work for a patient without trying many different treatments; (b) Save both doctors’ and patients’ time by eliminating the need for multiple follow-up appointments, lowering the cost of treatment, and potentially reducing the risk of allergies and side effects; (c) Shift healthcare from reactive to proactive, allowing doctors to address potential problems long before they become a risk.

Scope of Remote Healthcare in India

One of the main barriers to patient care is medical prescription and delivery, and this can also be done remotely. Medicine ‘ATMs’, already in use in rural areas of South Africa, ensure that patients obtain their medication in a medically safe way, without relying on inaccessible pharmacists or doctors. These ‘ATMs’ can be effectively scaled to become an information kiosk and patient portal that can support diagnosis, testing, and medication prescription. It will help reduce pressure on hospitals and community health.

Challenges faced by rural communities include lack of healthcare expertise (difficult to attract and retain medical staff in rural areas) and poor infrastructure.

Incorporating technology in healthcare systems can address these challenges. Technology can bridge the infrastructure and expertise gap. Virtual reality can be used in rural areas to assist healthcare professionals with appropriate training.

Due to severe shortages of intensive care staff (ICU) in hospitals during the pandemic, many providers have built remote or smart ICUs. This facility has allowed them to serve more patients simultaneously.

The Internet of Medical Things (loMT) is the collection of medical devices and applications that connect to healthcare IT systems through online computer networks. IoMT devices can transmit all essential clinical data to the consulting physician in real-time and help the treating physician make appropriate clinical decisions. Al and predictive analytics support many of these loMT tools that help predict a patient’s likely future condition. These tools are helpful in preventive medicine and wellness.

According to  McKinsey’s latest report: (a) Tele health will be a quarter-trillion-dollar industry post-COVID; (b) The use of tele health has increased 38-fold from the pre-COVID baseline; (c) The industry is projected to reach USD 10.6 billion in India by 2025; (d) Integration of tele health with other virtual health solutions and hybrid models is driving the industry; (e) The report says that these systems can improve the consumer experience, quality, accessibility, affordability, and outcomes. It has resulted in a drastic reduction in treatment costs while making deliveries more accurate.

Remote Healthcare for Rural India

Virtual consultation need to be complemented by physical/OPD counselling. Then patients can develop more confidence in the care provided. This physical model also facilitates post-operative care and second opinions for patients in smaller cities, thus eliminating the need to travel to larger metropolises for treatment, saving them time, money, and lost productivity. Remote care also protects them from any hospital-acquired infections.

Start-up Initiatives

Innovative start-ups, supported by the Government, across the nation are providing healthcare services enabled with the latest and most efficient technologies. The Atal Innovation Mission (AIM) has been set up by the Government to promote a culture of innovation and entrepreneurship. AIM supports the establishment of new incubation centres called Atal Incubation Centres (AIC).

AIC LMCP Foundation, Gujarat has incubated a start-up named Rises Analytics which is working on high-tech healthcare Al solutions. It has the vision to bridge the gap between patients and timely medical intervention. It also aims to extend diagnostic decision support to healthcare professionals in order to serve patients with efficacy, accuracy, and insights, with innovative technology TRAP (Treatment Response Assessment and Predictions). It gives chronic and critical care solutions for cancer and pulmonary conditions including COVID-19.

ZiffyHealth (incubated at AlC Pinnacle Entrepreneurship Forum, Maharashtra) is aspiring to evolve a robust and scalable healthcare platform, whereby all stakeholders (patients, doctors, and pharmacies) can have a seamless and highly secured flow of health data so as healthcare delivery can be accessible and affordable to the bottom of the semi-urban and rural Indian population.

Volar Alta (incubated at AIC-RNTU, Madhya Pradesh) is the one-stop shop for drone-based services. They specialise in surveillance, asset inspections, and transportation of medical essentials in rural and hard-to-reach locations using drones, minimising the time, and ensuring safety.

Conclusion

The scope for the digitisation of rural healthcare in the nation is massive. Once Internet connectivity improves, the rural-urban divide can be bridged more efficaciously. India’s healthcare systems need viable platforms that enable medical staff to transform their services systematically, reliably, and sustainably to improve quality of life. Leveraging technologies such as Al, Machine Learning, and Blockchain to advance interoperability in healthcare is an incredible prospect for the government looking at creating jobs and better employment opportunities.

Syllabus: GS II, Government policies and interventions for development in various sectors and issues arising out of their design and implementation; GS II, Welfare schemes for vulnerable sections of the population by the Centre and States and the performance of these schemes.

Source: Kurukshetra November 2022