Sanjay Joshi, CTO, Life Sciences and Healthcare, Dell EMC, elucidates how linking Aadhaar data can give better healthcare outcome to India
What is the role of data and how will it elevate the Indian healthcare system?
There is a lot of development going on in the Indian healthcare space. Particularly, Aadhaar, the nation-wide biometric card, which even includes retina scans, is an interesting and robust set of data. Right now, if the government actually wants to understand the national scale of diverse health issues be it maternal or child health, air and water quality issues, it can analyse the Aadhaar data. To begin with, every state government should monitor these data closely. 70 percent of people reside in rural India and with one doctor per 2000 citizens, the Indian healthcare system can he helped by digital approach, data intelligence and a patient-centric culture.
Engineering-based Dell EMC, Centers of Excellence (CoE) in Bengaluru and Pune, are providing healthcare data and cloud solutions.
How to combat NCDs via technology and what does Dell EMC offer?
Rising incidents of lifestyle-related, non-communicable diseases like cardiovascular disease (CVD), chronic obstructive pulmonary disease (COPD) is a great challenge. According to the Institute for Health Metrics and Evaluation (IHME), an independent global health research center at the University of Washington, CVD is the top killer in India. However, the second largest killer is COPD and the largest source of this is air pollution and smoking. We need to address these issues with technology and growing pool of digitally-empowered patients. The government is working on smart cities, but I would say that without healthy cities we cannot have smart cities.
Dell EMC, an infrastructure company is service-oriented and we are also looking to make data centres more efficient and let the people who move the business forward take care of the business part rather than taking care of hardware management and IT infrastructure. For example, if my data is in 10 different places,it can be seen in a given time with solutions like Elastic Cloud Storage (ECS) and Isilon (it is an unstructured file-based data system). We need to focus on healthcare data because 20 years down the line, the primary healthcare will disappear, as everything will be replaced by data and information, and it will be useful for rural economy. As Dr Leroy Hood, famous futurist, Systems Biologist and Seattle native, wrote in Nature journal that healthcare will be seen as 4Ps: Predictive, Preventive, Precision and Participatory. Hence, India needs to put in more effort and money to scale up in healthcare.
Can you share the details on pan-cancer genome projects?
Initially, six countries were working on cancer projects, which, has now scaled up to 16 countries. India is looking into specific cancers like pancreatic cancer, head and neck cancer, breast and ovarian cancer. I have talked about it to many scientists, who believe that there is a viral vector to cancers and many are working on it.
Do you think tele-radiology could benefit the current healthcare industry?
As a tele-radiology believer, I would say telemedicine is definitely going to be the largest transformative change for healthcare, especially in places that lack access. Technology has always been there but we need the government’s understanding to move IT forward by having more and more innovations. For this, both the central and state governments should interact with each other. Our goal ultimately is to get to a point called Vendor Neutral Archives (VNA), like addressing communicable disease or simple things like typhoid, diarrhoea, dermatological care and skin problems. VNA is a central imaging archive, we need a larger adoption of it as it can scale up the value-chain for telemedicine. It consolidates multiple imaging departments into a master directory, associated storage and lifecycle management of data. Besides, modalities like radiology and pathology will be the key delivery areas in tele-medicine; for example, bringing in portable ultrasound for mother and child health. Our focus is to say how physicians can understand the modern medicines as it is happening. The stethoscope which was invented in 1800s is now wireless, a couple of Indian star-ups are working on it.
Tele-medicine can help elevate rural health ecosystem if we collaborate with small start-ups and governmental agencies. And, since tele-medicine is critical, we need to push the technology forward.
The Global Data Protection Index commissioned by Dell EMC informs only 24 per cent of public healthcare providers in Asia are very confident of fully recovering systems and data to meet business service level agreements in the event of a data loss incident. Your comments?
The core tenets of building a secured information and recovery platform is the access control. We need to look into who is coming into your data or information system and how can you authorise the right people to look at the data. An identity manager is important and critical for healthcare for which Aadhaar can be used as it comprises unique IDs and can be attached to a patient ID as well. Nevertheless, we need to have robust security system for the same as future warfare are going to be in biology. Other than Isilon, Dell has acquired RSA, which is one of the largest security companies. Data protection and people who handle data are need to be regularly trained, globally, Germany and France are the two countries, which give lot of importance to data protection.
How important is it for the public health system to invest into IT?
From a public healthcare perspective, the biggest issue for Indian healthcare system is 1:2000 doctor and population ratio. As the doctor has no information about the patient history, countries like Taiwan, Japan, South Korea have public health cards.
Some of the technologies look upon a card which is used for both transport, health and fixing appointment with the physicians. There comes the role of Internet of Things (IoT), which will shape the future of many industries, including healthcare. Therefore, healthcare organisations must first get their data strategy right, so that these new technologies can add value to patients by increasing survivability and life expectancy or providing predictive and prescriptive indicator for diseases.
How Dell EMC is unique from other IT companies and what are the digital transformations you are working on?
The US has invested in digitising healthcare records. Similarly, India’s Aadhaar card can be a good role model for digitising public healthcare system. Public and private healthcare should be integrated but looking forward, it is a huge challenge, as integration of structured information in the medical records is important. We need to know things from the infrastructure perspective; for example, statistics on smoking pattern among patients, Computerized Patient Order Entry (CPOE), drug reconciliation — which monitors the drug a person takes.
Moreover, EMC is present in more than 50 per cent of the US hospitals and partnered with Independent Software Vendors (ISVs) like Siemens, Philips and GE. From national scale perspective, I would highly recommend that India should consider building national-scale imaging archive and the state governments should control their own archives. Dell EMC would like to join hands with the Indian government in building up a national-scale pandemic disease infrastructure. We can create disease registries for communicable and non communicable diseases and showcase how big data can help.