‘Apollo TeleHealth will upgrade 100 primary healthcare delivery centres of the government in collaboration with a local partner in Malaysia’

Vikram Thaploo, CEO, TeleHealth- Apollo Hospitals, speaks to Prabhat Prakash on the impact that telemedicine is making in the health sector and how it can support the overburdened healthcare system

How has telemedicine evolved in the last two decades?

Over the last two decades, telemedicine has evolved significantly both as a technology and as an idea. It has grown from an under-utilised used technology to a tool that has become quite widespread. The shift has largely been brought about by the advancement of ICT infrastructure, wide penetration of the internet as well as smartphones everywhere.

It was two decades back when the concept of telemedicine was operationalised in India. Apollo TeleHealth is the healthcare organisation that has taken the lead in pioneering this. On March 24, 2000, the then US President Bill Clinton, on his maiden visit to India, had commissioned the world’s first Very Small Aperture Terminal (VSAT)-enabled village hospital at Aragonda in Chittoor District of Andhra Pradesh. This marked the formal introduction of telehealth services in India. The concept was hailed as promising for addressing the healthcare gaps in a country like India. However, it was a slow starter, and its widespread use did not pick up until almost a decade. The past 10 years have been game-changing, with more and more startups entering the telehealth fray and establishing viable teleclinic networks to provide consultations to under-served populations. At Apollo TeleHealth, our presence has grown significantly over the past decade. Today, we have active public-private partnerships (PPPs) with several state governments whereby we run telemedicine-enabled primary healthcare centres, pharmacies as well as tele-emergency centres.

Today, telemedicine is recognised as having major potential not just to serve rural and remote populations, but also as a tool to provide better care to patients with chronic diseases and reduce outpatient consultations. A report by one of the big fours said that if telehealth replaced 30 to 40 per cent of in-person outpatient consultations, India could save up to $10 billion and improve care for the poor and those living in remote areas.

How are emerging technologies (blockchain, artificial intelligence and machine learning) driving the evolution and revolution in telemedicine?

Emerging technologies such as artificial intelligence (AI), machine learning (ML) and blockchain are pushing a continuous evolution in the telehealth space by making telemedicine facilities more effective and versatile while also offering greater security of data and information. At Apollo TeleHealth, we are already using such emerging technologies to bring about greater automation and efficiency. For instance, we are using AI-based tools to identify and fill training gaps and consistently improve the performance of our centres. Similarly, use of Internet of Medical Things (IoMT) in projects helps automate several routine tasks like switching on of air conditioners (ACs), lights, etc, thereby helping save energy. Automating a series of manual tasks allows the human resource to focus on more important things.  Predictive healthcare and disease risk assessment is another area which benefits immensely from AI. At Apollo, we have already developed several health risk assessment tools where AI is used effectively. One example of this is the Apollo Cardiac risk score, which is 90 per cent accurate and better than the commonly used cardiac risk score.

The synergies between AI and telehealth also have the potential to institute quick monitoring of remotely collected data. As more and more consultations and disease monitoring start happening remotely, it is bound to create mounds of data. To sift through this data quickly and effortlessly, we need AI-based applications, and this is already happening in the industry. For example, an algorithm based on machine learning has shown promise in diagnosing diabetic retinopathy in the early stages, which has been found beneficial for use in-home care, remote medical care and self-examination. Similarly, deep learning technology is also helping improve radiology diagnostics. While blockchain is still not being widely used in many sectors, we have made our platform based on blockchain primarily to handle the security of the sensitive patient data.

Elaborate on telemedicine’s impact on rural healthcare in the last two decades with some examples.

In many rural areas where the doctor-patient ratio is abysmal, and people have to travel long distances for physician consultation, telemedicine has been a boon. The real difference on the ground started showing in the last 10 years as more and more private players have entered the sector and created viable models of telehealth at different levels. Some of these models are based on PPPs, while others are entirely private-run teleclinic networks. While it is too early to gauge the overall impact of the sector on the health scenario in the entire country, it is evident that in areas where such models are working, there has been significant improvement in healthcare access.

Apollo TeleHealth has created several telehealth-enabled primary healthcare centres in the country that has helped overcome the problem of shortage of doctors and specialists. At one of our centres in Andhra Pradesh, a young man walked in with a lump and pain in the neck. The medical officer at the there conducted multiple investigations, and in quick telehealth-enabled consultations with specialists, the man was diagnosed with thyroid cancer at an early stage. He was quickly referred to a cancer hospital and responded well to treatment. In many such cases, what happens is that lack of access to a specialist delays diagnosis and the disease becomes untreatable.

Recently, Apollo TeleHealth signed a Memorandum of Understanding (MoU) with TeleHealthcare Malaysia, what would be its impact? How will it help improve your organisation’s competencies?

Under this MoU, Apollo TeleHealth will upgrade 100 primary healthcare delivery centres of the government in collaboration with a local partner in Malaysia. The scope broadly involves providing technical know-how and remote specialist consultations. As many as three million people living in rural Malaysia will be benefitted from this programme. While we are available in as many as 48 countries, this is the first project on such a major scale that we are implementing in another country. Different countries have different healthcare challenges, and greater exposure internationally will boost our capability and know-how.

What are your plans and growth strategies for the next three years?

We are aiming for an expansion of our services over the next three years to scale up our reach to touch 25 million lives globally by 2022. We are targetting to add 5,000 points of presence globally over the next two years. The Malaysia project is one of the ways through which we will accomplish our objective. We are also working on expanding our presence in India significantly. The organisation aims to add new products and services to its kitty over the next few years with a focus to offer comprehensive healthcare solutions through telehealth in states where healthcare suffers from a major dearth of resources. We are also aiming to hire up to 15,000 new employees by 2022.