Balancing the clinical, financial, and operational value of digital offerings in healthcare is the need of the hour
Who knew that the integration of IT with healthcare will emerge as pivotal pillar in the delivery of healthcare in India. While the pandemic created so many challenges, it has necessitated the healthcare industry to adopt and innovate for disease management and bridge the gap between technology and traditional way of delivering healthcare for enhancing the patient safety and care.
As we reflect on what comes next, it is an opportune moment to pursue real transformation for better connected and integrated data and information systems.
Highlighting the role of IT in healthcare, Rahul Rastogi, CEO and Founder, Agatsa said, “Technology plays an important role in the digitisation of healthcare. Moreover, COVID -19 has accelerated the pace of its adoption and use. Not only healthcare, but also radiology, diagnostics, medical technology, and health insurance have reaped the benefits of this technology. Physicians and patients have also benefited from the ever-changing technology. Digital health solutions have been developed and implemented to enable providers to save costs and time, help patients take control of their health data, and allow stakeholders to change their business models to include more personalised treatments for patients.”
“In addition, technology has proven to be very effective in detecting, managing, and curing various diseases that were once tedious tasks. Before the introduction of technology, there were cases of misdiagnosis due to human error. However, with technology, these can be eliminated through accurate and instant diagnosis. AI is being used in oncology to detect cancer; machine learning applications help accurately detect disease in bleeding tissues. In addition, many complex procedures are supported by AI-driven robots”
Satish Manchala, Founder and Managing Director, MedleyMed believes that, “Chronic care cases have seen the maximum effect and the disease management in chronic care cases has benefitted the most through the new age app, devices and basically the integrated solutions. The access to service providers, facilities, report review and consultation with doctors, home sample collection and medicine delivery all has been integrated and got a push forward due to technology. So, at all levels technology has affected the outcomes. Solutions discovery is one major area which has benefitted the maximum and to best help the patients.”
Krishan Kumar, Marketing Head, SoftClinic GenX explaining the role of IT in disease management said, “IT is helping in coordinating treatments across multiple health care providers and communications for the patient where self-care efforts can be also effective. Purpose of disease management includes reducing healthcare costs and improving patient quality of life by preventing or minimising the effects of the disease, including delaying disease progression. Effective use of IT can improve care coordination in the healthcare ecosystem, it can streamline daily clinical processes. Additionally, all the chronic disease management happens outside of the hospitals and clinics, IT has a tremendous scope to assist care teams and patients with communication, education and monitoring key data points. Monitoring disease progression, offering patients reminders on when to take their medications and facilitating communication between medical providers and patients are a few examples of where IT can assist”
Current status of scalability of IT in healthcare
Healthcare segments like radiology, diagnostics and medtech are now working towards digitising the overall experience of the domain. However, there is a need to scale up the clinical, financial, and operational value of digital offerings and services from all the healthcare stakeholders.
Talking about the market size and scalability, Vinay K Mayer, Director – Market Research & Consulting, Asia Research Partners LLP explains, “The healthcare industry’s IT market is set to grow exponentially over the next few years, due to the increasing digitisation of healthcare. Post-COVID, e-health has become the new norm, and is expected to grow at a substantial rate! The size of the Indian e-health market is expected to reach a whopping US$ 11.2 billion by 2025. The market for healthcare digitalisation is growing rapidly due to the rising demand for preventive care solutions, the emergence of various entrepreneurship ventures, and growing partnerships & funding.”
“With the Indian Government prioritising healthcare, the market for medical technologies and IT in medicine is on the rise. In general, it is expected that the volumes of global markets and the demand for IT solutions in diagnostics, radiology, medtech, or health insurance will grow by more than 10X”, he added
Emphasising on the current scalability of IT in medtech, Vishal Gondal-Founder and CEO, GOQii Smart Healthcare said, “major advances in wireless technology and computing power are driving innovation in medtech, leading to the development of an increasing number of connected medical devices that are able to generate, collect, analyse and transmit data. The data, along with the devices themselves, are creating the Internet of Medical Things (IoMT) – a connected infrastructure of medical devices, software applications and health systems and services.”
Stressing on the insurance sector, he adds, “There has also been a rise in demand for insurance due to the new-age insurance players who are transforming the industry. These companies add simplicity, transparency, and easy-to-use channels to expand insurance accessibility. This has led the overall industry to adapt to the changing times with disruptive technologies to stay competitive. The digitalisation in insurance has spread through all the processes in the system namely policy pricing, claims management and customer service to underwriting and even risk analysis, technology has disrupted many key functions.”rocesses, information and work flows. IoMT devices can help to reduce the need for expensive and invasive procedures.”
According to Aneesh Nair, Co-Founder and CIO, MyHealthcare, Artificial Intelligence (AI) and Machine Learning (ML) are playing an important role in diagnostics and also radiology. He added, “AI, ML is playing a pivotal role in making diagnostics more affordable. In developing countries such as India, the cost of tests such as blood reports, scans, etc. is a major barrier that stops people from seeking medical help. Now, tests are becoming cheaper with technologies such as AI and ML. What would earlier cost thousands of rupees is now available for a few hundreds. This is encouraging people to conduct regular check-ups, monitor their health, take timely corrective measures, better manage chronic ailments and lead healthier lives. Additionally, ML is automating medical imaging, which is removing the element of human error, as well as making the process faster. This is ensuring precision and accuracy in diagnostics, and reducing wastage of time and resources. ML is not only helping conduct tests such as ECG, EEG, CT, etc., but also interpreting these scans and creating reports quickly, in effect assisting doctors in making the right diagnosis and providing care in a timely manner.”
IT implementation in balancing the cost management and patient experience
With the Indian healthcare system emerging from the impact of the pandemic, one aspect that they are focusing on is balancing the cost management with patient experience.
Sharing his views on this, Gaurav Parchani, CTO & Co-Founder of Dozee, “One aspect that most hospitals and healthcare systems are focused on is managing costs. But apart, from simply managing costs, healthcare leaders are looking to find financial predictability. And that’s where technology has the potential to help hospitals make better decisions in areas such as operations, management of the patient flow, staffing, scheduling, and the supply chain. As a result, it can lead to better quality and efficiency of care and patients’ access to it. Technologies also play a very critical role in optimising hospitals’ operational decision-making, which in turn can lead to improvements in the quality and efficiency of care and patients’ access to it.”
“In addition to this, when we have all of a patient’s information is available in a single view, such as digital monitoring of patient information, clinical history, medication history, medical staff treating a patient, and respective cost-sheets for payments and billing, hospital receptionists can automatically generate patient bills for any department based on staff requests. The pre-configured master data, such as rate-cards and predefined rules for night charges, emergency charges, senior citizen charges, and insurance, makes finance management even easier. It also assists hospitals in tracking all transactional activity and ensuring that all payments, refunds, or credit notes are processed on time. To summarise, improving the patient experience has emerged as a top priority in healthcare. Market demands and medical awareness precipitated an irreversible shift. Patients nowadays prefer to be treated as customers. They expect personalised care that is technologically advanced. However, striking the proper balance between human and machine usage is also critical. Patient satisfaction does not require complete automation. One should never ignore patient feedback and always provide accurate, timely, and dependable care”, he added.
Dr Adith Chinnaswamy, COO & Co founder, MedisimVR while talking about the patient satisfaction and cost management says, “IT implementation in the Indian health care system is a monumental task, but one which will reap rich benefits in the years to come. Operational cost cutting will occur when we start streamlining and automating various facets of healthcare, such as digital communication systems for tele consultation which will vastly improve patient experience, Electronic Hospital Record (EHR) maintenance systems which will reduce the manpower required for hospitals, the advent of artificial intelligence in various medical fields will also reduce margin for human error, leading to overall improvements in the quality of healthcare.”
Nitin Gupta, India Head, Suki adds, “Technology solutions have great potential to help providers and health systems capture significant value. Physician burnout has been an issue for years, and has been exacerbated by the COVID-19 pandemic. Physicians who are burnt out are at risk of making medical errors, reducing their hours, or leaving medicine altogether – all which have significant cost and medical access implications. Tech solutions can help provide relief.”
Explaining about optimising staff cost and role of technology, Afsal Salu, Co-Founder, BestDoc said, “Technology can help in various operational aspects such as ease of collecting and dealing with patient feedback (both inpatient and outpatient). It can also help in creating better experiences for admitted patients and their visitors by streamlining their routine non-clinical requests. The use of technology for managing inpatient care also helps in optimising staff costs for various departments such as housekeeping, maintenance and IT. Healthcare providers can track the productivity of their staff and reward top-performing staff. They can also use analytics to take smart staffing decisions and allocate non-clinical resources as per need.”
Deepak Sharma, Co-Founder and CEO, MedLern stresses that Indian hospitals are not yet gearing up to take advantage of this stream of innovation. He said, “It is an exciting time for re-imagining the future of healthcare – innovations are pouring out of labs, health, tech, and deep-tech areas like AI, IoT, nanotechnology Blockchain, etc. Regulators in more developed countries are gearing up to evaluate and approve novel and innovative therapies, including digital apps. Innovation will fail to diffuse fast if hospitals don’t need a strong digital foundation. This means moving the needle on three key axes: learning and digitisation of processes, the readiness of employees, and evangelisation to customers.”
“IT systems that can enforce policies in areas like formulary, procurement, and requisitioning through transparency and control can produce dramatic results. Tools that can monitor asset utilisation in key areas like OT, ER, radiology, etc. can identify low-performing assets to enable rationalisation of investments as well as demand generation strategy to optimise the capacity. Digitisation of key areas like compliance and record keeping still has significant potential to save time and cost and relatively low-key investments can generate significant returns on investment”, he added.
Alok Bansal, MD Visionet System India and Global Head of BFSI Business believes that in the face of rising costs, increasing digitalisation and diverse demographics in need of critical care healthcare system must become smarter, simpler, more accessible and cost-effective without compromising on positive patient experience. He said, “It is important to scale up operational efficiencies, increase data safety, enable interoperability, identify existing technological gaps and get past workflow barriers for an efficient and smooth service and transaction flow. To achieve all this, there should be synergy between health sector reforms and health service delivery processes.”
Vikram Thaploo, CEO, Apollo Telehealth also added, “With increasing labour costs, demographic shifts, and an uncertain regulatory climate, the time has come for the healthcare sector to embrace the world of smart technology to cut healthcare costs – without sacrificing the quality of care. Every healthcare provider uses a slew of systems to store data, treat patients, and manage day-to-day operations. Using smart technology to integrate these systems into a unified system and combine the data into a single repository can help in quicker diagnosis and treatment, giving organisations to embark on a new era of forward-thinking technology. Such interoperability will help enable doctors to understand the exact needs of the patient, share data between systems and the cloud, and drive efficient analysis that can lead to better patient care.”
Policy interventions and Public-Private Partnerships (PPPs)
While private sector is actively driving the tech disruption happening across the ecosystem, government is also recognising this revolution by launching digital initiatives like National Digital Health Mission (NDHM) which is important to create a conducive market for innovation in healthcare and also creating opportunities for investment. However, in order to fast track and strengthen the overall digital health infrastructure and ecosystem, focusing on more PPPs in this direction is very important. No single company or product has all the resources to create all aspects of a tech-based system. Each will have its own strengths and core competencies.
Elaborating more on government initiatives in disease management via IT, Pradipta Kundu, Director Health Mission, eGovernments Foundation said, “Public health relates to taking care of the population and the first step is having information on what diseases affect populations. Population scale disease prevention and management measures are highly inefficient without IT infrastructure. Good quality, timely data is critical for policy makers, decision makers, managers and most importantly our frontline health workforce, who manage day to day diseases. Sharing information in paper-based systems is slow. Therefore, IT helps in sharing crucial information in a timely fashion. Disease surveillance becomes faster, and hence enables taking quicker action as well. We have learnt through painful experience of COVID-19 pandemic how important timely data is to not only reduce mortality and morbidity of citizens but also to improve the overall health of citizens.”
“We believe that India is undergoing a rapid digital transformation of governance across domains including healthcare. We have managed to get quite a few things right as a country – for example – we are global pioneers on establishing digital public infrastructures for different sectors. For example: ABDM, Aadhaar, UPYOG, DIKSHA are all improving the capacity of governments to deliver services in their sectors. In addition, we have more steadily progressed towards harnessing the latent energy and talent in the Indian tech ecosystem to serve the larger public good through more collaborations with industry, academia and civil society on the digital front. The effects of these transformations will continue to unfold over the next decade.”
On the PPP front, she says, “It’s important to build PPPs with a multi-sectoral lens when helping governments establish digital public infrastructure. The market players can bring in the capacity to implement, while policy-focused organisations, domain experts and civil society help in improving translation of policy intent into the ground execution. Getting this set up right up front is often crucial to the success of the digital transformation. Each company should not try and build their own stack from the ground up as this will just lead to the creation of silos. Rather each company needs to create and open up APIs that allow other companies to use their products. These APIs may cut across government departments and knowledge domains, but it is precisely this cross-pollination that can lead to the creation of innovative new public products.”
Emphasising the role of PPPs, Chhitiz Kumar, Head of Sales and Service, Philips Indian Subcontinent said, “PPPs are a great way to increase efficiency in healthcare delivery, improve accessibility while lowering the costs. The creation of resilient and sustainable modern healthcare systems, especially in tier-2, tier-3 and aspirational cities in the country, requires a partnership-based approach to address public health problems through the combined efforts of public and private institutions. The Indian private healthcare sector has made tremendous progress over the last two decades and emerged as a partner to the government in its mission to extend the reach of healthcare in the country. The public sector has also evolved during this time frame with commencement of district level planning. While there are some gaps that need to be plugged, the overall outlook for the healthcare industry in India is quite optimistic.”
Elaborating more on the capabilities that a private sector can bring in the PPP model, he added, “Private healthcare institutions in India possess several key attributes including efficiency in service delivery, capital for projects with the ideal risk-reward equation, and clinical bandwidth to run services in a PPP setting. On the other hand, public healthcare institutions are typically characterised by wide networks of healthcare infrastructure and a steady flow of needy patients, which could serve these patients even better with infusion of modern technologies and best practices in healthcare. It is evident from these attributes that PPPs can be mutually beneficial for both the institutions as their qualities and needs are complementary. Private sector can provide the capital and efficiency to public institutions to address their requirements while the public institutions can provide the private sector with assured patient flow and a predictable business model. From innovative financing models to health technology solutions, the private sector can play a pivotal role in the India’s digital health transformation journey. But no-one can succeed on their own. Collaborations between public and private sector parties allow governments to leverage private sector investment and capacity to address system-wide problems in partnership that neither public nor private sector could tackle alone.”
Mudit Dandwate, CEO & Co-Founder of Dozee said, “PPPs are a must for mass transformation of public healthcare and driving technological scale. Currently, the most significant challenges affecting healthcare in India are affordability and accessibility. And, at present, the Indian government spends 2.1 per cent of GDP on healthcare compared to 9.7 per cent across OECD countries, with more than half (55 per cent) of healthcare expenditure coming from citizens. Experience has shown that PPPs could help improve healthcare delivery across India, especially in rural areas. In fact, PPPs have shown to play an extremely important role in enabling the make-in-India innovation. Early-stage start-ups and innovation require an ecosystem to help them scale and this is where government initiatives and PPP opportunities play an extremely important role. So, while the government is driving Aatmanirbharta, the ecosystem plays an extremely important role in making this happen. While this is important for India, India is also a proving ground for technologies that will scale internationally to developing as well as developed economies.
Way forward
While the healthcare sector has been slower to adapt, interesting business models are gaining momentum. Hospitals and healthcare industry will have to be open and flexible when it comes to embedding these digital solutions in the system and will require a continuous investment in their workforce to adapt their skills in the digital age.
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