Frugal innovation, digital health, data sciences, community mobilisation at the district level is the way forward for India: Experts

There is a possibility of creating a global impact on public and private health using digital technology by combining the expertise of Indian cost-effective healthcare and NHS expertise

At the Healthconomics: Joint Stakeholders’ Roundtable of India and UK on the Emerging Landscape of Healthcare Delivery in Wake of COVID organised by PHD Chamber virtually, health economists dwelled on prevention and workforce skilling and management as a key aspect. Prof Randeep Guleria, Director, All India Institute of Medical Sciences pointed out that frugal innovation, digital health, data science, community mobilisation and surveillance systems at the district level is the way forward for India to handle the pandemics and manage healthcare. 

The eminent panellists present were at the meeting were Ruchi Ghanshyam, Ex High Commissioner of India to the UK,  Professor Sir Malcolm Grant, Ex-Chairman, NHS, UK, Prof Derek Bell, Chair, Acute Medicine, Imperial College, London, Prof Ravikant, Director, AIIMS, Rishikesh, UP, India, Prof (Dr) Randeep Guleria, Director, AIIMS, New Delhi, Mahendra Singh, Expert Member, Digital Health, AI in Health, Telemedicine & Innovation, WHO Geneva, Dr Deep Goel, Senior Director & Robotic Gastrointestinal Surgeon, BLK Hospital, New Delhi, Dr Shreeraj Deshpande, Chief Operating Officer, Future Generali India Insurance Company Limited, Prof Bejon Misra, Founder, Partnership for Safe Medicines (PSM) India.

The round table meet was graced by the special presence and address by Sanjay Aggarwal, Senior Vice President, PHDCCI & Chairman & CEO of Paramount Cables Group and the session was moderated by Prof Parag Singhal, Consultant Endocrinologist, UK, Dr N Subramanian, Chairman, Health Committee, PHDCCI & Director, Medical Services, Indraprastha Apollo Hospitals and Vivek Seigell, Principal Director, PHD Chamber.

Agarwal told that the hospital industry is expected to reach $132 billion by 2023 from $ 61.8 billion in 2017; growing at a CAGR of 16-17 per cent. He has also mentioned that the best & qualified doctors India have, who are providing cost-efficient treatment in India and Government initiatives like Ayushman Bharat and to allow FDI up to 100 per cent under the automatic route, India can also become a Healthcare Delivery hub of the world. 

Agarwal further gave some specific suggestions regarding investment in the hospital infrastructure, technology transfer and investment in training and skilling of the medical professionals especially the paramedics, nurses, medical technicians & clinical trial experts.

Prof Singhal in his opening remarks mentioned about the impact of COVID pandemic on the healthcare system and the most affected are the vulnerable population. Prof Singhal mentioned that in this crisis the conventional clinics have been replaced by telephonic clinics in the UK. He also mentioned that India has a low-cost healthcare facility and both the countries should collaborate to use technology and maximise the capacity to focus on the primary care and preventive healthcare.

Dr Subramanian mentioned facts and figures about the overall mortality ratios and preventive mechanism like 68 per cent of deaths were due to Non-Communicable diseases and over 1.5 million deaths could have been avoided with the proper preventive measures. He also mentioned that more than two hundred thousand people are in end-stage renal failure. He also talked about the healthcare expenditure India is only 3.5 per cent of the GDP of which only 1 per cent + is spent by the Govt and the rest is shouldered by the individuals.

Dr Subramanian mentioned that if NCDs and Mental illness were not prevented then we will face $47 trillion of additional burden on healthcare.  He also said that we need interventions in terms of preventing illness & early diagnosis, which will help in saving the cost. He urged the government and private agencies, researchers to come forward a find a mechanism for making the entire Healthcare system affordable & accessible.

Ghanshyam, Ex High Commissioner of India to the UK shared some very important issues and concern areas of each country. She said that one of the silver linings of the Pandemic has been that Countries have looked at collaborating wherein India has sent HCQ to US and UK. She said that collaboration is required between the two countries and this is the time for the public and private sector to work together for a positive outcome. She has also mentioned about the skilled workforce (Indian diaspora), whereas many Indian origin doctors got trained at the British Association of Physician and returned to India with higher effectiveness. She said Healthcare infrastructure requires huge investments and one should think of innovative ideas to tackle the ongoing pandemic. She has also mentioned that the use of technology to be taken forward and the world has to be united to emerge from this pandemic. 

Professor Grant talked about the various challenges faced by different Government while facing the crisis and many Governments have failed to tackle the same. Sir Malcolm talked about the NHS strength being the skilled and expert workforce they have and meanwhile and expressed the challenges and failure of providing enough testing and the PPE kits during the pandemic. Sir Malcolm mentioned focusing on preventive care and a need to promote the role of universities in healthcare which would get breakthrough in COVID vaccine. He has also mentioned about the need for higher investments in research facilities and workforce. 

Prof Bell spoke of the need to focus on sustainability and on self-care management as the learnings from COVID 19. He also mentioned that technology has played a major role in managing the COVID situation as public responded more to the online platforms and phone calls on messaging during these pandemic times and hence we need to build more capacity in these areas as well. He also expressed his doubts and thoughts on how to balance the investment viz-a-viz population and how to build a preventive infrastructure. Prof Bell mentioned about the backlog of elective care and focus on self-care management. He highlighted that we need to think of public health and there’s a lot more investment is required in the entire Health care system.

Prof Kant mentioned about the focus on the prevention as prevention is better than cure. He has also mentioned maximising the use of telehealth technology to cater to more population. He talked about the preventive care by Yoga and Ayurveda while focusing on schooling by water purity, nutrition orientation and vaccine. He has mentioned that tertiary care requires more money which can be only reduced by focusing on primary care. He also said that to increase the standards of private medical schools and emphasised on the school education to play a role in hygiene and nutrition.

Prof Guleria shared the ongoing challenges the country is facing while fighting with the COVID-19 situation. He also mentioned the improvements in the testing strategy our country has adopted. He said that earlier we could only manage 10,000 tests per day for COVID and now we have more than 1200 labs for COVID testing and performing more than 3.5 lac tests every day. He also mentioned about their research paper with Department of biotechnology regarding the recycling of PPE kit as to reduce the import dependency. Prof. Guleria mentioned about the most important facility started by AIIMS, New Delhi as “Contact” which is teleconsultation application providing 24*7 online audio-video consultation to the patients at large. 

Singh said that a rapid management system is required to fight against this pandemic. He said we need to think about planning, execution of capacity building and increasing the testing for COVID-19. 

Singh also stressed on telemedicine consultation, which could be very effective during these challenging times. He also said that finding a vaccine is not only the solution but we need to be prepared and focus on the prevention.

Dr Goel talked about the bilateral relationships and how the UK and India could look at various aspects of partnership in conducting training programs and digital health technology transfer.  

Dr Goel highlighted that telemedicine has become an integral part nowadays, as more than 150 consultations are done through digital Health, which helps in saving the time. Dr Goel said with the new modern technology and new advance equipment in the healthcare industry the functioning of any tests conducted have become much smoother and accurate.

Prof Misra highlighted various ongoing issues and said that patients do not identify the healthcare sector either run by a government or private sector but consider if they are able to access the most affordable and effective healthcare or not.

Prof Misra urged that to empower the patient to make a choice of the healthcare mechanism. He also urged to promote AYUSH in the UK. Prof Misra also mentioned about the world’s largest Government funded scheme Ayushman Bharat and creation of more than 1,50,000 health and wellness centres which is a big opportunity to collaborate for technology and foreign investor for  infrastructure development while ensuring the quality and affordability of healthcare. 

Dr Deshpande talked about the ongoing Ayushman Bharat Yojana, which aims to provide free health coverage to more than 50 crore population. He has shared data related to the Indian population and the insurance coverage where he has mentioned that still 50 crore people remain uncovered in the country. 

He has suggested that can we make health insurance as a mandatory model and how one should do that. 

Seigell mentioned about the areas of collaboration in digital technology like telepathology and teleradiology to increase the diagnostics capabilities and setting up of chronic disease management Speciality clinics to address the unique needs of the patients with long term medical conditions requiring significant patient self-care.

He has also mentioned the possibility of creating a global impact on public and private health using digital technology by combining the expertise of Indian cost-effective healthcare and NHS expertise.