Mumbai: Mohit Sood, Regional Managing Principal, ZS India spoke to ETHealthworld’s Prabhat Prakash on the disruption, opportunities brought about by the COVID-19 pandemic and how emerging technologies are changing healthcare delivery.
The digital revolution is changing the landscape of the healthcare sector. How well prepared is India in incorporating the changes? What are the current challenges in implementing advanced technologies? How are the challenges addressed?
The adoption of advanced digital technologies such as artificial intelligence (AI), machine learning (ML), blockchain, 5G, robotics, cloud computing, and the Internet of Things (IoT) has helped support the three pillars: availability, accessibility, and affordability of healthcare development globally and achieving Universal Health Coverage (UHC).
The health-tech market in India is at a nascent stage but is evolving rapidly, backed by capital investments and government support. It is making strides towards growth, especially during the COVID-19 pandemic, which led to foundational shifts such as rapid adoption of virtual healthcare and digital innovations, and public-private collaborations for vaccine and medical devices development. The government launched several well-designed schemes and programmes supporting digital healthcare adoption. The development of tech-based platforms such as Aarogya-Setu (for contact tracing, syndromic mapping, and self-assessment) and Co-WIN (for universal COVID-19 vaccination) are two great examples.
However, the Indian market has faced several challenges implementing such technologies, the major being the need for supportive infrastructure and a skilled workforce. In addition, some of the other challenges faced by the industry are lack of data access and standardisation, concerns related to healthcare data privacy and security, patient hesitation, and regulatory ambiguity.
To neutralise the impact of such challenges, centrally governed programmes like the National Digital Health Mission have opened the door for good opportunities to accelerate data collection, integrate with central repositories, and synthesise the information in a way that translates into the maximum benefit for patients.
Additionally, industry stakeholders are focusing on investments in privacy-enhancing technologies such as data encryption and training, and building skillset to handle AI-enabled software and applications. The companies are also organising campaigns to spread awareness and knowledge about the positives of AI, which is important to aspiring professionals and patients.
What is your organisation doing in the public health space? What are the use cases?
Non-communicable diseases (NCDs) linked to lifestyle changes, ever-evolving and emerging pathogens resulting in pandemics or epidemics, along with infectious diseases- pose a triple burden health scare for the Indian public.
It is now a known fact that medical care contributes to only 20 per cent of health outcomes and the remaining are driven by socio-economics and behavioural components. There is also enough evidence from the commonwealth fund and other organisations to demonstrate that countries with better health outcomes invest more in social services and in ensuring equitable access to patients.
We are partnering with various life sciences clients across the value chain with projects ranging from the development of health equity strategy, understanding patient biases for trial recruitment, and identifying at-risk patients leveraging clinical and social determinants. In addition to our project work with life sciences companies, we are investing in health equity and other aspects of public health in many other ways. Our goal is to establish sustainable partnerships with other players in the healthcare ecosystem to expand equitable access to healthcare and improve health and wellness outcomes for all.
What percentage of the market remains underserved due to the usage of the conventional healthcare delivery approach? How can accessibility and availability be increased in underserved regions?
Despite investments in the healthcare sector over the last five years, India continues to grapple with a startling demand-supply mismatch of healthcare infrastructure and services. Though the challenges are daunting, they provide a ‘tremendous opportunity to bring equity in healthcare delivery and disrupt traditional health care models’. Digital technology without a doubt is going to be the biggest enabler of this change in India. Telemedicine and e-health solutions are fast emerging as a convenient alternative to expanding reach to underserved rural markets. Care is increasingly moving outside the hospital, and retail healthcare will make it a new reality. Health kiosks and mobile health vans can ensure easy access and reduce the burden on clinical and hospital personnel.
In addition, the government-led Initiatives such as ‘Make in India’ to lower the prices patients pay for products, Ayushman Bharat Digital Mission (ABDM) and the push to adopt EMR and deploy AI for predictive analytics will likely enable the delivery of better treatments and early disease or at-risk pool detection. We have also been seeing private players expand beyond metro cities to tier II-III regions. Public-private partnerships, to be honest, will play a key role in further advancing the country’s health infrastructure for more resilient and robust care delivery.
In the last three years, India has borne witness to a plethora of start-ups across the nation. What have been the shortcomings in the Indian scenario?
India has seen an upsurge in several digital healthcare startups, primarily after COVID-19, providing impactful and innovative tech solutions, prioritising convenience, and access to care. In 2021, there were 3,548 active startups in the health-tech space, up by 8.9 per cent from 2020. Categories such as e-pharmacies, teleconsultation and e-diagnostics, fitness, home healthcare, healthcare IT, and analytics have emerged. These are expanding healthcare access, lowering costs, improving clinical outcomes, and enhancing the overall patient-care experience.
However, the market scenario saw various unfavourable factors or shortcomings, which are as follows:
Regulatory ambiguity: Indistinctness around regulations has led to varied issues like lack of infrastructure for designing AI applications and limited reach of solutions. The existing or recently formulated AI companies are majorly startups, not recognised by a national or an international governing body. As a result, AI penetration in the Indian healthcare sector has remained low due to difficulties implementing solutions by new companies.
Lack of standardisation: Being at a nascent stage, the sector has complexities and uncertainties. The lack of data integration and standardisation brings inconsistencies in patients’ medical records and directly impacts safe care. Hence, embedded clinical guidelines are vital for standardised and evidence-based practices.
Lack of public-private partnerships: New startups require appropriate exposure to offer and promote their products and services. One of the still largely untapped potentials lies in facilitating more robust partnerships between new-age health-tech startups and public organisations.
How can Health IT change the landscape of the ever-evolving nature of healthcare delivery?
Health IT has experienced disruptive changes in the past few years, with the entry of emerging technologies. Healthcare will continue to evolve via technologies like AI, IoT, and automation.
The e-health sector in India is geared to reach $9–12 billion in gross merchandise value (GMV) by 2025 and $40 billion in GMV by 2030, according to a report by RedSeer, a Bengaluru-based market research firm. The net promoter score (NPS) in the Indian e-health sector saw a 47 per cent growth in 2021.
The healthcare ecosystem in the country would continue to be significantly impacted and transformed with the help of the health IT sector. With the IT transformations, the healthcare sector will continue to improve in diagnosis, treatment, health records management, and drug development.
What can healthcare players do to detect and capitalise on disruptive innovations for the benefit of patients and the business?
The Indian healthcare sector comprises a gamut of companies ranging from e-pharmacies startups, and pharma companies to medical devices incumbents providing products and services to a mass population. Inside healthcare, the health-tech industry is gaining traction and has emerged as the leader in terms of growth.
The health-tech market has been driven primarily by innovation and large capital investment, fuelling the advent of innovative products and services. Startups and other established players should look out for trends and developments in the industry, to detect or capture the available opportunities.
A few key strategies to detect and capitalise on disruptive innovation are:
Outline the ecosystem strategy: To create an integrated ecosystem, companies should develop collaborative relationships with patients, healthcare providers, and regulators who support them while evaluating their offerings and analysing the space for improvement.
During the pandemic, for instance, tech-driven startups made a major impact on the usage of telemedicine practices, home healthcare, video consultation, and remote patient monitoring. These startups had government backing through various initiatives and conducive guidelines, such as telemedicine practice guidelines 2020.
Digital technology deployment support through partnerships: The past few years have seen a disruption in the industry by patient-centric products and services- a domain which may attract healthcare players in the future. Healthcare companies having a firm industry hold are continuously engaging and developing partnerships with technology companies to develop innovative solutions to be tested and implemented faster at a low cost and with reduced risks.
Analyse and enhance the agility of the organisation: Lessons and learning from the pandemic era are very important for a firm to gauge its actual level of agility and understand what can be done to improve it. Based on shared values and cross-functional mind share, companies should promote agility and foster innovation continuously.