Combination of technology and skilled human workforce can address the last mile gap in healthcare delivery: Sachin Gupta, CEO,IKS Health – ET HealthWorld

Shahid Akhter, editor, ETHealthworld, spoke to Sachin Gupta, Founder and CEO, IKS Health, to know more about digital adoption in healthcare and how it can enable various stakeholders to understand patient journeys from a clinical & administrative standpoint.

Your views on digital adoption helping the future of Indian Healthcare system?
Health systems across the world have seen some of the most demanding times for healthcare. The pandemic has left health systems overwhelmed and some of them were tested to their limits. The pandemic was also pivotal in highlighting some of the glaring gaps in our healthcare ecosystem in India. We need a more efficient management of the overall health ecosystem, and adopting a combination of technology with a skilled human workforce to address the last mile gap in care delivery can dramatically improve access & clinical outcomes.

Digitization has the capability to potentially alleviate some of the rudimentary issues that we continue to face with patient data, like on-demand access to healthcare information, personal, medical, family and social histories (PMFSH), record of patient interactions with the healthcare ecosystem and financial data related to care delivery. Further, digitization of patient records will enable various stakeholders to understand patient journeys from a clinical & administrative standpoint to make them more efficient over time.

How, in your opinion, technology has helped load off the burden on the healthcare infrastructure especially during the pandemic?
Technology is embedded in all aspects of our lives. In healthcare, it opens up a whole new world of possibilities to remove barriers to access, improve physician & patient satisfaction and to eventually improve the quality of care.

During the Pandemic, Physicians & Patients, both adopted new technology rapidly to adapt to the realities of stay-at-home mandates & reduce the risk of exposure to the virus. Some of the most prominent solutions include:

Telemedicine: While this is not a novel concept, the adoption levels for Telemedicine / Virtual Care was very low due to lack of regulatory incentives, unfavorable reimbursement models, lack of clear evidence of it’s effectiveness in patient care and patient / physician preferences. During the pandemic, Telemedicine was the go-to solution to enable Physicians to care for Patients while minimizing the risk of exposure and adhering to lockdown directives. The pandemic has been one of the most critical pivots for the adoption of Telemedicine.

Remote Monitoring Devices: Remote patient monitoring devices became increasingly important for monitoring patients with chronic conditions and comorbidities, especially during the pandemic. Especially in more developed nations, like the US, the technology & expanded reimbursement mechanisms enabled Physicians to monitor patients, identify issues and drive interventions at the right time.

Electronic Health Record Systems: Despite the challenges that have made EHRs cumbersome & tedious, availability of patient records in electronic form that could also be accessed on portable devices were critical in enabling virtual care. During patient visits, access to their data, historical medical data and references, documentation, quick access to previous medications and related responses etc. was important in maintaining continuity in patient care. Availability & adoption of EHRs in developed nations helped them manage patient care more effectively during the pandemic.

Patient Engagement via Mobile Apps / Platforms was also critical, even in countries like India where the portability andavailability of these devices made it easier (and in some cases possible) to continue to triage, diagnose & even treat patients through a combination of remote consults and in-person interventions.

All of these are technologies focused on patient management, this isn’t even touching on all the life-saving technology that helped in rapid vaccine development, ventilators, and other medical devices that were pivotal in helping manage & treat impacted patients.

Your organization’s role during the pandemic in the U.S and in India?
The pandemic was a black swan event that no one anticipated and it significantly disrupted all sectors. The healthcare provider space was at the center of dealing with the pandemic, but it was significantly impacted with decline in patient visits, reduction in profitable elective surgeries & increase in less profitable medical procedures while increasing costs for transforming facilities to be covid-ready as well as creating more temporary capacity. Healthcare organizations at such time had to focus on processes that improved productivity and provided good patient experience remotely while reducing fixed costs.

As an organization that is committed to helping Physician Enterprises deliver better & safer care through an on-demand, scalable & variable cost infrastructure, we were able to continue to help client partners absorb revenue shocks, while providing the same quality & consistency in their care delivery. Our model of extending the Physician Enterprise through a centralized, globalized & technology-enabled delivery platform, enabled Physician Enterprises to continue to serve patients and deploy their resources to what mattered the most. Our solutions provided Physicians more time to see more patients, clinics to deploy their nurses & medical assistants to more direct patient care and because of our variable cost model, provider enterprises were able to optimize their infrastructure cost to a certain extent as their revenues dipped significantly.

When the pandemic hit, we swiftly transitioned to a remote working environment almost overnight & continued to serve our clients. Many of our client partners expressed gratitude for our continued service delivery that experienced no disruption despite the challenges. We were also able to expand many of those relationships and sign up new enterprise clients during the pandemic as they increasingly saw the value of our solutions in helping them achieve their strategic objectives.

How did the US cope as they are already digitized, was the impact easier?
While healthcare ecosystems in every country were challenged by the pandemic and many factors contributed to the impact of Covid on society in general and the provider enterprises in particular, there is little doubt that the widespread adoption of digitized patient records is a significant advantage. The availability of electronic patient health records enabled Provider Enterprises to continue to care for patients remotely, engage them through a multi-channel approach and improved triage & diagnosis outcomes.

One of the biggest challenges that US healthcare is still grappling with is the interoperability of data between different stakeholders in the ecosystem. This means that all information about the patient’s history outside of a particular provider enterprise, may not be fully available to another enterprise. More regulatory changes are on the horizon, especially after the 21st Century Cures Act passed in 2016 and the recent rules published by the ONC. However, those changes will take a while to be implemented and there may be a need for establishing more standards for availability & exchange of data amongst various care providers in the care continuum.

Your views on the future of Clinical Documentation in India?
With increasing complexity and specialization in care delivery, combined with the administrative complexities, the importance of clinical documentation has only continued to increase. In developed countries, like the US, Canada, Germany & the UK, clinical documentation standards are comprehensive & clinical documentation acts as a fulcrum on which care is transitioned between different providers. It has been empirically proven that better documentation lays the foundation of improved care delivery.

This is reflected in the richness & comprehensiveness of documentation standards across most developed nations, but is a nascent idea for emerging countries like India. Anecdotally, the comprehensiveness & completeness of clinical documentation also seems to improve with EHR adoption, which is also in its infancy in India. Due to these & other factors (including how students are taught to practice medicine, the historical practices of medicine & the standards of clinical documentation or lack thereof), we see gaps in our documentation standards. For example, a typical outpatient visit is documented in 20-25 words in India (vs. around 400-450 words in the US).

We believe that India will adopt some of the globally accepted clinical standards for clinical documentation over time, driven by a combination of regulatory changes, academic research, reimbursement models (as Healthcare insurance adoption increases) and the demand from patients to deliver more comprehensive & holistic care across the continuum of providers.

What is the company’s growth and expansion in India?
We were established in 2006 with the singular mission of helping Provider Enterprises deliver better, safer and more efficient care for their patients and we haven’t wavered in that mission. Over the years, we have created a centralized, globalized and technology-enabled platform that is helping bridge the demand-supply gap in care by optimizing & redesign the care delivery infrastructure for Provider Enterprises. In this journey, we have grown to be a team of over 4,000 colleagues across India & the US including over 700 Physicians, 500 clinicians and 200 technologists enabling this mission. Over this period, we have gone on to expand our client install base from 1 Physician to over 30,000 Physicians and provided enriching career opportunities to thousands of our colleagues, while being debt-free and cash flow positive.

As we look to the future, we see that US healthcare is approaching a pivotal point where the increasing demand-supply gap, combined with the need to drive more efficiency will lead them to look for innovative solutions like ours that can help them improve productivity, efficiency & improve patient experience. Our goal is to continue to expand our client install base to over 100,000 in the next few years while growing at high double digit rates. This will be enabled by expanding our product lines to become an integrated practice management solution that helps succeed in both fee-for-service and value-based care reimbursement models in the US. This will help create thousands of more jobs and help establish a unique delivery model that leverages the levers of standardization, globalization, centralization and automation in helping Physician Enterprises deliver better, safer care.

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