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A Dose of Technology: ICT promises to improve the reach and quality of healthcare

February 27, 2018

A Dose of Technology: ICT promises to im...

The Indian healthcare sector has so far had a conservative approach towards adopting IT and telecom solutions. However, of late, it has increased its uptake of information and communications technology (ICT), realising its potential in delivering better healthcare. Going forward, m-health, telemedicine and the increased adoption of big data will help in extending healthcare services to remote pockets of the country. Senior executives of enterprises operating in this space talk about the emerging IT trends in healthcare, the status of technology adoption and the future outlook…(From left to right: Abhimanyu Bhosale, Co-founder and Chief Executive Officer, LiveHealth; Chitrang Dalal, AVP, Product Management, Credihealth; Prasad Nagaraja, Delivery Head, Information Technology, Columbia Asia Hospitals, India; Dr Shankar Narang, Chief Operating Officer, Paras Healthcare; Bruce Schwack, Director of Communications, Netmeds.com; Lakshman Sharma, Chief Information Officer, Asian Institute of Medical Sciences)


What role do ICT solutions play in the healthcare industry? What are some of the ICT initiatives undertaken by your organisation?

Abhimanyu Bhosale

The world we live in today is powered by ICT. Every interaction and transaction is directly or indirectly powered by ICT. In healthcare, we have seen a significant rise in the adoption of enterprise resource planning (ERP) solutions. As of now, diagnostic centres and laboratories have the highest adoption of and need for ICT technologies. For instance, technologies like TeleRadiology enable radiologists to view and report on radiology reports remotely, saving a lot of time and cost. We are a product technology company, so almost all our work entails the use of technology to enable seamless transactions in healthcare. We help medical laboratories and hospitals in digitalising and automating the management of medical records, as well as provide end-to-end solutions for report management with offerings for all stakeholders in the ecosystem.

Chitrang Dalal

With the advent of ICT, the healthcare industry is heading towards remote diagnosis and telemedicine, which is where internet of things (IoT) will come into the picture. Credihealth is moving steadfastly towards making healthcare more accessible and transparent with the help of ICT. To this end, it has built three robust platforms, which are as following....

• CrediCommunity: Get personalised and detailed answers to all your health questions by verified doctors and medical experts for free. We strive towards making CrediCommunity the biggest healthcare portal where patients and doctors can connect and interact.

• Video consult platform: With the spread of the internet, we are working towards making healthcare accessible to the masses. We are providing patients with alternatives to traditional consultations. Video consult ensures a convenient and seamless online experience. It helps skip the waiting room hassles, thereby saving time, effort and money, and enables people to avail of online consultations anytime from anywhere.

• CSC program: With a strong commitment to simplifying access to healthcare through mobile technologies, Credihealth has tied up with the Ministry of Electronics and Information Technology to deliver its online services through 250,000 common services centres (CSCs) across 16,000 pin codes.

Prasad Nagaraja

ICT enables the integration of various channels of communication to provide multiple solutions across enterprises, especially healthcare. In general, the adoption of ICT in India, particularly in healthcare, is still at a nascent stage. In my opinion, the healthcare industry is still struggling to find and engage with reliable virtual private network or leased line service providers who deliver on high uptimes. The choice of such service providers is limited. Therefore, ICT is still a couple of years away from becoming a reality here.

Dr Shankar Narang

ICT plays a critical role in improving healthcare for communities. By providing new and more efficient ways of accessing, communicating and storing information, ICT can help bridge the information divide that has emerged in the health sector in developing countries. Therefore, ICT in healthcare can help in bridging the gap between health professionals and the communities they serve, and medical researchers and the practitioners who need it. Through the development of databases and other applications, ICT can provide the capacity to improve health system efficiencies and prevent medical errors.

Bruce Schwack

Our entire existence is predicated upon the integration of healthcare and ICT. Earlier, nearly 100 per cent of the retail prescription medicine business was conducted in brick-and-mortar shops, represented by more than 1 billion face-to-face transactions. The launch of Netmeds.com heralds a new paradigm in the pharmacy industry. Unlike any other purchase in the realm of e-commerce, only the purchase of prescription medicine requires “written permission” for a successful transaction. The new paradigm allows the uploading of handwritten prescriptions on the web and mobile app. In order to facilitate this process, it was necessary to train a staff of licensed pharmacists to decipher the uploaded prescriptions, vet them for validity and digitise them so that they could initiate the next step in the transaction process.

Lakshman Sharma

ICT is playing a major role in patient self-care and education, communication between patients and providers, electronic data storage and data sharing. The Asian Institute of Medical Sciences provides patient self-care by making their investigation reports available on our portal and updating them about doctor appointments through e-mails and SMSs. Further, we have launched a mobile app for seamless interaction between patients and the hospital. There are solutions for centralised storing of radiology images from multiple locations for timely and accurate treatment, and lodging a direct claim with the third-party administrator for faster claim approval to reduce discharge time. We are also in the process of implementing electronic medical records.

How are the telemedicine and m-health segments expected to evolve in the Indian market?

Abhimanyu Bhosale

Telemedicine is already big in India, though m-health is still catching up. The most important question actually is, how pervasive and accessible are these technologies? Many hospitals have a mobile app nowadays, but it is not being utilised for the right purpose. Mobile apps should exist to improve convenience, make the patient experience more user-friendly and ensure personalised care. Most healthcare mobile apps are not usable due to their end-user experience. In addition, mobile technology in healthcare faces challenges like privacy and capability. Further, only basic functions such as booking appointments or checking results online are possible at present. Therefore, m-health has a long way to go, but once it is up and running, I believe it will disrupt telemedicine.

Chitrang Dalal

M-health is set to play a very big role in the wellness segment. Wellness applications such as steps tracker, heartbeat tracker, calories burnt and sleep patterns have started to gain traction in the m-health domain. As people adapt themselves to the online healthcare platforms, m-health and m-wellness innovators ought to show us the future – a future where we are all connected to the entire healthcare value chain right from diagnosis and consultations to treatment and wellness through our mobile phones. Moreover, the deployment of m-health in the actual treatment process will become significant with remote diagnosis, IoT and telemedicine finding enough penetration and acceptance in the market. Meanwhile, video, tele, e-mail, SMS and chat-based consultations are going to grow tremendously in 2018. Once people get used to mobile-based consultations, things will move towards video.

Prasad Nagaraja

Reliable and robust broadband connectivity that is generally available to large sections of society is fundamental for telemedicine to become a reality. In developed countries, this has taken off well and the adoption rates are significant. In India, falling 4G data tariffs and internet penetration hold the key to the growth of telemedicine and m-health in the next few years. The fact that needs to be highlighted is that patients and consumers of healthcare should have a seamless experience when compared to face-to-face meetings, especially for routine diagnosis and reporting. This is possible only if broadband connectivity is available beyond the pockets of big cities, in remote locations as well, where access to healthcare centres is limited.

Dr Shankar Narang

India’s telemedicine market is growing at a compound annual growth rate of over 20 per cent and holds the potential to cross the $32 million mark by 2020 from the current level of over $15 million. In the past decade, the number of sub-centres across India has increased by about 6,300, primary health centres by about 1,800 and community health centres by over 2,000.

Bruce Schwack

These segments will evolve to such an extent that they will become, by and large, the mainstay of medical practice. “Hands-on” physical examination is expected to reduce in importance while the physician’s ability to consult the patient via Skype and WhatsApp is likely to be enhanced with the advent of smarter apps and “home-owned” devices.

Lakshman Sharma

The use of telemedicine and mobile apps is gaining traction. The Asian Institute of Medical Sciences has implemented telemedicine services in various locations like Dhanbad (Jharkhand), Moradabad and Sambhal (Uttar Pradesh), as well as various other remote locations. Further, we have a mobile app platform that is used for scheduling doctor appointments, and providing patient investigation and radiology reports.

What is the scope of big data analytics, cloud and IoT in the healthcare industry?

Abhimanyu Bhosale

Cloud is and will continue to be one of the biggest game changers in healthcare. Cloud deployment is making interactions, management and systems more accessible and cost effective at the same time. Big data will, however, still take a while to gain ground and will find increased uptake when the cloud becomes more pervasive and is adopted by many service providers. For some large enterprises, big data is already adding up, but it will take some time to make a significant difference.

Chitrang Dalal

For big data to play a significant role in the healthcare sector, data has to be centralised and the nation has to become technologically sound. For example, once health data starts getting linked with Aadhaar, big data can play a major role in the public health sector. A large chunk of the data that gets collated could be used for trend analysis as well as to predict disease outbreaks in the country. Hospitals have a huge role to play as they treat a large number of patients and over time, they can collect, preserve and analyse their patient data to draw better and more accurate inferences.

At Credihealth, we have served more than 800,000 patients across 700-800 hospitals till now. We have accumulated data from each of these customers, which can be used to guide hospitals on various aspects such as the demographic breakup of their audience and the most common ailments, among others. Further, we accumulate and collate feedback from our pati ents. This helps new patients make more informed and reasonable decisions while choosing their healthcare specialist.

Prasad Nagaraja

The scope of big data and analytics for the healthcare industry is immense. Many healthcare providers are either unaware or unable to evaluate the intrinsic value of the data they have built up over the years. One area where analytics can help is in following up on patients as a part of post-care treatment. Similarly, cloud can play a significant role in providing quick scalability and ubiquitous access for better organisational computing and data storage. Finally, IoT has the potential to disrupt the out-patient department business that we know today. The efficient deployment of proven IoT solutions can boost proactive diagnosis and care administration, especially in remote areas where access to quality healthcare services is limited.

Dr Shankar Narang

Big data is required everywhere and there is almost an urgent need to collect and preserve whatever data is being generated so that we do not miss out on something important. Big data analytics has become crucial as it aids in improving businesses and decision-making, and in providing an edge over competitors.

Lakshman Sharma

There is a huge need for big data in healthcare in order to maintain electronic health records (EHR), which include medical history, laboratory test results and demographics that are shared via a secured information system. In this way, doctors can provide more accurate treatment based on the information received from various data points of a patient. Another application can be attributed to real-time alerts. For instance, if a patient’s blood investigation parameter value shows an alarming increase, the system will send an alert in real time to the doctor. The Asian Institute of Medical Sciences is using the real-time critical value alert system. The healthcare industry is adopting IoT at a fast pace as integrating IoT features into medical devices improves the quality and effectiveness of service.

What are the key IT and telecom-related challenges faced by healthcare enterprises? How can these be resolved?

Abhimanyu Bhosale

India is still struggling with telecom infrastructure, due to which connectivity remains a major hurdle. Although competitive costs have made it more accessible, reliability will only come from good quality telecom infrastructure. Most enterprises still struggle with connectivity, scale and data management issues. We already have solutions for the last two problems on the list, but bad connectivity is hampering increased adoption of ICT in Indian healthcare.

Chitrang Dalal

From the perspective of hospitals, they have a number of independent systems that are not well integrated and efficient. Therefore, integrating all of these systems, I believe, is a major challenge for hospitals.

From the perspective of healthcare start-ups, hospitals systems and technologies are lagging behind tremendously. As per start-ups, hospitals have a traditional and rigid method of approaching IT and telecom-related challenges. Therefore, advancements in the field of IT by start-ups are going to take time to get implemented. For instance, even if a start-up wants to bring in a blockchain-based feedback system, a hospital may take time to adopt it.

Prasad Nagaraja

A key telecom-related challenge is to achieve a reliable and mission-critical service level in connectivity. While the cost per unit of connectivity has declined steadily in the past decade, the quality of service has not kept pace. Further, healthcare enterprises are stuck with legacy systems with rigid data structures, and are finding it challenging to digitally transform and adopt SMAC (social, mobile, analytics and cloud) tools.

Dr Shankar Narang

The healthcare industry is struggling to manage the ever-growing amount of digital data. Electronic medical records, digital imaging reports and numerous clinical applications are putting pressure on the existing infrastructure. In addition to the need for adequate capacity and real-time access to disparate sites, digital data containing health information must adhere to stringent security measures.

Bruce Schwack

Lack of adequate telecom infrastructure, access to smartphones and other modes of connectivity are creating an inverse proportion, whereby the areas that could benefit the most, that is, Tier II and Tier III cities, and semi-urban and rural towns and villages, have the least access to both the devices and the bandwidth required to take advantage of IoT-enhanced healthcare practices. However, the government and NITI Aayog are working hard to increase both internet penetration and mobile adoption rates in the country. Further, public-private partnerships in the space are proving beneficial and hold a great deal of promise for improving the overall health profile of the nation.

Lakshman Sharma

Hospitals need to be accessible all the time. So, a healthcare organisation’s inventory is filled with complexities. Often, this results in the inability to track provisioning activities effectively, leading to lots of paperwork, the constant risk of over-payments, and the ever-present threat of downtime.

What are the key technology trends likely to be witnessed by the healthcare industry in the next few years?

Abhimanyu Bhosale

The next few years are going to be dominated by m-health. Artificial intelligence (AI) is also catching up very fast but, after a certain point, data is going to be the largest limitation. Every data point needs to be available for machine learning to make a marked difference. Therefore, in my opinion, the Indian healthcare industry will be dominated by m-health and AI in the next few years.

Chitrang Dalal

At first, from the patients’ perspective, a technology trend based on blockchain or the decentralised availability of information in the healthcare domain such as doctor information, feedback, reviews and consultation fees can help build the much-needed trust and credibility in the sector. Second, remote diagnosis and the adoption of telemedicine are expected to pick up. Third, access to information will be personalised and the recommendations will be based on a person’s information.

Prasad Nagaraja

In my view, technology trends such as digital patient engagement, IoT in pre-diagnosis, robotics in healthcare, AI to improve the productivity of healthcare professionals and virtual healthcare or telemedicine would significantly disrupt the healthcare industry.

Dr Shankar Narang

The upcoming technology trends will focus on personalised data, real-time information and blockchain. The healthcare sector is all set for a reboot. It will not only transform the lives of patients, but also witness greater efficiencies and scalability.

Bruce Schwack

AI will become integrate into platforms where medical assistant chatbots will provide prompt medical information to millions of patients, including a variety of consultative and diagnostic services. We have already introduced a robotic “assistant” that will take the patient through a series of questions and answers and if certain “triggers” are initiated, the bot will transfer the patient to a live doctor. The physician may then suggest tests, which can be conducted at patient’s home or office by remotely dispatched medical technicians. Further, the very nature of medicine being practised online in a uniform digital manner is creating a database of prescription drugs and chronic ailments, which was not available before. This new deep data dive will allow an analysis of the nation’s health records, conditions and therapies, helping to predict trends in a way that has not been available until now. Since it is widely acknowledged that lifestyle diseases are on the rise, this new analysis modelling can help halt their rise through the demographic and geographic study of populations.

Disclaimer: The views expressed by  Prasad Nagaraja are solely those of the author in his private capacity and do not in any way represent the views of Columbia Asia Hospitals India, or any other entity of the group.

 
 

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