Shuvankar Pramanick, Deputy CIO, Manipal Hospitals

There has been increasing uptake of digital technologies across the healthcare sector of late. The healthcare industry is deploying a mix of traditional and disruptive technologies such as mobility, big data analytics, cloud, artificial intelligence (AI) and machine learning (ML) to ensure that the overall care process is effective and cost efficient. In the wake of the Covid-19 pandemic, mobile health, telemedicine and cloud consulting have gained significant traction. Shuvankar Pramanick, Deputy CIO, Manipal Hospitals talks about the em­er­ging information and communication technology (ICT) trends in the healthcare space, the status of technology adoption and the future outlook…


How has technology transformed the Indian healthcare sector? What are some of the key digital trends?

As information techno­logy in the healthcare in­d­­us­­try evolves, the scope of information sharing is expanding beyond the four walls of individual institutions. Achie­ving this level of integration will require the software models to overcome a host of technical obstacles and they are accessible, affordable and widely supported, primarily by the government.

Since the second wave of Covid-19 be­gan sweeping over India, the focus on the healthcare sector has been renewed. In the midst of the pandemic, it has had to innovate and change, and digital healthcare has become a solution for reducing the imperfections in caregiving and personalising the experience. A clear learning that emerged from the first wave, however, was that healthcare and ancillary sectors must not be looked at in silos but as part of the larger ecosystem.

When the first lockdown was announ­ced, our early investments in technology allowed us to continue operations and make vaccines. Gradually, the physical distance between consultant and patient pro­mpted the idea of connectivity and technology being explored in other ways.

Remote monitoring of patients throu­gh technology became the most important innovation. Over the past one year, there has been massive adoption of teleconsultation, supported by a huge change in be­haviour, even in the elderly, who are usually not comfortable with video calls. This is just one instance of how digital technologies can be integrated to create an ecosystem that could lead to better treatment and care for patients.

Last-mile connectivity for effective and timely healthcare in rural India is a challenge, and is India’s ground reality. Health­care technology has taken up this challenge, and the healthcare business has fo­und a new channel for business. So it is a win-win situation.

Technology has changed healthcare in two tangible ways: it has increased accessibility to treatment and led to more reliable outcomes. Robotics has transformed the ever-evolving field of orthopaedics and as far as knee replacements are concerned, ro­­botic assistance during surgery can po­tentially lead to faster recovery, a more natural feel and improved longevity. Tele­medicine, AI-enabled medical devices and blockchain electronic health records are just a few concrete examples of digital tra­nsformation in healthcare.

There are five key focus areas where technology has evolved in a massive way in the healthcare ecosystem:

  • On-demand and personalised healthcare
  • Big data in healthcare and predictive healthcare
  • Treating patients through virtual reality (VR)
  • Growth of wearable medical devices, sensors, etc.
  • Most importantly, AI.

What are your views on the e-healthcare trend that has emerged amidst the pandemic? What are your projections for the e-health market going forward?

The e-healthcare trend has definitely em­erged in a larger way, as I mentioned. The pandemic has created the need for this te­chnology among consumers as well as providers. Both patients and consultants are now well versed in this medium of treatment, and it will continue.

Electronic health records; vendor-neutral archives; picture, archiving and communications systems; laboratory information systems; telehealth; prescribing solutions; medical apps; clinical decision support systems; and pharmacy information systems are the main focus areas of the e-health market.

As per the Global Opportunity Analysis and Industry Forecast 2019-2027, the glo­bal e-health market was valued at $74,476.4 million in 2019 and is projected to reach $230,640.4 million by 2027 at a compound annual growth rate (CAGR) of 14.5 per cent from 2020 to 2027. India’s e-health will have a gross merchandise value of $11 billion-$15 billion by 2025, up from $1.4 billion in 2020, the year that brought in significant needle movement for the sector, as per Redseer Consulting.

The government plans to increase its healthcare spending from the current 1.6 per cent to 2.5 per cent of the GDP by financial year 2025. There is a significant opportunity for improving healthcare services across the country.

What are the key use cases of new-age technologies such as AI, internet of things (IoT), cloud, big data, augmented reality (AR)/VR in the healthcare sector? How are you leveraging these solutions?

AI in healthcare has experienced a long history of research and development. With the development of advanced technologies such as IoT, cloud computing and big data, AI technology has become more widely adopted in the medical field. To this end, the technical basis of IoT, cloud computing, big data analysis and ML have been involved in clinical medicine, combined with concepts of specific algorithms such as activity recognition, behaviour recognition, anomaly detection and assistant decision-making systems, to describe scenario-based applications such as remote diagnosis and treatment collaboration, ne­o­­natal intensive care units (ICUs), cardiology ICUs, emergency first aid, ve­n­ous thromboembolism, monitoring, nursing and image-assisted diagnosis.

What are some of the challenges encountered while deploying new-age solutions?

  • Complexity: There is a need for multiple services to grow device counts, and a massive increase in internet bandwidth, as well as a need to drive requirements for lower latency, greater determinism and processing closer to the edge of the network. Thus, any failure or bugs in the software or hardware will have serious consequences.
  • Compatibility: Although different ma­nufacturers will be interconnected, the problem of compatibility that arises

wh­­en manufacturers do not agree on a co­m­mon standard will make people buy appliances from a single manufacturer, leading to a monopoly in the market.

  • Security and privacy: Location tracking and collection of inappropriate in­formation on any person is considered a challenge in the use of IoT services in the healthcare system. Patients may have concerns regarding attacks on their personal identity and privacy. Therefore, the influx of big data from millions of sources in the healthcare system can cau­se several security challenges. Mass­i­ve health data devices assemble and com­municate information directly with each other via the internet and the clo­ud, and collect, record and analyse data blocks. But the things or devices that are producing the massive amount of data are blowing out every day, which needs to be treated and managed.
  • Standardisation: The implementation of a unified data structure system across all hospitals is the biggest challenge in the Indian healthcare system, in turn creating a huge challenge in interoperability.

What is the future of telemedicine in India? How is it expected to transform the sector?

As I described before, telemedicine is the core requirement of the Indian healthcare system. I feel this is the fastest way to reach every corner of our nation and even small medical facilities can participate in this. The sector’s economic state, the complexity of connectivity and the population-medical hub ratio all indicate that telemedicine is the most effective solution to the issues of the Indian healthcare sector for the future. Research indicates that the potential for transformation is huge. The usability of mobile healthcare has inc­re­ased by up to 70 per cent. So, we can im­agine the growth.