The increasing adoption of technology solutions has transformed the delivery of healthcare services. Advanced technologies such as internet of things (IoT), artificial intelligence (AI), and augmented reality and virtual reality (AR/VR) are catapulting India’s healthcare sector into an integrated, efficient and patient-centric space. These technologies have pervaded the sector and enabled services such as telemedicine, e-pharmacy, personal health management and others.

The outbreak of Covid-19 pushed healthcare providers and consumers into the widespread adoption of health-tech services, and the arrival of Covid-19 vaccines is poised to further catalyse this momentum and ensure safe and efficient delivery. Moreover, the National Digital Health Mission, launched by the Government of India in 2020, is expected to bring in a digital revolution for the health sector. This will help in changing the focus from curative care to value-based care, promoting wellness and well-being.

A look at the digital health ecosystem in India…

Digital healthcare landscape

The digital healthcare market includes different segments such as mHealth, tele-health, electronic health records (EHRs), remote diagnostics and healthcare analytics. According to the India Brand Equity Foundation, mHealth is expected to dominate the market with a 40 per cent share by 2024, with tele-health in the second place. This will be fuelled by the rising demand for health and fitness apps to monitor daily activities.

That said, the ever-increasing importance of digital health and healthcare technologies has led to massive capital investments lately. In January 2021, MFine raised $16 million in a funding round led by Heritas Capital, with participation from the Singapore-based family office of Y’S Investment Pte Limited. In February 2021, Remedico, a health-tech start-up focused on providing mobile telemedicine, raised Rs 40 million via a bridge round investment led by Achieving Women Equity (AWE) Funds, LetsVenture and several angel investors. In the same month, Bengaluru-based digital healthcare platform MediBuddy announced the closure of its $40 million Series B funding round. Earlier, in June 2020, it had raised $20 million.

Further, in the third quarter of 2020, the total venture capital (VC) funding for digital health companies in India stood at $4 billion, with 195 deals. This was up 43 per cent quarter on quarter from the $2.8 billion raised across 161 deals in the second quarter of 2020, and a massive 100 per cent year on year from the $2 billion raised across 155 deals in the third quarter of 2019. Digital health consumer-centric companies topped the chart, accounting for $2.7 billion or 67 per cent of the sector’s total investments during the period. Further, tele-health companies received a record $1.4 billion in 41 deals in the third quarter of 2020, compared to the $962 million raised in 50 deals in second quarter of 2020, recording a 50 per cent quarter-on-quarter rise.

Government’s digital health mission

With the aim to develop the backbone needed to support the integrated digital health infrastructure of the country, in August 2020, the government unveiled the National Digital Health Mission (NDHM). The NDHM is based on the National Digital Health Blueprint prepared by the Ministry of Health and Family Welfare to create a framework for the National Health Stack, proposed in 2018 by NITI Aayog.

The mission, set to be rolled out in phases, envisages the creation of a few core digital systems to support a timely, safe and affordable healthcare ecosystem in which the country can progress towards universal health coverage. The key components of the NDHM include a health ID, a personal health record (PHR), the DigiDoctor, a health facility registry (HFR) and an electronic medical record (EMR).

  • Health ID: The Health ID will be used for the purposes of uniquely identifying persons, authenticating them, and threading their health records, with the informed consent of the patient, across multiple systems and stakeholders.
  • DigiDoctor: This is a single, updated repository of all doctors enrolled in the nation, with relevant details such as their names, qualifications, specialisations, registration numbers with state medical councils, years of experience, the institutions they received qualifications from, etc. Each of these doctors will also be assigned a free digital signature, which can be used for prescribing medicines.
  • HFR: The HFR is meant to be a single repository of nationwide health facilities, which will be centrally maintained in order to store and promote the exchange of standardised data from both public and private health facilities in the country. The registry will allow health facilities to create and update their profiles periodically. They will also be able to e-sign documents such as patient records, apply for empanelment, and more.
  • PHR: A PHR is an electronic record of the health-related information of an individual. It conforms to nationally recognised interoperability standards, and can be drawn from multiple sources while being managed, shared and controlled by the individual. A PHR differs from an EMR because the control of the information is with the individual.
  • EMR: An EMR is a digital version of a patient’s chart. It contains the patient’s medical and treatment history at a single health facility. The EMR is being envisaged as a comprehensive view of a patient’s health information at a given facility.

The challenge of the digital divide

Termed as a potential game changer for the nation, the NDHM is expected to face obstacles, especially in rural India. The building blocks of the NDHM include two layers – infrastructure and data hubs. Given the unequal access to internet services in rural India, the problem of slow speed and the lack of all-pervasive digital health resources can impact the implementation of the mission.

According to recent data presented in the Lok Sabha, as of December 12, 2020, NDHM used only Rs 5.2 million or 50 per cent of the Rs 10.6 million allocated for creating health IDs in 2020-21. Further, in the six union territories where pilots for this project were launched, 805,674 health IDs had been created till February 12, 2020.

Thus, in India, which is yet to fulfil the basic goals of healthcare, the implementation of a digital health effort must be evaluated thoroughly.

Emerging tech trends

Telemedicine

Telemedicine has witnessed a great thrust amid the Covid-19 crisis, which has accelerated the use of tele-health resources. Patients in remote locations can easily access and obtain any kind of clinical service through telemedicine. The technology allows specialised professionals in urban locations to provide emergency and intensive care services to hospitals in rural areas. Besides, it enables remote monitoring of patient health by collecting and sending medical data through electronic means for immediate interpretation.

IoMT

The internet of medical things (IoMT) is enhancing operational and clinical efficiencies and revolutionising the delivery of healthcare services in India. With the help of IoMT, professionals are able to track the progression and treatment of diseases, monitor patient health, and alter their medication accordingly. Further, this enables professionals to track patients’ medicine usage and ensure adherence to treatment plans, and provides real-time information on disease symptoms.

AR/VR

AR/VR can significantly enhance the delivery quality of tele-health. These technologies have been a big help for the sector during the Covid-19 pandemic. From enhancing patient and provider visits to helping educate medical students through procedure simulations, AR/VR has been turning science fiction into reality.

AI

AI helps in creating a personalised environment for both patients and healthcare service providers. It is transforming the approach to diagnosis and paving the way for faster and more precise methods of conducting surgeries. Further, the Covid-induced need for touch-free interactions has the potential to boost the clinical uptake of natural language processing, a branch of AI that allows computers to understand spoken remarks. Meanwhile, automated services such as symptom-checking chatbots will continue to ease administrative bottlenecks.

Improving the pace of Covid-19 vaccination

While 2021 has provided hope with the arrival of the recently approved Covid-19 vaccines, the secure, safe, and equitable distribution of these vaccines still remains a challenge. In a bid to ensure the efficient distribution of the vaccines, healthcare organisations are deploying strong data analytics and real-time tracking platforms. Advanced technologies such as blockchain, IoT, radio frequency identification tags and 2D bar codes are being used to track the vaccine supply, prevent counterfeiting and ensure last-mile delivery. In India, the union health ministry has developed a free digital platform and mobile application, CoWIN, to monitor the nationwide real-time delivery of the vaccines. CoWIN is an upgraded version of the Electronic Vaccine Intelligence Network, which is an indigenously developed technology. Health-tech will also be useful for post-vaccination supervision.

The way ahead

The digital health market is expected to record a massive spike on both the demand and supply sides of the ecosystem. Going forward, a focus on making the technology-enabled healthcare ecosystem a backbone for healthcare services will benefit India in solving several existing challenges.

By Shikha Swaroop