Digital Healthcare: Untapped Potential for the Last Mile Health Delivery

Dr. Jatinder Singh

Indian healthcare is one of the largest sectors in terms of revenue and employment. The healthcare market is worth US$ 100 billion. By 2020, this is expected to grow to US$ 280 billion that is a compounded annual growth rate of 22%. Healthcare industry comprises hospitals, medical devices, medical applications, clinical trials, health insurance, telemedicine and health insurance. Indian healthcare system includes two components- private and public. Public healthcare involves primary healthcare centres in rural areas and scant secondary and tertiary care institutions in cities. Private sector players provide majorly secondary and tertiary care facilities with more focus in Metros, Tier I and Tier II cities. Private sector has emerged as a burgeoning force accounting for almost 74% of total healthcare expenditure. The growth in healthcare industry is growing due to its extensive coverage and increasing expenditure by Government and private players. Rising income levels, increased health awareness, growing incidence of lifestyle diseases and better access to health insurance are the key contributors to growth. However, Indian healthcare system currently has insufficient infrastructure to meet the healthcare demands, particularly in rural areas. The public healthcare system is underfunded with overcrowded hospitals and clinics and inadequate rural coverage. This has resulted in supply-demand imbalance. There is an increasing incidence of age-related and lifestyle-related chronic diseases resulting from sedentary lifestyles and increase in carbohydrate rich diets. Moreover, our county has one the world's highest numbers of diabetes cases; cited as the diabetic capital of the world.

In India the demand for specialty, super specialty and tertiary care hospitals is very high. During spurt of seasonal disease, there is a broad gap between availability of hospital beds and required beds. Global healthcare organizations have opened their subsidiaries in India, for the reason of cheap labour availability. There is an enormous scope in the sector, but the sector has a slow growth; any new innovation needs extensive testing and regulatory approvals. The Medical Council of India (MCI) Code of Ethics Regulations, 2002 prohibits naming doctors or their credentials on any platform, thus preventing healthcare aggregators spreading their tentacles in open market. Challenges of funding, incubation and regulatory environment hamper their growth. Digital health care is one of the key drivers for reaching the unreached.

Virtual Healthcare

Technology has revolutionized the delivery of healthcare models by increasing the quality of delivery, reducing the cost and also reducing the turnaround time of workflows. Less accessibility of physicians in semi urban and rural areas results in limited healthcare facilities for masses in these regions. Telemedicine is the effective solution for these people by providing access to an extensive range of medical services. Information Telemedicine is a fast emerging trend and many major Indian hospitals have started telemedicine services and ventured in public-private partnerships (PPP). Telemedicine services in our country are valued at US$ 7.5million currently; this is expected to grow at a CAGR of 20 percent.

India is slated to become a global healthcare hub with the conglomeration of world class hospitals and skilled medical professionals; it is now the preferred destination for medical tourism. With the advent of increased technology penetration, Startups will increase medical tourism business. Startups are playing a predominant role in giving access to information to global patients about the multispecialty hospitals services and the cost of treatment. India's competitive advantage is in its vast pool of skilled healthcare professionals. India is also cost competitive compared to Western and Asian countries. The cost of healthcare services like surgery is about one-tenth of that in the United States or Europe. This has given immense opportunities to the multispecialty hospitals in the medical tourism space. As per to a sectoral outlook by Accenture on India, India hosts 150,000 medical tourists; this number will see a rise of 15% every year. Affordable cost medical innovation is attracting investment in domestic sources as well as foreign companies.

Blockchain

Blockchain technology use interoperability in healthcare organizations and create decentralized record systems with multiple locations. This can be shared with relevant stakeholders in the healthcare system. Specific set of standardized data can be stored directly on the blockchain for immediate access, when required. Patients' details like medical history, immunizations, procedures, services rendered and other preliminary data can be captured through blockchain technology. Blockchain can solve healthcare industry's problems by shared data-sharing and enabling an industrywide shift to value-based care. This has enormous potential. Blockchain provides proof of existence for every stored document. Patient health information, electronic health records and medical insurance claims are crucial for ensuring appropriate healthcare intervention. Blockchain technologies come in useful as the information is recorded and encrypted. With blockchain there is one single record thus reducing duplication or tampering of data. There is no third-party intervention or an administrator; this reduces overhead costs. Blockchain technologies can also be used in pharmaceutical supply chain. Each medicine throughout the entire supply chain can be traced, thus the counterfeit drugs will be total eliminated. Data is the new fuel. Valuable algorithms can be made to find better therapeutics, clinical research and clinical trials. A permissioned blockchain could collate data and studies across different research organizations which can be accessed by every researcher on the ledger A real-time access to data will removes data reconciliation process and end-to-end connections of the research can be established.

Healthcare Startups

Healthcare services are unorganised in India in terms of patient's connectivity to doctors, laboratory services, disease management, medicine delivery etc. Currently, healthcare sector has witnessed many Startups; most of them have created a platform for patient and doctors. India being a large and diverse county, there is a tremendous scope for penetration and innovation. Our healthcare services are largely skewed towards urban areas. We are short of doctors as there are just 0.6 per 1,000 inhabitants, and many medical disciplines lacks specialists. The fact that rural India accounts for over 70 percent of the population, is a potential demand source. Healthcare Startups have large scope to revolutionize healthcare services in rural areas by providing affordable and accessible healthcare solutions via innovation and technology. The trend has moved to more segments; Startups are now evolving in areas of fitness, health monitoring, medical device suppliers, hospital management systems, delivery of medicines, and of late, they are also in home healthcare services. Many Startups are providing personalized services to the consumers. The aspirations of consumers are increasing in terms of value with quality driven care. Many Startups are providing solution via wearables, IOTs, mobile devices enabling data collection for better health management. With the emerging digital technologies, health parameters of the patients like blood sugar levels, blood pressure, heart rate, etc. can be monitored on a single click. As consumers are becoming more aware of life style diseases, preventive healthcare is the new feature. Large numbers of Startups are venturing in this domain and there is greater adoption of preventive healthcare using technology-based devices. Many of them are working on building a central infrastructure by connecting consumers, physicians and hospitals with diagnostic labs chain and link data, communication and payments.

There is an investment opportunity of US$ 25-30 billion as our country requires 600,000 to 700,000 additional beds over the next five to six years. With this demand for capital, the transactions in healthcare industry will witness an exponential increase; Startups are going to be a game changer in this space by providing innovative solutions for accessibility and affordability. Of late, India has emerged as the hub of Startups, as many entrepreneurs have brought new technologies in different sectors. Healthcare Startups are showing traction guided by innovation and disruptive thinking in healthcare delivery models, technology-enabled online healthcare services and diagnostics. India serves as the fastest growing Startup base worldwide with ever growing B2C Startups in the health-tech sector.

With increasing number of HNIs, seed funds, incubators and other PE funds, the Healthcare Startups are on the growth trajectory and will be boon for the healthcare sector. Many incubators are supporting Startups that solve problems like practice management, drug discovery and medical technology devices. With increasing number of consumers in healthcare and increasing cost of healthcare services, India with its young tech-savvy entrepreneurs has emerged as a pivotal centre for Startups for frugal healthcare innovations. Startups use existing infrastructure and networks of people to reduce capital investments and operating costs.

Nonetheless, Indian health-care is witnessing an increasing trend towards innovations; many more initiatives are required to solve the healthcare issues faced by large and diverse population. There is an urgent need for a unified strategy that fosters sustainable innovations for encouraging Innovative technologies and Startups to enter and flourish in this sector. This is the only solution to serve the last mile customer.

(The author is Director, PHD Chamber of Commerce and Industry, New Delhi, E-mail: jatinder@phdcci.in)

Views expressed are personal.

(Image Courtesy : Google)