The Changes in the Indian Health Infrastructure
The regulatory policies in India surrounding health have evolved very quickly over the last year. There has been a fast-tracking of the process of applying for clinical trials, quick approval on diagnostic and RT PCR kits and the launch of Telemedicine Practice Guidelines 2020 by the Ministry of Health and Family Welfare.
There is also a huge focus on preventive care, not just treatment, as well as a sizeable increase in using evidence and data to accelerate innovation and a change in risk mitigation strategies and the way risk-based monitoring is done in clinical trials.
The use of technology to gather and make data more accessible and usable is one of the biggest changes in the Indian healthcare system. We’ve incorporated wearable devices and digital apps that directly upload data to secure cloud platforms so that patients in clinical trials can participate from home rather than traveling to study sites.
The Role of Technology
Companies across the spectrum — from clinical research firms to hospitals — are adopting novel technology platforms to make healthcare more accessible to patients who have limited access due to geographic distance, transportation issues or other barriers to visiting a healthcare facility in person. Parexel, a global clinical research organization and biopharmaceutical services company, quickly adapted to pandemic lockdowns by employing telehealth visits, wearable sensors, direct-to-patient drug shipments, electronic patient consents and technology platforms such as Clinbase to enable remote clinical trial monitoring.
“At the start of the pandemic, Parexel rapidly shifted traditional trials to decentralized and hybrid approaches to maintain clinical trial continuity and ensure patients continued to receive critically needed medications,” says Sanjay Vyas, Senior Vice President, India Country Head & Managing Director, Parexel. “As a result of our rapid response, we have been awarded 150 Covid-19-related studies for the treatment and prevention of the virus.”
SRL Diagnostics, which launched 15 RT-PCR Labs last year along with several new labs and 150+ collection centers, has made dramatic progress on the digital front. The company uses AI tools like chatBot to respond to simple queries like rescheduling and order status and to automate and expand their customer support team while maintaining rapid proactive communication with customers/partners. This reduced patient waiting times and drove immense traffic to the SRL mobile app and website. Over 2.5 million patients have made their appointments through the app and 75% reports are being digitally accessed. “We have also set up a Digital Pathology network in Mumbai, Gurgaon and Bangalore which allows our technicians and lab doctors to read images remotely, enabling real-time virtual collaboration between their multidisciplinary care teams,” says Anand K., CEO, SRL Diagnostics
As per the firm, future laboratories need to join hands with healthcare networks and with other healthcare providers which will play a key role in delivering quality patient care. To address the pertinent challenges in the healthcare space, ‘Diagnostics of the Future’ need to be driven by R&D, design thinking, and smart technology based on a foundation of smarter, safer, and sustainable labs.
According to the Accenture Digital Health Technology Vision 2020 report, 90% of health executives believe that to compete in a post-digital world, organizations need to elevate their relationships with customers as partners. Technology will provide the easiest solutions to make the above possible.
Multidisciplinary hospital, Hinduja, introduced video consultations from April 2020 and introduced services like tele-triage and [email protected] packages for patients who were isolated at home. The hospital started doing post-operative rounds using technology and did webinars for patient education and engagement. In terms of operations, patient tracking is digitized, the hospital uses an HMIS (Health Management Information System) to maintain all service details and medical records and a Lab Information System (LIS) for the lab department.
“We will be introducing new patient services like AI based solutions for digital consortiums, robotic process automation and predictive analytics in addition to expanding our VR based therapies,” says Gautam Khanna, CEO, P. D. Hinduja Hospital & Medical Research Centre. The hospital will also be collaborating with more partners in the ecosystem like ambulance providers, pharma companies, medical device manufacturers and emergency medical services.
69% of healthcare organizations are piloting or adopting AI. As per research conducted by Accenture, human-machine collaboration, along with including AI in the process and feedback loop, enabled explainable, more trustworthy results. When machines start doing simple tasks, people can work at a higher cognitive level—and the need to work 24/7 reduces.
Healthcare organizations must look at the new skills needed to enable smooth interactions between human and machines, and the workforce models needed to support these new forms of collaboration.
Tools For Healthcare Professionals
A technology firm like Wolters Kluwer is making a huge effort to support all stages of a healthcare professional’s journey with a digital learning experience and critical decision-making tools. MBBS students start out by using the company’s digital learning resources and as they become postgraduate students conducting medical research, they rely on the firm’s knowledge platform, Ovid, for access to scholarly content and evidence-based answers to medical questions. Applications like UpToDate and 5MinuteConsult aid practicing doctors in evidence-based clinical decision support, while Medi-Span reduces medication errors in hospital settings.
The firm has been working closely with government institutions to improve healthcare systems. “Our team in India has been working with medical institutes like the All India Institute of Medical Sciences (AIIMS), New Delhi, where UpToDate is being extensively used by doctors to deliver evidence-based care. We also work with organizations such the National Medical Library of India to enable students, researchers and practitioners in government medical colleges across India to access the latest peer-reviewed medical research through the Ovid platform,” says Shireesh Sahai, CEO, Wolters Kluwer India
Self-Reliance in Manufacturing
According to PM Narendra Modi, Production-linked incentive (PLI) schemes which are targeted at boosting domestic manufacturing and exports under the Make In India and Atmanirbhar Bharat programmes are expected to increase manufacturing output by over half a trillion dollars over the next five years. The sectors that the impact will be felt in are – electronics, automobiles and pharmaceuticals.
In the pharmaceutical sector, Fermenta Biotech is the only manufacturer of Vitamin D3 in India and has completely backward integrated its value chain by bringing in technologies for manufacturing cholesterol, the key starting material for Vitamin D. This has enabled the firm to provide a sustainable supply of Vitamin D for customers and end consumers.
“India’s heavy dependence on its neighbouring countries for Active Pharmaceutical Ingredients (APIs), intermediates and Key Starting Materials (KSMs) is a weak link in the value chain of our curative health as well as preventive health (such as vitamins) industries. Indigenous manufacturing, supported by the government through its Production Linked Incentives schemes, and implemented by the industry by enhancing capacities and capabilities for synthesis of APIs and KSMs, is the way forward,” says Prashant Nagre, CEO, Fermenta Biotech
Thus, from operations in various organizations in the healthcare sector to manufacturers of pharmaceuticals, technology is going to be essential in organizing processes and making healthcare more accessible. With the National Digital Health Mission (NDHM), patient medical history will be intact and remote health services will be available at scale but India will need robust 4G and 5G connectivity across villages and cities to make it a success.