HEALTH MATTERS. When our health sector goes digital

Shanthi Devi is a self-employed woman living in a small village in Aragonda, Andhra Pradesh. In her mid-fifties she is another unfortunate addition to the burgeoning list of people with non-communicable diseases in India. Her diabetes and hypertension need constant attention and she requires regular medical checks and tests.

Being in the hinterland meant she would often travel up to 80 km a day to get to the nearest medical centre with reliable equipment and a trained set of doctors and nurses. Often she was told to maintain her dosage or make just minor tweaks for which the daylong journey would have to be endured.

Two years ago, we started a new initiative for this region called Total Health. The intention was to provide holistic services that would take care of an individual’s physical, mental and social well-being. Telemedicine services were introduced which, for the first time, connected all the villages in the district to our hospitals in Hyderabad. Today, Shanthi Devi and many others need not travel 80 km to get medical advice. They walk to their telemedicine centre, avail of a remote consult, and ensure that their disease remains in check.

Telemedicine has been a boost to Shanthi Devi’s productivity and has also helped reduce the cost of care. This simple, yet revolutionary mode of delivery of care is a game-changer for the health delivery mechanism in our country.

In 2000, when President Bill Clinton inaugurated India’s first telemedicine centre at Apollo Hospitals, Hyderabad, it marked the first nascent steps of a move towards newer and more unconventional methods of delivering care. Today, telemedicine and its offshoots — telepathology, teleradiology and medical transcription — are fast changing the paradigm of healthcare delivery.

Our study of the Total Health model found that by providing telemedicine and other services, there was an 85 per cent reduction in travel by inhabitants of the districts’ villages to bigger cities for treatment.

Similarly, our initiative to connect 15 remote locations in Himachal Pradesh though a tele-link has ensured that medical services are on offer perennially. These regions usually remain inaccessible for over six months in a year.

We were also very fortunate to partner with the government in its newly launched telemedicine scheme, SEHAT. Through this scheme, we are endeavouring to provide access to medical services to over 60,000 Common Services Centres across the country. This initiative is the single largest telemedicine outreach programme of its kind in the world.

These and other such initiatives are small yet significant steps in ensuring quality medical services are accessible to every Indian — irrespective of where they live. The provisioning of and access to medical services cannot be a “post-code lottery” whereby where one resides determines what level of health services is on offer. With technology and the optimum use of resources geography can become history.

The signs of tremendous growth in health technologies are encouraging. A recent KPMG-FICCI report has predicted a compounded annual growth rate (CAGR) of 20 per cent for telemedicine services alone, from $8 million today to over $19 million in five years.

This will offer access to more Indians in the years to come. While telemedicine has fast become the mainstay of health technology deployment for the delivery of services, there are many other areas that are at the cusp of becoming disruptive innovations for the industry.

The move towards mobile phone and tablet platforms for a whole host of services is becoming a reality. With a tele-density of 77.2 per cent and with 970 million subscribers, India is one of the world’s fastest growing telecom markets. What is often not highlighted is that rural tele-density in 2015 stands at an impressive 47.78 per cent. This offers unique and ever-expanding opportunities to use the mobile phone as an enabler for health services.

Disease surveillance and management, maternal and infant education, awareness on prevention of NCDs and vector-borne diseases can all be enabled through SMS-based communications, videos and messaging services for the rural population. Further, mobile phone applications offering aggregator services for medical professionals, delivery of medicines and availability of diagnostic and test reports are set to enhance efficiency of services and also ensure faster access to medical treatment. The government must encourage application development in the health sector with a fund set aside to encourage young entrepreneurs in this field. Further the government’s MUDRA scheme should help extend credit to health technology entrepreneurs.

Similarly, the digitisation of medical records can be enabled under the Digital India initiative. The Digital Locker scheme launched in July looks to enable digital empowerment by providing cloud-based storage for key documents. This should be expanded to include standardised and easily accessible medical records.

Electronic medical record systems such as HealthConnect in Australia, SPINE in England, AORTA in the Netherlands, EMRX in Singapore and others have had a profound impact on the quality and continuity of care. As India moves towards a common platform on electronic medical records, I appeal to the entire healthcare fraternity to adopt a common platform and ensure its quick deployment for the benefit of all Indians.

The need to innovate in healthcare is both a challenge and an opportunity. There is a huge supply-demand gap in health infrastructure and human resourcing for the sector. With 80 per cent of doctors, 75 per cent of dispensaries and 60 per cent of hospitals in urban areas, there exists a great distortion in the distribution of health infrastructure. Similarly, the bed, doctor and nurse per 1000 ratio remains abysmally low. While focus on capacity creation and hard infrastructure development are key to reducing these imbalances, we also need a ‘mobile phone moment’ in Indian healthcare.

The advent of mobile phones in the early 2000s changed the way telephony could reach the masses. This inflection point ensured that we leapfrogged into the club of trillion-dollar economies. We need a similar movement for healthcare.

What the mind can imagine, technology can deliver. The government has provided focus and impetus to technology through its various schemes. This comes at a critical time for India. The disease burden of NCDs is set to become the single biggest economic, social and health challenge for the country. The erosion-productivity impact calculator (EPIC) model used by the World Economic Forum and the Harvard School of Public Health predicts that the economic burden of NCDs is likely to be $5 trillion between 2012-30. India can ill afford this huge hit on our nation’s growth and productivity.

The healthcare fraternity needs to ensure that we take advantage of the enabling policy environment to help create new technologies and innovate for a billion Indians to access quality healthcare. By 2030, no Indian should have to travel over 100 km to access healthcare. The investment in healthcare and technology should reap the digital dividend for all Indians.

The writer is the founder-chairman of Apollo Hospitals Group