Wednesday, August 16, 2017

This truly is the future of healthcare in India

If we look at all the industries that have been disrupted by e-start-ups, a few things stand out. First, of course, were the inefficiencies in the prevailing system—low penetration, a demand-supply imbalance, fragmentation of services, ill-informed customers and high costs. Second, and perhaps even more important, is changing the mind-set that governs consumption patterns in these industries.
It is this disruption that is more fundamental and transformational in nature. Before Amazon, no one would have dreamt of buying clothes or expensive gadgets without first trying them on. Similarly, before Airbnb and Uber changed our mind-set; staying in a stranger’s house or travelling in a stranger’s car would have been unthinkable!
Something similar has now started happening to healthcare in India. Consider this: 70% of the healthcare infrastructure is concentrated in the top 20 cities that account for only 28-30 % of the population in India. Additionally, the doctor to patient ratio in India is 1:1700, i.e. much below the standard WHO norm of 1:1000. Add to that, 76% of the population is not covered by a government, individual or privately sponsored health insurance thus, increasing out of pocket expenditure on healthcare for all strata of the society.
Along with these ills are the parochial mind-sets governing healthcare. The approach towards healthcare is very episodic in nature, to the extent that one consults a doctor only when one falls ill. India, infact most countries across the world, lack infrastructure that allows regular monitoring and instant detection of diseases, consequently increasing costs, as patients are charged on a fee-for-service basis, irrespective of the clinical outcomes.
India requires an all- inclusive long-term strategy to strengthen the foundation of healthcare. There is an immediate need to instil a preventive care mind-set across the eco-system comprising of healthcare providers, insurance companies, patients, healthcare and pharmaceutical companies. Additionally, the broken linkages within the eco-system need to be connected for capturing comprehensive patient data required for continuity of care.
But e-healthcare start-ups in India are now starting to change these mind-sets. In the process, they have started a revolution that will not only transform the industry, but make healthcare more accessible and affordable.
Some of this process is well documented by the media, especially when it comes to e-healthcare start-ups that provide information aggregation and e-Consultation, aswell as door-step service to patients. While many platforms offer patients greater choice, they don't address issues of time, travel and costs, at this stage.
However, three of the most disruptive and transformational processes initiated by newer e-healthcare start-ups are less known.
Patient-centric care
What is most interesting is the virtuous cycle that the combination of technology and Big Data has set in motion. Greater usage of digitised services results in capturing more data—structured and unstructured—which, in turn, helps in enhanced analytics and predictive healthcare.
This is allowing patient-centric care to truly emerge. The ability to collect and analyse data in real time and act upon it makes for timely interventions. These, technology enabled, interventions are customised as per a patient’s past / family medical history, lifestyle, economic situation and other circumstances unique to each.
The emerging model of patient-centric care is therefore a hybrid model—Hi-Tech as well as Hi-Touch. The use of technology allows it to provide for care that is personalised, enabling, and co-ordinated and that treats people with compassion and respect across the entire spectrum of wellness, prevention, cure and care.
Preventive healthcare
Perhaps the biggest benefit e-healthcare providers can offer is in the area of preventive health—an aspect almost completely ignored by the traditional healthcare systems around the world. It would perhaps not be unfair to say that while India has been able to establish a medical response system of sorts, it has failed to create a coherent, affordable and sustainable healthcare system.
Traditionally, our focus has been on treating illness when it occurs. This is evident from the alarming rise in preventable diseases such as diabetes, IHD – ischemic heart diseases which, prevented or detected early could shave off a significant portion of India’s disease burden.
This is a focus area for new-age healthcare start-ups. From EHRs as well as tracking the dietary, exercise and sleeping patterns of customers, they can build an information base and then, through technology facilitated Doctor Consultations, counsel customers to adopt healthier lifestyles.
Predictive interventions
By using the latest technologies, e-healthcare start-ups are venturing into realms that were impossible for traditional service providers. Wearables or implanted devices allow start-ups to continuously monitor patients’ health data, also giving these companies a better view of their customers’ lifestyle and health.
Artificial Intelligence (AI) helps structure and analyse the stream of data captured in the cloud by Internet of Things (IoT) devices, and do predictive analytics after comparing it to the patients’ medical and family history as captured in Electronic Health Records (EHRs). This mechanism enables the e-healthcare provider to nip a medical emergency in the bud, often even before it happens—with obvious savings on costs of emergency care and attendant escalations.
With devices, which can monitor and transmit vital data, getting cheaper patients now have a healthcare providers who remotely monitor their health on a continuous basis, rather than the episodic manner of traditional providers.
Tailored insurance services
While it is true that insurance penetration in India is low, it is also growing at a fast clip, especially among the middle-class. Since e-healthcare providers have easy access to patient data and the ability to analyse this data, using cloud services and AI technologies, they are able to recommend insurance plans that are tailored to customer’s needs and circumstances.
We now see the emergence of dynamic and usage based pricing in health insurance that are similar to pricing models that telcos have successfully adopted for reducing complexities.
In fact, traditional insurance companies are increasingly depending on new-age healthcare providers to create viable and helpful insurance schemes for their customers.


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