Viewpoint

Dr. Jeroze Dalal, Head – Medical & Clinical Operations, GSK
- On Digital Health Technology – The next Big Thing in Health Care

With the rise of Digital Technologies, Indian healthcare has started embracing digital health records, telehealth and Artificial intelligence (AI). India is the second biggest populated nation on the planet with 70% living in rural regions. To make healthcare accessible to majority of its rural counterparts Indian Govt. has taken several initiatives in terms of Digital Health Interventions. Technology in health is changing rapidly. Some of the current developments in technology that are applied to digital health care AI, telemedicine and Block chain Technology. But given the slow rate of adoption it may take longer to make their presence felt in India. India is an information rich country because of huge number of patients. However, there are no short cuts to build digital health in a methodical, coordinated and integrated way.

Traditionally, medicines and treatments have been created on a "one-size-fits-all" basis, with trials designed to optimize drugs for efficacy with the highest number of patients with the lowest number of adverse side effects. Modern technology, including genomics, AI, and digital twins, allows a far more personalized approach to be taken, resulting in treatments that can be tailored right down to the individual level.

With the increase in lifestyle related diseases, today people are living longer. The burden on existing healthcare systems continues with shortage of healthcare professionals. According to the Indian Journal of Public Health, India had just 4.8 practicing doctors per 10,000 populations and in villages the ratio is the lowest possible. Overall, healthcare is getting more expensive and too exclusive and so it is not synced with the needs of the people in rural regions. Building a firm foundation in digital health today is a necessary pre-requisite to enjoy the benefit of future growth. Although India has taken major steps towards providing better healthcare to its people, the country still is overwhelmed with several other problems like growing populace, increasing Non Communicable Diseases (NCDs), absence of requisite infrastructure, restricted access to healthcare facilities, non-adherence to treatment and non-availability of healthcare professionals. Technology and digital health will bridge the gap here.

Healthcare services lean heavily towards the urban areas even though the population makes up only about 30% of the total population. This small number enjoys access to over 60% of hospital beds while the rural population have access to only a third. And, with the pandemic in full swing, rural areas are bearing the brunt as they scramble to tackle COVID-19 by banking on a fragile healthcare system. Despite the doom and gloom, there’s a sliver of hope, thanks to technology and digitization. 2020 has already see digitization take healthcare by storm. The Indian government’s release of Telemedicine Practice Guidelines has also spurred the growth as it has legalized telemedicine and teleconsultation. I believe Remote Healthcare and Telemedicine are areas where technological advances have made a huge difference in our rural places.

We have seen a significant rise in number of telemedicine users. According to a report by Practo, 5 crore Indians chose online healthcare during the country-wide lockdown from March to May 2020. 80% were first-time users of telemedicine and 44% hailed from non-metro cities. Another report by McKinsey Global Institute estimated that if telemedicine were to replace in-person consultations, India could save as much as $10 billion by 2025. For the first time ever, India now has more rural internet users than urban ones. According to a report released by Nielsen and Internet & Mobile Association of India (IAMAI): 227 million internet users vis a vis 205 million in urban areas. Smartphone use is rising as well with mobile internet usage higher than desktop, laptop and tablet use across rural and urban areas. Meanwhile, as much as 68% of rural India’s internet population are active users. Although that’s lower than in urban regions, (thanks to low-cost internet connections and increased connectivity), delivering digitized healthcare has been easier. Of course, quality connectivity is still an issue in many areas and there’s a lot of ground to cover. With the current pandemic and future health scares pushing for connected care, there’s hope that this will improve. The pandemic has even seen the establishment of “virtual hospital wards” where a centralized team of professionals can oversee the treatment of numerous patients, all in their homes. Telemedicine has the potential to improve access to healthcare especially in rural populations. But this is dependent on winning the public’s trust – there are some situations where many people still feel an in-person interaction with healthcare professionals is required, so providers will need to consider this when implementing services. Digital Twins & Simulations are becoming popular involving creating models informed by real-world data that can be used to simulate any system or process; again, will make a big difference to those living in rural areas. This trend encompasses the idea of the "virtual patient” – digital simulations of people that are used to test drugs and treatments, with the aim of reducing the time it takes to get new medicines from the design stage to treatment stage.

In future it is likely that we will see methods to deal with patients safely and remotely expanded into other areas of healthcare, such as mental health and the provision of ongoing follow-up care for patients recovering from operations and major illness. Robots and the IoT are integral to this trend, and smart technology (machine learning) will alert professionals when sensors detect that intervention is needed or cameras spot that an elderly person has had a fall in their home.

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