Healthcare is getting a tech boost

EY Tech Trends series

Chapter V: Healthcare is getting a tech boost

Tech innovations signal lower costs in healthcare but higher access and quality.

This is part of the EY Tech Trends series wherein each chapter will focus on the rising shifts in key technology areas and the impact of these technologies across sectors.

In brief

  • While digital healthcare and telemedicine came into focus during COVID-19, they are now the future of healthcare.
  • Ayushman Bharat Digital Mission AI-enabled handheld and point of care cancer screening devices, imaging-based algorithms, digital pathology, and other developments are expanding the role of AI.
  • Both physicians and patients are now more confident in using digital services, but the government needs to strengthen the format of the policy.  
  • Among the new lower-cost higher-access channels of delivery, the number of daily teleconsultations have stabilized but are still five to six times higher than pre-pandemic levels.

The last two years of the COVID-19 pandemic have accelerated the growth of digitization and technological innovation in the healthcare sector in India. From the ambitious healthcare initiatives of the union government like the Ayushman Bharat Digital Mission (ABDM) and the National Health Stack to technological innovations like healthcare omnichannel platforms by many private players, telemedicine consultations in the public and private sectors, artificial intelligence-based IoT tools for diagnosis, targeted treatments, and monitoring, the healthcare sector has moved to “phygital” (physical+digital). Along with these advancements, trends like 5G, digital twins, and metaverse are all set to create an entire range of new channels for delivering care that have the potential to lower cost of care and vastly improve access, quality of care, and patient experience.

Digital public goods

The deepest influence of digital healthcare has been on government programs. Rolled out on 27 September 2021, the Union government-sponsored digital public good (DPG) project ABDM has already crossed 268 million Ayushman Bharat Health Account (ABHA) numbers, 28 million digitally linked health records, 170 thousand registered health facilities, and 97 thousand registered doctors and healthcare professionals. While the government dubbed it as the UPI of healthcare, the program’s transformative influence on the healthcare system is probably far more than UPI’s impact on financial technology. Similar to the way that multiple services could be built on the basis of the Aadhaar card, the core of ABDM is a scalable, interoperable public goods stack that starts off with an ABHA number (similar to the Aadhaar number) for patients coupled with the creation of an integrated platform that covers healthcare professionals and health facilities including hospitals and diagnostic players.

The ABDM facility allows a unified health interface and storage of personal healthcare information in a standardized and shareable digital format that healthcare facilities and professionals can access. ABDM has a value proposition for hospitals, doctors as well as for pharmacies. For hospitals, it will enhance the OPD experience of patients with faster registration through their phone using a QR code and ABHA, where the patients can enter their details. This will also extend to the admission and discharge processes. Additionally, the program is likely to provide a significant ease of claim processing and receivables management for hospitals, starting with settlement of claims under the Ayushman Bharat program. Doctors will benefit from ease of being searched, ease of using teleconsultation as a channel for patient connect, efficiency in follow-up and referral process and access to patient health records in an organized manner. For pharmacies, there will be benefits in terms of ease of discoverability, ease of tracking patient prescription, creation of standardized drug registry, visibility of drug level demand at PIN code level, and ability to collaborate with pharma companies on last mile data.

ABDM’s public dashboard provides near-real-time information, such as ABHA numbers, Healthcare Professionals Registry and Health Facility Registry. It acts as a one-stop window for information on the Mission’s progress at the state level. 

Integrated with the government’s telemedicine service portal eSanjeevani, ABDM will help patients share their health records with doctors. This will help convert the anonymized patient health data generated as part of the ABDM program into data models that can be used to develop predictive risk profiles and trends on changing disease patterns across different parts of the country, which can then be used to guide targeted policy intervention measures. The single, interoperable platform would have enough flexibility to absorb newer technologies and services as they become available. 

ABDM is an example of platform thinking that can re-engineer today’s chaotic and sub-optimal healthcare ecosystem into a tight, highly efficient network that allows one-touch access and spurs innovative services. It is also likely to give a fillip to startups seeking to disrupt the healthcare sector using technology.

Telemedicine and AI

The severe constraints in access to healthcare facilities and professionals triggered by COVID-19 witnessed much needed respite when the union government issued guidelines in March 2020, allowing remote consulting over A/V and text-based platforms. While teleconsultations had commenced in India well before the pandemic, the government impetus led to much wider adoption of this channel for patient connect across different ecosystem players. 

While there was a significant surge in teleconsultation appointments during the peak of COVID-19 in 2020 and 2021, the number of daily consults has currently stabilized, albeit at five to six times higher than the pre-pandemic levels. It is estimated that approximately 1.5 to 2 lakhs teleconsultation appointments are conducted on a daily basis in India, of which close to 50% is currently represented by eSanjeevani. While teleconsultations have grown in India in comparison to pre-pandemic levels, its penetration is a meager 0.5% of total consult volumes in the country. Given that more than 50% of Indians are smart phone users, 60% are internet users, and 50% are 4G subscribers, there definitely exists potential for increased penetration of teleconsultation-led doctor appointments. The ramp up of the government led eSanjeevani platform is testimony to that. Further, with 5G technology around the corner, virtual experiences are expected to improve significantly, driving even faster adoption.

In an aspiration to transform into comprehensive digitally enabled primary healthcare providers, teleconsult platform players are now expanding their services to also include online diagnostics, online pharmacy, and electronic health record services. With the expanded basket of offerings, digital players are transforming themselves into omni-channel platforms, garnering a higher share of wallet from patients and also enhancing their stickiness/preference by serving as a one-stop solution. 

Overall, both physicians and patients are more confident in using digital services, but the government needs to strengthen its policy support format. While the government had earlier given a broad set of approvals for telemedicine practice, the National Accreditation Board for Hospitals and Healthcare Providers (NABH) has initiated work on Digital Health Standards for accreditation of Telehealth providers. 

In the endeavor to provide access to quality diagnosis and treatment options at the right cost, AI-powered technology interventions have witnessed progress and early success. There are AI-enabled handheld and point of care breast cancer and cervical cancer screening devices, imaging-based AI algorithms that help in faster screening of abnormalities, AI-based digital pathology specially in complex departments such as hematology and histopathology, and AI-based speech to text technology for faster creation of patient medical records. The role of AI has expanded well in the field of healthcare and various pilots and proof-of-concept studies are constantly being undertaken. We do see the emergence of partnerships currently as well as in the future between various ecosystem players including governments, private/trust-based healthcare providers, insurance companies and health tech players to leverage AI-powered technologies for improved access, enhanced quality, and reduced cost of care. 

Summary

The healthcare sector in India is going through a wave of digitization and technological innovation. From huge government healthcare initiatives, such as Ayushman Bharat Digital Mission and the National Health Stack, and teleconsults to AI-based tools for diagnosis, targeted treatments, and monitoring, the healthcare sector has become “phygital”. To benefit from these developments and build on them, partnerships are fast emerging between governments, private healthcare providers, insurers, and health tech players to leverage AI-powered technologies for improved access, enhanced quality, and reduced cost of care.   

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