Far too much illness and uncertainty, and far too many disruptions have characterised the Covid-19 pandemic. With the onset of new waves of infection and emergence of variants, we are confronted with the same question repeatedly – what’s the future of ‘brick & mortar’ healthcare delivery system, and how will we ensure the resilience of healthcare systems?
Each time we have been hit by a new wave or by reinfections, there has been a pause on visits to hospitals, elective surgeries get postponed and even routine vaccination schedules get thrown out of the window. All steps and interventions towards preventive healthcare or chronic disease management are first to be displaced or put on a backburner.
The only silver lining in all this, is the seamless healthcare provided through digital healthcare tools. The pandemic has compressed digital transformation timelines in healthcare to 6-12 months, from earlier estimated 4-5 years.
India has emerged as one of the biggest adopters of digital healthcare– nearly 80 % rise in consumption of digital healthcare services after Covid-19. Aarogya Setu & Cowin have achieved global recognition for contact tracing and streamlining digitalized vaccination processes for our 1.3 billion population. Start-ups and innovations that emerged during the pandemic, be it personal wearables, 24*7 tele-medicine, robotics and 3D printing, or process automations, AI(Artificial Intelligence) & ML(Machine Learning) based predictive tools, all have put digital on a fast track and are transforming healthcare like never before.
There is no turning back, as digital healthcare has improved healthcare outcomes, processes and is building more equity. Covid-19 has given us a moment to rethink healthcare in ways that will help us reach those whose needs and access issues were not being catered to earlier. India’s 900 mn active internet users by 2025, rising tele-density and increasing smartphone base, augurs well for digital healthcare apps and tools. This in turn should lead to more value based, equitable healthcare.
Here is an illustration on how value-based care will get a boost through digital health care modules. India has approx. 77mn people, who are diagnosed with diabetes. This has made India, the diabetes capital of the world. Usually the focus is on episodic acre and it is the patient who visits the doctor with an issue. Digital healthcare is transforming these mechanics and design of healthcare delivery. Diabetes focused apps can connect patients with doctors, give them regular reminders for medicine compliance, updates such as dietary or exercise counselling, at low cost and across geographies. This implementation of continuum of enhances patient experience and standardises outcomes, cost of care, and treatment delivery through a collaborative chain of activities.
This is particularly beneficial to those living in remote or rural parts of our country, where the doctor-patient ratio is dismally low- often just one doctor per 25,000 population. It is estimated that innovative healthcare solutions like tele-medicine could save India between USD 4-5 bn every year, replace half of in-person outpatient consultations, and reduce the cost by 30% less than equivalent in-person visits. Reduced waiting time, on-demand doctor availability, no infection risks, EMRs availability, have all increased the demand for digital health.
Digital apart from strengthening the iron triangle of cost, quality & access, will go a long way in streamlining the supply side- reduced administrative burden on providers, real time updated registries & repositories of doctors and other healthcare workers, availability of full medical history of the patient to consulting doctors, and better time management for doctors who can spend more time on patients. In the not-so-distant future, a software platform could emerge as the biggest provider of healthcare, creating a smart bed less hospital just as Airbnb has emerged as the biggest hotel chain without owning any rooms.
However, for the future of healthcare to be successfully anchored in omni, we need to bridge the digital divide. For instance, 47% of global population is not using the internet, & the cost of available broadband exceeds affordability targets in 50% of developed countries. Similarly, in lower income economies, only 32% of population has basic digital skills.
We need to address these underlying issues of lack of skills, connectivity, affordability and accessibility. Multi-stakeholder participation is the way out, along with upskilling healthcare professionals in digital tools, sustaining investments, and providing conducive policy support. Initiatives such as the National Digital Health Mission (NDHM) are timely and will provide necessary support for integration of digital health infrastructure in the country.
What stands out most in digital health ecosystem, is that it empowers the patient, who can now make informed decisions about treatments basis medical history, lifestyle preferences and other factors. It offers immense opportunities to integrate continuum of care with insurance and pharma, and thus reduce drops offs in patients’ funnels from diagnosis to treatment. Providing digital health access and tools to all could go a long way in accelerating our mission towards achieving Universal Health Care, that leaves no one behind.