Smartwatches checking vitals to highlight a potential medical condition. Robots performing medical procedures over 5G networks. Patients consulting doctors over video calls on a mobile phone. A government app helping vaccinate more than 2 billion people during a global pandemic. Twenty-five years ago, such events were in the realm of fiction, at least in India. Today, these are very real, recent happenings.
The adoption of technology has massively transformed the healthcare space in India in the past few decades, with the pandemic further accelerating the trend. What will the space look like in 2047, when India completes 100 years of independence? While it is difficult to accurately predict where the space will be, it is possible to spot a few trends that have emerged post-Covid-19. For instance, people have become conscious of leading a healthy lifestyle, and are ready to spend more on preventive health. Covid-19 also stretched healthcare infrastructure and service delivery to their limits, setting the stage for more investments and the inclusion of advanced technology to combat future pandemics and existing life-threatening diseases.
“Creating a tech-enabled resilient health ecosystem to effectively manage the ongoing pandemic and responding to any pandemic in the future is the need of the hour,” Mansukh Mandaviya, Union Minister for Health & Family Welfare, said in a tweet in May 2022.
Take tele-medicine, for instance. The platform, where doctors can diagnose and treat patients remotely using telecommunications, is one of the first technologies the government deployed during the pandemic. Called eSanjeevani, it is a national tele-medicine service to provide free of cost tele-consultations to citizens for Covid-19 as well as non-Covid-19 ailments. eSanjeevani has clocked around 80 million tele-consultations till December 2022. In less than three years, it has become the world’s largest government-owned tele-medicine platform.
“The pandemic has made it clear that prioritising healthcare is necessary. In particular, it has demonstrated how digital and remote care technologies could revolutionise healthcare in the future,” says Vikram Thaploo, CEO of Apollo TeleHealth.
Incidentally, eSanjeevani is a part of the Ayushman Bharat Digital Mission (ABDM), the government’s digital health initiative. The established under ABDM supports seamless exchange of data across primary, secondary, and tertiary facilities to ensure continuum of care. “For India, simple advances like tele-medicine and electronic medical records will help since this will save travel and expenses for the expanding middle class,” says Dr Anoop Misra, Chairman of Fortis C-DOC hospital in New Delhi.
With the focus on preventive health, there has been an emergence of disruptive models from healthtech start-ups with the adoption of technology. According to a report by advisory firm RBSA Advisors, the Internet of Things (IoT), in conjunction with tele-medicine, has created a new Internet of Medical Things (IoMT), which will come to play a critical role in monitoring and preventing illnesses. AI-driven analytics, tools and machines can help healthcare providers find the right approach for each patient with more efficient, precise and impactful interventions.
Emerging technologies are helping to develop novel, better treatments while lowering costs. Over the next few years, artificial intelligence (AI), data and IoMT will have swiftly expanded from simple devices designed to track vital signs such as heart rate and blood oxygen levels to smartwatches that are capable of even complex scans such as ECGs and smart textiles that can track blood pressure and also predict the risk of heart attacks.
“Apart from physical illness, a growing importance is being placed on developing digital wearable devices that are capable of detecting signs of mental ailments with the use of physical indicators such as sleep patterns, activity levels, and heart rate to detect when a person may be at risk of depression. Wearable medical devices are incorporating some of these functionalities in the coming years,” says Gaurav Bagga, Head of Product & Engineering at Pristyn Care, a Gurugram-based healthcare company.
“Wearables can improve personal wellness because lifestyle disorders like high blood pressure and diabetes are frequently brought on by inactivity or poor dietary choices. However, in order to harness the power of wearables in making healthcare cost-effective and personalised, we require enabling the potential of the network and building a supporting infrastructure,” says Thaploo of Apollo TeleHealth.
“Going forward, hospitals will be the base for acute care and with technology, healthcare will move into people’s homes to provide guidance on their basic medications and wellness,” says Dr Bishnu Panigrahi, Group Head of Medical Strategy and Operations at Fortis Healthcare.
Public health experts believe that India’s healthcare system must strike a balance between offering top-notch treatment in upscale urban hospitals and making sure that the vast rural masses have access to suitable medical facilities. Besides, what will also help will be the easy availability of and access to medical devices at reasonable rates. For that to happen, these need to be made in India. The government has already taken the first step by coming out with a production-linked incentive scheme for manufacturers of medical devices.
Meanwhile, the virtual or remote healthcare space will be key for India going forward. According to data analytics website Statista, the global market for virtual or remote healthcare is expected to be over $450 billion by 2030. A significant factor that will help its growth will be the use of AI. By using AI-based algorithms, patients can connect with healthcare providers or doctors with desired experience and access customised solutions aptly suited to their present health conditions. Data and analytics will play a big role in the transformation of the industry. By enhancing the ability to quickly adapt data and analytic techniques, adaptive data analytics (ADA) is already at the forefront of new-age research in the sector.
Medical experts say that the screening procedure can be sped up and an earlier diagnosis can be made by merging AI with portable screening equipment. “AI and IoMT have become dominant forces in business because they provide more ways to connect and exchange data, as well as the operational benefits that come with them,” says Hari Subramnian, Founder & Director of LifeSigns, a healthtech start-up. “IoT in healthcare and remote patient monitoring are developing in tandem to revolutionise the core notion of patient care. Biosensors will be able to help you make better decisions and keep an eye on your health in the future,” he adds.
But there are challenges. Public health experts say that efforts must be made to ensure the privacy of data and the development of a favourable regulatory environment and policies that prioritise patient care.
Plus, not all the digital elements are connected. According to a report by industry body CII, in India, technology in the healthcare space is used in silos. For a robust mechanism to develop, digital elements need to be connected for applications to run smoothly. “Unlike big hospitals, smaller hospitals and clinics are not able to afford digital systems as they are expensive. Hence, to enable the use of technology, the central government has developed the Health Management Information System where it is in conversation with technology providers to enable the smaller players to store their data in the cloud at a reasonable price,” says the report.
In the next few years, the healthcare space is also likely to be impacted by 5G, which has already been rolled out in some parts of the country. A PwC report says that one of the areas in which 5G shows tremendous promise is remote surgery. With ultra-low latency internet powered by 5G, a healthcare professional could operate on a patient located on a different continent. The report says that this would be done through equipment that mimics the healthcare professional’s movements instantaneously. “Robotic surgeries, deep healthcare management in rural areas and distribution of our centres of excellence, virtual teaching and participative experiments, everything can be done in a distributed way because of 5G,” Sunil Bharti Mittal, Founder & Chairman of Bharti Enterprises, had told BT at the India@100 Summit. And in December 2022, as a taste of things to come, Bharti Airtel and Apollo Hospitals successfully carried out 5G-driven, AI-guided colonoscopy trials.
The PwC report also states that through the use of multiple health sensors, 5G minimises the time, cost and effort involved in R&D trials by ensuring the seamless flow of information from the patient to the provider and then on to research labs.
Besides 5G, another factor that could affect what the sector looks like in 2047 could be omics—collective technologies used to characterise and quantify pools of biological molecules and to explore their roles, relationships and actions. “The service can accelerate drug discovery and development to create cures for patients. It can also transform care by identifying the best treatment or prevention for patients. With the help of genomic data, clinicians can profile individual patients’ tumors or circulating markers in blood and take decisions at the point of care. Usage of technology can bring personalised treatment options for cancer patients even in India,” says Dr Rowland Illing, Director & Chief Medical Officer for International Public Sector Health at AWS. Some parts of the world are already using this service. For instance, Amazon Omics by AWS is currently available in Singapore in the Asia-Pacific region.
Panigrahi of Fortis adds that going forward, patients will be treated based on their genetic profile. “EMRs will help us gather patients’ data and this will be the base on which AI will come into play, directing us on appropriate treatment modalities.”
T he development of the healthtech sector could be key to the transformation of the healthcare space. According to a report by RBSA Advisors, the Indian healthtech market is expected to grow at a CAGR of 39 per cent and touch $50 billion by 2033. The market, which comprises six segments—tele-medicine, e-pharmacy, fitness, wellness, healthcare IT, analytics, home healthcare and personal health management—is currently worth about $2 billion, making up less than 1 per cent of the overall healthcare industry in India, says the report. “Wider application of robotics, machine learning and AI, wearables and on-body devices, blockchain, among others, are going to change the future of healthcare. Cloud infrastructure in healthcare record maintenance and increased focus on digitalisation of patient healthcare records is likely to accelerate further,” it says.
The application of robotics is growing rapidly in the healthcare and medical industry and going forward, wider application of ‘humanless’ systems and technology is expected, especially in surgery, prosthetics, therapeutics, healthcare logistics and pharma manufacturing, among others. 3D bio-printing will find its application in drug testing, living human tissue production, medical research and development, says the report.
But what about funding? “Healthcare booking platforms, healthcare IT and fitness & wellness tech are the top segments in the heathtech sector that have received the highest funding in 2022… Even though there is a decline in funding in 2022 as compared to 2021, funding in the sector is still higher than the pre-pandemic levels,” says Neha Singh, Co-founder of Tracxn, a capital markets company. “The healthtech sector in India can prove to be a big opportunity for investors in the future.”
The healthcare sector, therefore, is poised for growth in the next two and a half decades, powered by tech. Good health, indeed, will be good business.
@neetu_csharma