Dr. Shameer Khader

 

Published on Feb 28, 2017

India accounts for 17.86%of world population. With its unique position as a growing country with a gross domestic product (GDP) of 7.56% and a rapid population growth with 1.252 billion that need affordable, accessible and high-quality healthcare, India is at the pinnacle of requiring healthcare innovations.

 

 

 

Several global economic indicators suggest that the GDP of India is growing irrespective of short-term challenges. However, sustaining the growth and improving the quality of life can only be achieved by improving the quality of healthcare and wellness. India is making significant advances in various areas of science, technology, and economic indices, but the country continues to fight flu, dengue, tuberculosis, hepatitis. The Indian population is predominantly uninsured, with only 17% percent of Indian population have some form of coverage. The cost of care is free or minimal in federally funded government hospitals, medical colleges, and primary health centers.

These public health organizations collectively offer some of the lowest cost of care compared to other countries. Private healthcare providers also play a significant role in healthcare delivery, medical education, and training. The patients often have to wait for non-emergency procedures, and hence patients often rely on private hospitals for faster access to care. India also has a variety of regulated care providers.

Patients seek care from various government recognized medical, functional or alternative medicine practices. For example, a patient could consult a physician for emergency care but later move to an Ayurveda based rehabilitations next week. Here, the transition from one provider to another makes the compilation of healthcare delivery data and adherence to care pathways and medications a major challenge.

While the public health is relatively low-cost, its impact on how it improves the quality, value and the outcomes are very limited. Due to the lack of methods and process for continuous data collection, aggregation, and analytics, measuring the quality of care improvement across complex delivery systems is impossible. Such gaps in leveraging data challenges the healthcare providers and policy makers design, local regulations that could improve outcomes. India needs to develop a unique model for funding nation-wide clinical trials, data-driven strategy to compile and analyze real-time data instead of the manual, time-consuming survey based methods to propel the country to healthcare innovations.

The affordability and adoption of digital technologies and social media including mobile phones, internet connectivity, social network and other emerging technologies are encouraging. For example, India has an estimated digital footprint of 425 million Gmail users, 300 million smartphones, 160 million WhatsApp users and 155 million Facebook users. India could leverage such technology trajectories and digital literacy to build and scale a nationwide, centralized, open, and quantifiable, learning healthcare delivery system.

Building a digital health infrastructure and compiling a nation-wide electronic medical record (EMR) system and big data resource of healthcare delivery would help to understand the factors driving the value acrosshigh volume patient population. Emerging technologies including data science, data visualization, machine learning and artificial intelligence can be then used to develop cost-effective solutions that improve outcomes. For example, strategies need to be developed to predict and mitigate the incidence of infectious diseases. Introducing novel, patient engagement strategies to improve the patient and provider satisfaction from diverse socio-economic and regional backgrounds are key.

While infectious diseases are prevented to an extend due to rigorous vaccine campaigns, strategies should also be developed to help patients to take proactive steps to prevent non-communicable diseases like cardiovascular diseases and

Cancer. Building informatics solutions and gathering healthcare data from public and private hospitals, non-governmental organizations and other agencies should come together to develop a National Health Informatics Policies.

 

 

Such diligent data-centric approaches would further elevate the relevance and impact of various unique public healthcare programs in India. For example, central government funded programs like Jan Oushadhi and various state government led programs offers free generic medications that cover various diseases.

However, the outcomes from such programs, quality of medicines and its efficiency in improving the quality of life of patients are not measured. Designing technological solutions and linking to the outcomes, patient satisfaction surveys, developing portable diagnostics using mHealth applications should enhance and help to gain valuable insights to expand and improve such programs.

Infrastructure to develop healthcare and providing technological advances need public-private investment. Genomic medicine coupled with clinical bioinformatics and translational bioinformatics are emerging as a critical data and analytics approach that could proactively help to predict the health and disease onset on a population scale. For example, in 80’s, the Indian government has launched a unique information technology network to improve bioinformatics research centers.

Expanding these 168 Bioinformatics Centers under the leadership National Informatics Centre (NIC) –  Biotechnology Information System Network (BTISNET) could evolve as the backbone for maintaining a centralized digital medical record and genomic archival centers for the nation. India has recently developed the largest biometric database and unique identification system in the world and received world record for launching the highest number of satellites in a single space mission.

India can leverage most of the existing infrastructure to improve the digital health infrastructure. Linking the Aadhar card with a digital health record in a secure environment could help to compile longitudinal health-related transactions.

Linked data on a population scale could be used to design and develop effective therapeutic, surgical and wellness strategies. Such audacious innovations at the interface of medical research, scientific advances and technology require exceptional workforce.

With 420 medical colleges, 9.29 lakh physicians and allied health professionals the doctor to patient ratio of 1:2000 is low and needs to be improved. India has a high technological workforce with 5000 engineering and technologies colleges with 1.5 million students adding to the engineering workforce annually. Training medical students in engineering and engineering students in biomedical and clinical technologies could also lead to the development of native solutions for various healthcare challenges.

Developing unique MD-PhD programs linking major research institutions and medical colleges and introducing novel MD-ME programs by linking engineering schools and medical schools will help to develop future leaders in this area that requires interdisciplinary training.

Healthcare should be the next frontier for India, to design and deliver innovative solutions and technology would help to scale and finesse cost-effective and high-quality precision healthcare and wellness strategies that improve the quality of the healthcare delivery and outcomes.

About the Author:

Dr Shameer Khader is a leading biomedical and healthcare data scientist and currently he works as a Director of Bioinformatics, Data Science and Precision Medicine at Philips Healthcare, Cambridge.