India has always been a country of paradoxes. As of Jan’21, India had a population of 1.4 BN people, 1.29 BN Aadhaar digital biometric identities, 1.1 BN mobile connections, 761 MN smartphones, 624 MN internet users (45% of country’s population)*.
No doubt, the country has made great strides in:
We would probably consider these as very strong signs of a developed / advanced nation. But, Despite all such developments, India’s:
Healthcare is considered an integral non-income component in any measure of economic development. India’s Digital Health Mission seeks to challenge and change the entire Healthcare ecosystem.
*Datasource:DigitalIndiaReportbyDatareportal,uidai.gov.in,Statista
Addressing the poor level of Health Outcomes will be foundational for India’s progress. Efforts to improve the quality of care are particularly challenged by the lack of reliable data on quality and by technical difficulties in measuring quality. Ongoing efforts in the public and private sectors aim to improve the quality of data, develop better measures and understanding of the quality of care, and develop innovative solutions to long-standing challenges.
The National Digital Health Mission has set up powerful objectives to accelerate progress towards UN Sustainable Development Goal 3.8 of Universal Health Coverage, uplift the healthcare scenario and improve the quality of care.
Spanning across Personal Health Records, Tele- medicine and E-Pharmacy- the new healthcare shift is offering promising opportunities.
The improved health outcomes would bring increased productivity and in turn, an additional benefit of $200- $250B to India’s GDP” over next ten years*.
*Source:BostonConsultingGroup
The Key players in this paradigm shift are Government, Health Professionals and Insurers and an Emerging breed of Health-Tech startups (to play an increasingly central role in driving innovation. The Digital Health Mission is already creating multiple opportunities, both at the macro and micro levels.
However, India continues to highlight multiple paradox and challenges within healthcare sector. While there is a simultaneous success and failure, healthcare is clearly on a sustainable edge.
Sources:OECD.org,NationalHealthProfile2019,IBEFblog,BusinessToday.In
India tremendously lags in quality of medical care, with relevant information at point of care also lacking.
India has the opportunity to move forward using the HIMSS EMRAM 8-staged Maturity Model as a roadmap which comprises of 7 levels encompassing everything from Ancillaries to EMR.
Yet, the Healthcare sector has been grappling with very slow adoption rates of an HMS / EMR.
“Electronic health records were never a technology challenge but an adoption challenge, which only dissolves when clinicians realize the potential of EHR or when there is mandate either from a top management or from the government,” – Prashant Singh, Director and CIO at Max Healthcare.
The Challenges in adoption were primarily on the financial considerations of high costs of procurement and maintenance. Designing of the system without considering fundamental (e.g. number of clicks just to prescribe a sleeping pill) and well- known standards and medical codes such as:
International Finance Corporation (IFC) panel discussion (Sep’20) called out key aspects of EMR in emerging markets.
Ensuring affordability of EMRs in emerging market will be important. Flexible pricing structure for different facility sizes needs to be designed and offered. Cross subsidization across large systems and smaller facilities is another option. This could also be achieved through local government initiatives and funding.
Think global, act local for EMRs. Use international libraries like ICD 10 and others. Data should be transmittable for research and development. Standards should be global.
Hospitals should be a combination of both digital/paperless and paper based for now. Some services can be completely paperless, but in some, it must be a combination. Hospitals should try to be paperless as much as possible and have a timeline for eventually going fully paperless.
In India’s context, the adoption of EMR has been drastically low. This is due to a) several gaps in the system, b) lack of awareness & computer literacy, c) perceived high cost of implementation, d) lack of technological resources, e) complicated EMR interfaces and f) legacy issues to adopt new systems. The usage of EMR is limited to the big corporate hospitals in the metro cities and some select states and districts in India
These challenges must be tackled head on, especially with initiatives like Ayushman Bharat presenting a valuable opportunity for building a person-centered health system. When this system is fully implemented, Ayushman Bharat will be the world’s largest healthcare program that’s digitally driven.
With all said, multiple drivers indicate that Healthcare sectors will be the one to create value and impact.
Source:SMERGERSIndustryWatch–IndianHospitalSector
Health IT providers can help their clients address questions by being a bit more in tune with the innovation that is available to them and adopt that in a nimble, agile manner. You don’t have to deploy everything at once, but if you have a vision and implement in succinct stages, I think that will help the market get to where they need to go.
It’s not about regulatory clicks; it’s about care delivery anywhere and technology addressing the cloud, mobility and Internet of Things that will allow patients to achieve wellness through participating in their own health management – moving them along an awareness to wellness continuum.
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