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 Convergence of IT, engineering, communication systems and facets of artificial intelligence in Indian healthcare delivery are clearly influencing the standards of healthcare in India in terms clinical outcomes and patient safety, according to Dilip Jose, managing director & chief executing officer, Manipal Health Enterprises Pvt Ltd. In an interview with Nandita Vijay, he gives an insight into the relevance of these technologies in the years to come. Excerpts:
How do you view the current healthcare scene in India from a private hospital perspective?
The potential demand for healthcare services in India are clearly visible for many years now. It is the population, large ageing segments, as well as the dual burden of communicable and, increasingly, non communicable diseases. The challenges in translating this latent demand into consumption are around access and affordability. The changes in the past decade or so in terms growth in income, increased coverage of medical insurance and also government run health schemes, have helped bridge this gap to some extent. All players in the entire spectrum of care, diagnostics providers, pharmaceuticals and medical equipment manufacturers have benefitted from the increase in demand.
However, large sections of the society are still well away from healthcare of acceptable quality that is also within their means. While schemes like the proposed National Health Protection Scheme (NHPS) that aims to bring over 50 crore people in its ambit are attempts to tackle this in the medium-term, its success would depend on infrastructure and human resources to cater to this newly induced demand. The private healthcare providers certainly would have a significant role in developing this ecosystem. What needs to be understood yet is the ability of the private players to do it in an economically sustainable manner, as the price points for such schemes are likely to be significantly lower than those prevailing. All in all, it would be interesting times ahead that call for innovation, frugal operations and process re-orientation.
What are the visible trends that are driving the growth of Indian healthcare sector?
One notable trend is the convergence of IT, engineering, communication systems and facets of artificial intelligence, with healthcare delivery. This wave is clearly influencing the standards of healthcare in terms clinical outcomes, patient safety, cost of treatments as well as reach. As the entry barriers of such convergences become lower and adoption becomes widespread, it would be a key lever for growth and improving penetration.
Artificial Intelligence has a great role to play in the healthcare delivery systems and has transformed the industry drastically. Robotic assisted surgeries is being used rapidly across all verticals of healthcare including oncology. Real time tracking in ambulances help doctors to monitor patients during emergencies. Home ICUs and live streaming provide patients hospital like care with apt treatment and timely observations.
The private sector, especially corporate hospital networks, has played and would continue to play, a major role in driving such models and proving the concept in our country. These models, albeit with a time lag, would then encourage replication by other providers making such features and technology available to a much larger segment of customers.
One other trend is the growing interest of international hospital groups and investors to enter India. This is an additional validation of the demand led growth that is expected to persist as geographical spread and affordability improve.
Could you identify 3 challenges in this sector that has impacted the growth of healthcare in the last one year?
Inadequate access continues to be a bane for the sector. With resources, both technology as well as qualified personnel, unevenly distributed across the country; there are large swathes with little or no healthcare facilities. Even fresh investments seem to follow this pattern and therefore the challenge of reach is likely to remain for many years to come. The issue is further exacerbated by the lack of affordability. In fact, unplanned and unfunded healthcare expenditure is a major reason for people slipping into poverty.
Another major challenge is with availability of people. India does not produce the required number of healthcare personnel both medical and managerial. Evidently, this impedes the ability of the sector to grow.
A country like ours with its huge population, morbidity patterns, regional diversities, inadequate healthcare infrastructure and problems around nutrition and sanitation, needs a comprehensive and long-term policy to take us to acceptable healthcare metrics as per the world standards. We are still some way off from such a roadmap and that lack of clarity can only come in the way of growth.
How do you see the Union Government’s National Medical Commission Bill to bring in a transformation in this space in India?
The bill was conceived with the intention of resolving some of the problems in the current system of medical education, more specifically those related to uniformity in standards, transparency in assessing merit of intake, lack of growth in number of type of doctors produced and to bring in a system of ongoing quality assessment of professionals. This purpose of the bill is certainly laudable and there are no two opinions about the need to reform the medical education space. But, what would be really important is to communicate the intent clearly to all stakeholders, take everyone’s inputs and deal with any concerns that any section might have. A uniform understanding of what the Bill provides for and a buy in from all relevant groups would be key to its success. After all, the Government and all others would only want the healthcare sector to do well, as that has far reaching impact on the entire nation.
What is your outlook on the Indian medical device industry and the healthcare start-ups coming out with novel technologies to transform patient care?
With over 70 per cent of the medical devices still being imported, there is a huge potential for India to create strong domestic capability in this sector. This can certainly help reduce the cost of treatment, increase access and develop products that are appropriate to local needs. Programmes like ‘Make in India’ would encourage start-ups and technology innovators to take up this challenge. There are already examples where hospitals and others in the healthcare ecosystem are supporting incubation of ventures of this kind. This can only grow as a trend and success stories start trickling in.
The Budget 2018 announcements and the Ayushman Bharat or the National Health Protection Scheme can boost the Indian healthcare growth. National Health Policy (NHP) and NHPS are the main drivers for achieving the goal of Universal Health Coverage in India. Please comment
The proposed NHPS is an important step towards making healthcare accessible for a large section of the population and is a welcome initiative. While the finer details are still being worked out, it seems that a lot of work has already gone into this. If implemented thoughtfully, it has the potential to significantly change the health indices of the country. As always, a lot would depend on the focus and thoroughness of execution and in taking everyone along – the beneficiaries, providers, drug manufacturers, insurers and medical professionals. A scheme of such importance and far reach can only benefit from a collective goal and teamwork.
State governments including Karnataka have come out with Private Medical Establishment Act, so how would healthcare majors with multi -city investments cope with such regulations?
The Act has good intentions, however as in the case of all such schemes, the success hinges on thought through details and buy-in from beneficiaries, medical professionals as well as hospitals. At this point, many private providers are still waiting to see how the scheme pans out and figuring out ways as to how services can be delivered by them in a sustainable manner.
India is the hub of medical tourism and will it continue to be the focal point for specialty care for developed world?
India with its world-class hospitals, top-notch clinical outcomes and service quality, delivered at a fraction of the cost of that in the developed nations, is certainly a preferred destination for international medical value travel. While a lot of this happens in the metros, with improving international flight connectivity, smaller cities too are witnessing rapid growth in this segment. The price advantage that India offers for such patients is expected to continue and medical tourism would continue to grow. Convergence of technology, as was described earlier, would reinforce this advantage.
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