Dr Shuchin Bajaj is a serial entrepreneur and investor. He holds an M.D. in Internal Medicine from Rajasthan University and is the Founder Director of the Ujala Cygnus Group of Hospitals. Dr Shuchin Bajaj also heads the Business Development, Branding, Marketing, Fund-Raising & overall management responsibilities within the organisation. Before his stint in Ujala Cygnus Group of Hospitals, he was the founder and CEO of Altius Healthcare (2008-2011) and the Founder Director of Cygnus Medicare (2011-2019). He is the recipient of the British Government’s 2015 Chevening Gurukul Fellowship for Leadership and Excellence award at King’s College London and was also selected for freeship to the ‘Innovating Health for Tomorrow” Fellowship at INSEAD, France in 2017.
With disruption becoming a popular watchword of our times – shaped by technology innovations, supply chain restructuring and shifting lifestyle habits spanning most of our industries – Covid-19 has truly given meaning to the word. Even as the governments, as well as healthcare organisations, are scrambling to meet the ongoing challenge, the outbreak engulfing virtually every corner of the planet has already brought the future of healthcare upon us. How does one picture this future of healthcare?
Resetting of our priorities
Although healthcare is a typically high priority subject in our daily lives, the sheer speed and the scale of the pandemic with its all-round snowball effects has taken that prioritisation many notches higher. As a result, the allocation of healthcare expenditure by governments, including in India, will be raised as a proportion of total output in their respective economies. Additionally, a healthcare emergency force will be a permanent feature of healthcare systems given the frequency of virus/disease outbreaks in recent years. Back in the middle of March itself, the Indian government had declared the outbreak a ‘notified disaster’ mandating the state’s Disaster Response Fund (SDRF) usage for temporary accommodation and provision of food, water and health care for people in quarantine camps. Such ad-hoc measures would acquire a degree of permanency in times to come. At the same time, funding and support for R&D into communicable diseases, epidemiology etc. would increase.
Virtual healthcare/telemedicine no more virtual but ‘real’
Although telemedicine has been increasingly seen as a recent phenomenon, thanks to COVID, it is set to become a predominant mode of how we receive our healthcare. Propelled by physical/social distancing rules precipitating a somewhat lasting behavioural change in our everyday lives, we are likely to increasingly make appointments, seek diagnosis, get testing and receive doctor’s prescription for medication – all on the virtual platform obviating the need for the in-person clinic visits.
In this respect, the issuing of telemedicine guidelines by the government in the wake of COVID to examine and manage patients through teleconsultations leveraging IT platforms such as voice, text, video and data has been a significant development. At the same time, both government and private players are likely to invest heavily into the upgrading or even wholesale overhauling of legacy IT systems so far meant mainly for recording payment of bills. The new IT systems while facilitating remote diagnosis and treatment would record patients’ health history and data incorporating digital solutions such as EHRs/EMRs. Notably, Kerala has made considerable progress in terms of putting EHRs in place.[1] Even some companies have already come up with innovative remote tech-based healthcare. For example, a start-up from Bangalore has built a remote health monitoring device which is being used in quarantine centres in Maharashtra, MP and Rajasthan. In another rather innovative example, one company is even administering chemotherapy remotely.
Nonetheless, an integrated health data exchange network across the country supported by foundational digital health infrastructure in place based on cloud storage and sharing will be the way forward for diagnostics, treatment as also for conducting clinical trials and research. In this context, privacy laws will have to be revisited to enable an exchange of patient/participant data among researchers, universities and healthcare practitioners. There will also be a need for a nation-wide framework to standardise protocols to facilitate the exchange and maintenance of data and patient transfers.
Future hospitals not a building but a network/mobile hospital
Unlike the traditional brick and mortar hospitals, the hospitals of the future will be a modular and scalable network of healthcare givers and community healthcare hubs with a centralised care coordination centre in place. Connected through a unified digital infrastructure, the coordination centre will steer and guide the entire doctor-patient-attendant interaction workflow by way of sending practitioners, equipment and machines, including ICU beds depending on where they’re most needed on a 24/7 basis. While this complete package of future hospitals could be some years away in our country, an IIT Madras-trained start-up has already devised foldable and portable hospital units that could be installed by four people within two hours anywhere. However, in the near future, automated disease screening kiosks, face recognition tech and unmanned reception facilities could become more commonplace.
AI and big data to power the future of healthcare analytics
AI and big data will redefine how health data is collected, analysed and used in the country. Already in action in a limited way, AI is helping healthcare researchers and practitioners in the identification of Corona patients through rapid screening of chest X-rays while also monitoring the progression and the degree of lung infection. It is also being deployed for epidemiological forecasting and contract tracing in collaboration with Google and Apple. Some institutes are even using it for treatment of Covid-19 by repurposing medicines derived from the highest success probability scenario against the disease.
Robotics & automation
With robotics going more mainstream, there will be increased use of machines/humanoids for manual and non-specialist support functions such as record-keeping, delivering food and medicine to patients etc. With time, precision medicine and robotic surgery will gain more traction wherein tiny robots could not only help give doses and injections but also guide in administering general treatment more accurately while allowing a more personalised medicine. Some AI-based medical chatbots are already helping us with basic health and hygiene queries.
Next-generation wearable technologies
Very soon, we would have moved up the technology ladder from fitness trackers and smartwatches to wearable ECG and blood pressure monitor to biosensors which could track data on a person’s movement, heart rate, respiratory rate and temperature. With the help of these wearable devices, doctors would be able to get an update on a patient’s status anywhere anytime enabling better clinical analysis.
Digitisation of supply chain/rise of e-pharmacy services
With increasing digitisation and application of advanced analytics across the value chain, including R&D, manufacturing, quality, supply chain and sales, the pharma industry is set to wear a new look. With the ongoing shift from pay-per-use to value-based care and the need for instant delivery of pharma products regardless of location and time, companies would need to bolster their supply chains, and align with hospitals and care centres evolving new integrated business models also accounting for ePharma. This requires adequate regulatory norms to be worked out. Although the government has come out with draft rules, they need to be notified.
Role of Information Officers will become more salient
With high technology serving as the backbone of the healthcare delivery system coupled with the need for swifter response mechanisms, the traditional hierarchy in healthcare administration will see a change. The role of Information Officers across healthcare organisations will acquire salience.
In all, while COVID accelerates an immediate pivot to contactless care coupled with a surge in hygiene economy, the future of healthcare is filled with boundless possibilities.