Leverage digital technology to improve delivery of health services

Digital technology can have an enormous impact on enhancing healthcare efficiency, access and outcomes, thereby helping to achieve universal health coverage and related sustainable development goals.

India, home to one-sixth of the world’s population, is central to global health. The country has a rich pool of talent in science and technology, but it suffers disproportionately from the global burden of disease.

While tremendous progress has been made in the last few decades in reducing infant and child mortality and improving life expectancy, the public health sector is perennially plagued by an inefficient and inequitable healthcare system that is unable to provide better services. Nearly 80 per cent of the healthcare facilities are concentrated in major cities, and millions of people living in rural and remote areas across the country still lack access to quality healthcare. Besides, healthcare costs continue to rise, pushing many into a poverty trap.

Moreover, the population is ageing, and the nation is in the middle of an epidemiological transition, with chronic noncommunicable diseases rising rapidly, along with the continued burden of communicable diseases. This double burden is putting pressure on an already overstretched healthcare infrastructure.

Against this background, technology and innovation can play a vital role in enhancing efficiency in programme implementation, improving the quality of service and reducing the cost of healthcare, as demonstrated during the Covid-19 pandemic.

We need to shift to a more digital-centric healthcare model. During the pandemic, the people faced many challenges in accessing healthcare. Besides, there was inadequate real-time data to track the evolving situation and plan interventions. With fragmented data and limited data exchange mechanisms, the need for an effective use of technology, such as data analytics, to improve facilities and solve healthcare problems has been felt.

Health informatics technology, including the national web portal and telemedicine, facilitated the delivery of the home-grown Covid vaccine at an unprecedented speed in India. The CoWIN platform helped people fix appointments online for vaccination and then download certificates after receiving the shot. Drones were deployed to deliver vaccines in hard-to-reach areas. A national telemedicine service, eSanjeevani, was launched in the middle of the pandemic in 2020. It saw three million consultations within the first year.

Since then, India has expanded information communication technologies, achieved near-nationwide mobile network coverage and strengthened digital public infrastructure, including the National Health Stack as a framework to create digital health records for all citizens of India.

Experiences in the country and around the globe demonstrate that technology has the potential to help in many healthcare areas, such as patient care, surveillance, data management, communication, information and prevention.

Diagnosis and treatment using telemedicine and teleconsultations, the provision of patient follow-up for treatment adherence in chronic disease conditions, such as diabetes, and using mobile technology and artificial intelligence (AI) for the early detection of cancer can benefit a patient. Further, electronic health records can facilitate the digital sharing of patient information among specialists. These measures can help avoid delays in diagnosis and treatment, thereby reducing the cost.

To ensure health security, web-based disease surveillance, the use of handheld techniques for the collection and transmission of data, big data for predicting epidemics, and data analytics are some applications that can help strengthen the early warning system. A rapid response thereafter can contain further spread, preventing an outbreak in a local area from progressing to a pandemic.

Technology can also aid in capacity-building through distance learning, webinars, online training courses, video conferencing and information-sharing through social media sites.

The most disruptive among newer technologies is AI, defined simply as a simulation of human intelligence using computers. There are many types, including machine learning, which can harness vast open-source data and predict or detect epidemic signals much earlier than traditional surveillance based on case reporting, thereby complementing the ongoing surveillance system. In addition to the detection of cancer at an early stage, AI can play an important role in accelerating a vaccine or drug development process. By overcoming the challenges faced by a weak health system, AI can be both revolutionary and highly sustainable.

Recognising that healthcare costs are growing day by day and that financial and human resources are limited, the concept of appropriate technology — technologies that are scientifically valid, socially acceptable and universally available to all at an affordable price — can help strike a balance between the available resources and the emerging needs.

Initiatives are needed to conduct a gap analysis in terms of the availability of infrastructure, human resources, data management, data security and privacy as well as the skill set needed for this field. The outcome of such an analysis can help develop a national digital health policy and strategy.

It is imperative to have a national policy and a firm commitment to investing in digital technology, which needs to be integrated in all health programmes and healthcare services. In this regard, it is important to build partnerships with the private sector, which offers the bulk of the healthcare provision in the country.

The integration of digital technology and AI into primary healthcare can indeed revolutionise India’s public health system, paving the way for universal health coverage or healthcare for all by 2030. But the availability of appropriate bandwidth is a prerequisite for that.

The nation must prioritise research and the development of new technologies as well as the improvement of the existing ones. Researchers should be encouraged to develop appropriate technologies that promote health, ensure equitable access to these technologies and advance sustainability at the national and local levels. To build a sustainable pool of talent on a long-term basis, we should lay special emphasis on science, technology, engineering and mathematics as part of the education policy.