Solving India’s healthcare mess requires an innovative approachAtul Banga
Here are the five things that India should focus on to be able to leapfrog a lot of healthcare problems that even developed nations are struggling with.
India spends a dismal 4.7 percent of its GDP on healthcare, with the private sector dominating healthcare delivery across the country. The miserably funded and poorly monitored public healthcare sector has resulted in a few private providers getting monopolistic power. These providers have often been under controversies due to concerns regarding high medical costs and unethical practices. High healthcare costs coupled with low health insurance penetration has led to huge out-of-pocket expenditure for patients across the country. Compounding the issue, an astounding 70 percent of the Indian population still resides in rural areas and has very limited access to health providers.
As no stakeholder in the healthcare ecosystem can work in isolation, the healthcare delivery in India needs to undergo a change at all levels.
Below are the five things that India should focus on to be able to leapfrog a lot of healthcare problems that even developed nations are struggling with:
- Public reporting of healthcare outcomes: Professor Michael Porter in his famous article for the Harvard Business Review had argued how healthcare needs a fundamentally new strategy. A strategy which at its core is about maximising value for patients, that is, achieving the best outcomes at the lowest cost. India has a great opportunity of becoming the leader in value-based healthcare. Healthcare providers presently do not get rewarded for delivering value and their brand is mostly independent of the outcomes they are able to achieve.Rather than competing on value, they have just been competing on their claims of having better technology, superior facilities, and a high industry ranking. Policy makers in India can play a vital role in promoting competition by forcing providers to publicly report outcomes and ensuring that the outcomes data is made available to all stakeholders of the ecosystem. To be able to do this, outcome measures and their collection and analysis methodologies will have to be identified and standardised for each health condition.
- Universal system of electronic medical records: Collecting outcomes data would require health providers to make a significant amount of investment on technology. But the focus here has to be on using technology not merely for reporting but for achieving better outcomes at a lower cost. Clinicians world over have frequently criticised IT systems and pointed out that they are not user friendly and interfere with patient interactions. The aim should be to have an efficient IT system that is easier to use and helps clinicians improve the quality of their care. Different IT systems should readily be able to share information leading to the creation of a universal system of electronic medical records.This system will contain every patient’s full medical history and will be accessible to any clinician in any healthcare organisation while still providing privacy, security and autonomy of patient information. Once the data is collected, turning this data into information becomes vital. This data needs to be leveraged to see how clinical processes and protocols can be redesigned and improved. Medical data can be analysed to understand emerging healthcare trends, track diseases, understand health policy impacts, and to determine which treatments are most effective.
- National health insurance system: Policy makers need to address the fact that India is known to have one of the highest out-of-pocket expenditures on health globally. States like Karnataka, Gujarat and Tamil Nadu are providing cashless health insurance but the need of the hour is a national health insurance system. This system should be able to provide economically viable health coverage and reward high quality, cost-effective patient care using the assistance of new age technologies like analytics and artificial intelligence.Health insurers with the help of predictive analytics can analyse patient records and billing to detect claim anomalies which were difficult to predict by previous methods. Policy makers should explore the Aadhaar card’s utility as an effective health tool. Integrating Aadhaar into the healthcare system will help India move further ahead of many other countries in terms of being able to link all the health data. Treatment and transactions would become paperless and frictionless and the probability of fraud will be reduced thanks to the authentic Aadhaar information.
- Telehealth: As illustrated above, around 70 percent of Indian population lives in rural areas where there are insufficient medical facilities. Adding on to the problem, there is a lot of wastage that happens by using physician offices and emergency rooms for treating minor conditions. There is an urgent need to ensure that quality and timely healthcare reaches every nook and corner of the country. Mobility and digital technology platforms have the potential of bridging this deficit by allowing doctors to remotely treat patients in under-resourced areas efficiently and economically. The startup ecosystem of India has a lot of players which are working in this regard. A World bank funded startup, A3MT, remotely connects patients in most unreachable corners of the country to doctors who are able to monitor them throughout the year. Another startup Intelehealth, with the help of health workers, checks symptoms of patients which are then sent to a cloud-based health record system that a remote doctor reviews and makes recommendations on.
- Mobile technology equipped health workers: Last mile healthcare delivery can also be improved with the help of India’s large community of health workers referred to as ASHAs (Accredited Social Health Activists). These workers, if equipped with mobile technology, have the ability of bringing lifesaving care to the doorstep of those living in far-flung areas and thereby augmenting the public healthcare system. Mobile tools can enable ASHAs to provide health services far from the clinical setting and make healthcare more accessible to patients, create new mobile diagnostics, improve the collection of public health data, and improve communication with healthcare professionals.
Solving the healthcare mess that pervades in India is no way a mean task; it would require innovative and out-of-the-box thinking from all participants of the ecosystem.
(Disclaimer: The views and opinions expressed in this article are those of the author and do not necessarily reflect the views of YourStory.)