By Ratna Geetika, Madhu Viswanathan, DVR Seshadri
‘Prevention is better than cure’ is a well-known adage and nowhere is this more true than in primary health. Primary healthcare is a proactive approach to healthcare that emphasises preventive measures, management of chronic conditions and promoting self-care. This approach also ensures timely notification of serious illness and enables overall improvement in public health. While the benefits of primary healthcare are clear, it is easier said than done.
Variation in education, income and priority levels poses a serious challenge to primary health leading to under-allocation of resources. Further, societal norms and beliefs on healthcare and attitude towards regular care also affect the adoption and utilisation of primary healthcare. It is here that technology with its cost and distributional advantages can play a pivotal role in providing accurate diagnosis, managing operations, and facilitating effective collaboration between various stakeholders.
Technology in healthcare can aid the achievement of four basic As with respect to the community it serves. These include Awareness, Adaptability, Accessibility, and Affordability.
Examples where technology has already enabled primary care and wellness centres include:
• Screening & preventive care: Remote diagnostics has made it easy to operate machines that diagnose remote patients and transmit the data to specialist physicians.
• Internet of Medical Things: This technology can reduce the cost of equipment maintenance by monitoring expensive equipment centrally.
• Remote-controlled surgeries: Complex surgeries can be performed through remote-controlled robots in areas where quality healthcare access is poor.
• e-ICUs: These enable specialists based in a centrally-located ‘command centre’ of a super speciality hospital or a specialist ICU care-providing organisation to read the vital health parameters of patients and guide the team stationed in the local hospital to deliver high-quality care.
• Continuous health monitoring: This can be done through telemedicine/telehealth, artificial intelligence (AI), virtual patient care, remote monitoring, and genomics.
Shaping the Future
Digital tools and technologies are proving to be crucial differentiators for timely intervention in disease prevention, helping predict the onset of diseases based on symptoms, as well as design and implement better treatment protocols. Several examples from the Indian context attest to the power of technology-enabled healthcare services:
• Karma Healthcare has been the pioneer in primary healthcare delivery in remote areas, adopting various technology models, which include telehealth, robust quality assurance system, IoT (Internet of Things)-enabled services, and e-Clinics. Their solutions are cost-effective, reliable, accessible, and accurate in diagnosis and treatment.
• iKure delivers primary healthcare, wellness and disease prevention services to remote communities in India through a combination of innovative technology, training and sustainable business models.
• Nanohealth is an enabler of comprehensive healthcare provision by using an integrated technology solution that provides proactive and continuous care to patients, especially in chronic care management.
• Cloud Physician offers remote monitoring and advisory solutions to ICUs of different hospitals. It employs web-based healthcare applications, Machine learning (ML) and AI to analyse patient data and provide timely clinical decision support.
• Niramai offers efficacious diagnosis for breast cancer by employing leading-edge technologies. Its proprietary Thermalytix, powered by AI uses a high-resolution thermal sensing device and a cloud-hosted analytics solution to analyse thermal images. This is further aided by a web interface, SMILE (Software with Machine Intelligence for Life Enhancement), that helps upload demography information about the patient and her thermal images. Testing on more than 4,000 women in 12 hospitals/diagnostic centres and screening camps suggests high levels of accuracy of the company’s solution.
• BrainsightAI merges AI and neuroscience to enable higher precision in the diagnosis of neurological and psychiatric problems in patients. It does so with high levels of accuracy. It provides faster and deeper insights relating to these problems, which, in turn, helps in earlier detection of psychotic disorders.
• Electronic Medical Records (EMR) capture information about patients’ medical conditions, medications and key events, which can be shared on the internet for referrals and timely clinical decision-making.
No More a Luxury
Technology is vital to delivering good quality healthcare services, especially in geographies with a low density of doctors, as is the case with rural India, where most of the Indian population lives. The accessibility of healthcare facilities in India is skewed in favour of the affluent sections of the population in urban India.
India has world-class doctors, clinics, and technologies at the high-end. However, most of the country’s population cannot afford anything better than basic healthcare. Accessibility in remote areas is restricted by an acute shortage of healthcare facilities and professionals. Technology is imperative in such resource-constrained environments to bridge the divide between the healthcare ‘haves’ and ‘have-nots’.
Digital technologies have already opened a plethora of possibilities for shaping the future of primary healthcare in India. They are ushering in a host of changes in policy and practice while creating new patterns of communication, empowerment and engagement among the key stakeholders in the communities served. The use of digital technologies empowers and augments the capabilities of the healthcare workforce and improves the quality of primary healthcare in the far-flung hinterland of India.