Ashvini Danigond, Founder and CEO of Manorama Infosolutions Pvt Ltd (MIPL), is a successful global entrepreneur and tech-innovator working on Innovations in healthcare information technology (IT). She has been conceptualizing, architecting and delivering world-class healthcare solutions for over 17 years. With Master ’s degrees in Healthcare, Computer Sciences and a degree in Law, this enables her in adopting a unique 360-degree command of Data Sciences covering Domain, Technology and Regulatory nuances.
The second wave of the Covid-19 pandemic in India has led to the healthcare system bursting at the seams. The healthcare system has been reeling under various pressures which relate to the comparatively slow speed in adoption of digital technology, and resistance to share ownership data of patient treatment, which have given rise to a considerable number of challenges, especially at the district administration level. This has had a domino effect, whether it comes to planning for maintaining stocks of Remdesivir, conducting vaccination drives, availability of medical oxygen or ultimately bed management in a hospital. It is pertinent to point out that there is no centralised repository available in India to highlight the current status of the health crisis. Generally, the data collected for patients in the country is split between the government and private healthcare systems, this, too, is conducted partially.
The Scourge of Covid-19 and the Healthcare Sector
The novel coronavirus has unveiled the weak links in the healthcare armour. The current Covid-19 cases are being stated to be a mixture of various strains. After proper identification of the first lot of the novel coronavirus strain, a new double mutant strain of the SARS-CoV-2 virus has been detected in India. Similar strains have been detected in more than 17 other countries across the globe. However, the healthcare community in India does not have any statistics available to plan their activities or devise any further course of action.
The shortage in the supply of Covid-19 vaccine exposes uneven digitisation in supply chain and production. For instance, the demand for Covaxin was relatively low at the end of February 2021. Of the seven companies who are licensed manufacturers of this medicine in India, at least 6 lakh doses available with pharmaceutical companies were on the verge of expiry, the production was curtailed. By around mid-March 2021, the situation changed and a rapid rise in demand was experienced as Covid-19 cases started rising.
In this regard, manufacturing companies have enhanced efforts for production, but the cycle to increase production to optimum capacity is 45 days. For India, the maximum number of doses it can produce is around 42 lakh per month.
To add to the issue, the fight against Covid-19 is marred by shortage of medical oxygen in various parts of the country. Take, for instance, a state like Maharashtra has a total production capacity of about 1,150-1,200 metric tons. Out of which, the State government has reserved 80 per cent of the supply for medical use. However, as per a directive from the state chief minister, the medical use had already reached 700 metric tons, which now should be between 850-900 metric tons. So, now 100 per cent will be required to be reserved for medical use and there is an urgency to think beyond it as well.
Digitisation Holds the Key to Broaden Access to Quality Healthcare
The healthcare sector continues to remain badly placed considering the current surge in Covid-19 cases. Digitisation of the healthcare ecosystem and processes remains crucial in order to salvage the situation.
It would be pertinent to point out that in various European countries, Electronic Health Records (EHRs) are an important data resource for research purposes. On the contrary, a country like India continues to be at the nascent stage of adoption of digitising patient records. It may be noted that some of the states have mandated the use of EHRs in public hospitals, this includes a couple of large and specialty hospitals as well who have also adopted the use of EHRs. These health records, however, are generally used to maintain summary records of patients to consider for billing instead of clinical purposes.
Further, only a few population health management (PHM) tools— which involves working to improve the health outcomes of groups instead of individuals—appear to be available with authorities. However, PHM makes financial sense when hospitals are paid capitated rates to care for populations or when it can be used to raise the volume of care delivered.
Similarly, access to health records of patients across multiple settings can be available through health information exchanges (HIE), which aggregate data in a particular region and make it available to healthcare providers through a single interface or Application Programming Interface (API). HIE helps healthcare providers to develop analytical insights to risk-profile their patient populations and in the bargain intervene in a timely manner. For companies engaged in healthcare in India, clinical data management continues to pose a considerable challenge.
It needs to be pointed out that Healthcare Big Data Analytics (BDA) holds considerable potential to improve the quality of care and introduce better efficiency and delivery models by finding the associations from massive volumes of healthcare data, in the bargain offering a wider perspective of clinical expertise based on medical evidence and various tests. Essentially, BDA performs three types of analytics: descriptive analytics, predictive analytics, and prescriptive analytics. The descriptive analytics helps to explore insights, while making healthcare practitioners understand what is happening in a particular situation. Predictive analytics relates to various statistical techniques initiated to analyse and extract key insights from big data. On the other hand, prescriptive analytics is comparatively a modern type of analytics that combines descriptive and predictive analytics. This then when modeled using Artificial Intelligence (AI) and Machine Learning (ML) tools can provide intelligent insights. This would result in better clinical and operational results.
In an effort to enhance accuracy in diagnosis, longitudinal clinical data of individuals is extremely useful and can aid in analysing a whole variety of issues, involving symptoms, pharmaceuticals, and dosage. It would be comparatively difficult for medical professionals to draw the right conclusions without this knowledge.
Going Beyond the Obvious
In India, the need to adopt digital technology to streamline processes such as medical record-keeping, sharing of healthcare data, appointments and other healthcare processes remains crucial in making informed decisions for adopting a particular line of treatment.
Telemedicine and e-pharmacy, envisioned under the National Digital Health Mission (NDHM), have already gained currency as the country grapples with the second wave of the pandemic, which has proved to be helpful for patients living across geographically distant locations.
The introduction of Health Facility Registry (HFR) remains a step in the right direction as well. This will have a live and consolidated database of healthcare resources and infrastructure within the country.
In the larger interest of things, however, it remains crucial to incentivise healthcare providers for adoption of digital healthcare ecosystems as part of their delivery and care models.