Health 4.0 in Indian Healthcare and Coronavirus on World Health Day

What is Health 4.0, what has Indian government done to achieve this healthcare vision and how are the  industrial houses helping India to realise this vision? Read on to find out.

Scope of Health 4.0

In this system, modern, emerging technologies technologies are integrated with available data along with the use of artificial intelligence to create a healtchcare industry based on predictive analytics. This is an advanced system over Health 3.0 in which technologies were used to deliver healthcare solutions, but the usage of emerging techs and predictive data analytics was either absent or minimal. In Health 3.0, EHR systems were designed to store data accurately and to capture the state of a patient across time. It eliminated the need to track down a patient's previous paper medical records and assists in ensuring data is accurate and legible. In Health 4.0, predictive analytics based on emerging tech such as AI, ML are integrated with the EHR. Further, IoT devices are being used and the usage of telemedicine is expanded across a wide geographical area.

While Health 3.0 allowed the enhanced availability of real-data, Health 4.0 focuses on extracting important information and analysing these details to deliver healthcare services and solutions. The data portability is increased and an integrated analytical ability to access and interpret data from anywhere, anytime is enabled. There is also a focus on proactive preventive measures based on predictive analytics of the data.

“Today we have predictive risk models which predict the risk % of patients having a cardiac arrest or having any chronic medical vulnerability. Predictive models are becoming the necessary tools to fight against illnesses. This enables early clinical.”

--Arvind Sivaramakrishnan, Group CIO, Apollo Hospitals

Technologies are useful for Health 4.0 are AI, ML, Robotics, Cloud Storage Platforms, advanced printing and screening machines, Big Data Analytics, Telemedicine, IoT enabled healthcare devices and Data Security solutions, among others.

With the increase in the need for the emerging tech, Health 4.0 also demands an increase in the skilled professionals who can manage these technologies and provide predictive analytics insights. Further, medical professionals have to be enabled with the tech skills to be able to provide medical advice in this emerging tech-enabled pre-emptive system.

“We are investing in technologies such as telemedicine, virtual healthcare consultation, digital symptom checkers, etc. We have chatbots trained with advanced modelling to understand and take queries in this situation and help people access better healthcare.”

Dr Satish Prasad Rath, Chief, Innovation & Research, Aster DM Healthcare

It is to be understood that Health 4.0 is not so much a part of medical service, but it is more of an industrial endeavour to extend emerging tech and predictive analytics to the field of medical service. The entire medical service landscape has to re-modelled to accommodate this industrial endeavour.

It is also being argued that a dehumanised medical system may be detrimental to its receptivity by the patients or the potential people needing healthcare in an emerging-tech environment. Hence, it is being argued that a mixed system of integrating human doctors to the IT platforms that manage the technological aspects of Health 4.0 would be more viable.

“Predictive models are coming to this fore during the epidemic, but they are heavily dependent on the data that is being fed into these models. What we need doing forward are robust data models, that will be useful in capturing, parsing and putting the data into data lakes for getting accurate analytics. Our data capture on the ground remains a big source of concern.”

Dr Vikram Venkateswaran, Editor, Healthcare India & Member, IET  Healthcare Working Group

Indian Government Efforts

Indian government had been taking steps to digitise healthcare since the 1990s. In 2010 the plan for Health 3.0 was formulated. The current government decided to raise the expenditure on healthcare from the erstwhile 1% to 2.5% in 2020. Further, in January 2020, it brought out a National Digital Health Blueprint. It has a vision to link the private and public health sectors in the primary, secondary and tertiary healthcare domains, so that a corroborated data can be collected and analysed. Health records are to be fed into an electronic database system, in which other directories such as State Databases of healthcare professionals, inventories etc are to be integrated into this single national electronic database. This vision is based on a three-tier availability of infrastructure – country-wise internet connectivity, health centres across the country in every single locality and trained healthcare professionals. The long-term vision is to being the country at par with the scale of Health 4.0 by 2030.

"People in rural areas and in small towns own smart phones and can access the internet using it for both communication and work, even if they can’t read their medical data.”

– Ravi Ramaswamy, Sr Director, Healthcare Philips Innovation Campus

Further, the government links the healthcare vision to the goal of sustainable development of the country this means that healthcare should not be developed in isolation of other problems. NHP, the National Health Portal of India includes in its goal to work with other departments to remove poverty, provide quality education, gender equality, clean water and sanitation, affordable clean energy, employment, sustainable cities, protection of consumers and products, peace justice and strong institutions and climate action, among others. Thus, the government’s vision of Health 4.0 is not limited to healthcare, but it is an integrated vision that includes other dimensions of lives of the people of the country.

“Governemnt should evolve a clear strategy to enable Public Private Partnership in the diagnostics to achieve quality advanced diagnostics at affordable rates and better clinical results.”

--Dr GSK Velu, Chairman & MD, Neuberg Diagnostics 

It is essential to be aware of the challenges involved in this vision of healthcare. In a country like India, various segments and geographical regions are in different stages of healthcare facilities. To bring them all on a single parameter is a monumental task and requires large amount of financial and skilled human resources. It also requires either a transfer of large-scale transfer of technologies from abroad, or a monumental innovation of technologies inside India. For the first, large amount of revenue outflow has to happen. In present times of downsliding economy of India, this is further going to place a burden on the Indian treasury and on the people. The second is not possible in a coming near future.

Another challenge is that this kind of vision of healthcare is not going to be affordable for most people in India, who don’t have the purchasing capacity to spend on this very expensive healthcare system. In order to make this healthcare system affordable for everyone in India again requires some ingenious thinking on the part of the government to evolve strategies that can work in a short period of time. Whether the government can meet these challenges remains to be seen.

“The COVID-19 pandemic has had a wide reaching effect across businesses globally. However, the IT industry continues to support critical functions for healthcare, banking and backend IT for government services.  We can also help the government in a lot of areas, especially in remote and telehealth management, as Tech Mahindra has an expertise in these services. In fact, the government has been forthcoming in enabling the IT industry to ensure continuity of these services.”

--Venugopal Reddy Kandimalla, Senior VP, Global Head, Healthcare & Life Sciences, Tech Mahindra

Coronavirus and Health 4.0

The disparate situation of India’s healthcare has become evident with Coronavirus outbreak in India, which has claimed more than 100 lives so far. By an estimate, if 1% of the Indian population gets critical and needs ICUs and isolation units, India would need 1.3 Crores of ICUs and isolation beds. This would be apart from the units needed to serve other critical patients. The reality is that India does not have 1.3 Crores ICUs and isolation beds. If such a scenario happens, ICUs and isolation beds would have to be taken away from other patients and given to Coronavirus patients. In small towns and rural areas, situation is even grimmer. This reflects upon what kind of efforts are needed to make India compliant with Health 4.0. Large-scale strategic planning, efforts and resources are needed to execute such a plan. Besides, dedicated and skilled workforce is required to make Health 4.0 a reality in India.

“The pandemic has led to a healthcare crisis globally. At the same time, it has also triggered the demand for digital solutions and innovation in technology to empower healthcare providers with revolutionary applications and solutions. We believe technology will be a key driver in Health 4.0, enabling functions like telemedicine, data collection and analysis, individualized healthcare options, disease prevention and quicker diagnosis for designing targeted responses and holistic treatments. We expect technologies like Artificial Intelligence of Things and Machine Learning to boost the healthcare sector and create a system that enables effective collaboration between individuals and healthcare providers. We believe the government is committed to boosting healthcare through IT. Authorities are striving to make innovative technology available, as can be seen from the number of control rooms and centres that have been set up to contain the spread of the epidemic.”

-- Rajiv Bhalla, MD, Barco India

The good news is that there have been efforts from the industry to help the government build a healthcare system that is in line with the vision of Health 4.0. Healthcare India from Deloitte is making efforts in data collection and data management. Aster DM is also involved in investing in emerging-tech enabled diagnostic systems, using AI and other techs. Prominent hospitals such as Apollo are using predictive analytics to arrive at diagnostic decisions. Tech Mahindra and Barco India have also made significant investment in developing emerging tech enabled healthcare diagnostic systems to help the government.