Robotic Surgeries can turn into double-edged Swords

How tech-savvy, digitally-native, and open for change are Indian hospitals when compared to their global counterparts?

Indian hospitals are increasingly becoming more tech-savvy and digitally capable, strongly intending to adopt modern technology. However, it’s important to consider the economic factors and differences in the scale of operations. In India, doctors often see a significantly higher number of patients daily compared to their counterparts in countries like the US. Cost considerations also play a major role in technology adoption. While some Indian hospitals are more advanced than those in the West, direct comparisons can be challenging. By and large, Indian hospitals are competitive and driven toward enhancing their digital capabilities.

Who is your focus when deciding on any technology change- the patient, the doctors or the regulators?

The focus depends entirely on the solution’s purpose. If the technology aims to increase clinical adoption, doctors are the primary focus, as they are the end-users. For solutions related to patient engagement, the user interface needs to be intuitive and pleasing to enhance the patient experience. Meanwhile, if regulators are the focus, the solution should meet compliance and data security standards. Ultimately, understanding the target audience’s needs drives the design and implementation of technology solutions.

Given the rising threats and incidents like those involving AIIMS and ICMR, we emphasise network security to prevent intrusions.

What spurred the idea of an AI assistant- was it tested before? How did you wield it in an Indian context? Are outcomes worth sharing?

AI assistants, similar to those we use in our daily lives like Alexa or Siri, inspired the healthcare version. The aim was to ensure that doctors could focus on patient care without getting bogged down in administrative tasks. Voice-to-text technology has proven effective, even in Indian languages, thanks to advances from tech giants like Google and Microsoft. Although healthcare remains universally similar, integrating regional languages has been crucial for success in the Indian context. The outcomes have been promising, enabling doctors to manage high patient loads more efficiently.

How do you ensure accuracy and privacy in QR-sample collection and other data-collection systems?

We’ve adopted a multi-layered approach to data security, including the use of token numbers instead of patient identifiers in QR codes. This ensures that sensitive information isn’t displayed publicly. Moreover, all data stored is encrypted both in transit and at rest, using zero-trust solutions to prevent unauthorised access. This setup ensures that patient data remains secure and private at all stages of its journey.

What have you introduced in CRM recently?

To increase patient engagement and loyalty, targeted patient-reach to reduce patient coordinator workload, and enhance efficiency – We have synced our HIS (Hospital Information System) with a patient engagement platform. It enables patient post-discharge follow-up, patient medication management, automatic reminders, health-improving suggestions, educational materials, and videos that help patients get better at home. It also covers help for patients in appointment booking, rescheduling, inquiry, and wait-listing for unavailable doctor slots.

Even though robotic surgery is getting popular and requires a lot of training for the clinicians it may become difficult to practice non-robotic surgeries and also restricts their move to another hospital where Robotic surgeries aren’t available.

Anything on the Doctor’s side?

Yes, to save physicians’ time, increase patient footfall, and support Clinical Decision an AI-based assistant is introduced into HIS application. Using conversation b/w patient and doctor, the assistant enables automatic case-sheet filling, a suggestion of diagnosis, lab test, radiology test, medication, treatment as well as auto-generation of prescription in a single click.

Is CRM in healthcare different from CRM in retail? In terms of caution on zero-party and first-party data areas as well as interoperability issues? Especially after the AIIMS and ICMR incident? Can you zoom in on how network security is strengthened at this hospital?

Yes, CRM in healthcare is fundamentally different because patients aren’t looking for promotional offers or loyalty rewards. Healthcare CRM must focus on patient needs and treatment histories with utmost sensitivity to privacy concerns. Given the rising threats and incidents like those involving AIIMS and ICMR, we emphasise network security to prevent intrusions. Our systems are designed to maintain a secure separation between hospital networks and public internet access.

A Checkpoint report recently estimated the average number of weekly cyber-attacks in Indian healthcare at over 6900- is it because this sector holds all kinds of data (financial, PII, sensitive medical, insurance, and family data)? Is it because Indian hospitals lean towards outdated technology or because of the increased use of digital surfaces?

The healthcare sector is a prime target due to the vast amount of sensitive data it holds, including medical records, financial information, and personal identifiers. While outdated technology plays a role, the real issue lies in the rapid digital transformation, which often creates vulnerabilities that attackers exploit. Securing this data with robust cybersecurity measures is essential to mitigate these risks.

Does compliance accelerate the road to technology or does it introduce some necessary friction in healthcare?

Compliance often catalyzes technology adoption by making manual data handling practically impossible. Standards like JCI or NABH push hospitals to embrace digital solutions, ensuring data is consistently captured and monitored. However, the flexibility of compliance requirements should be considered to cater to different healthcare settings, allowing technology adoption to be more tailored and less rigid.

What are you most proud of in terms of technology’s role in this hospital? What gaps remain? What’s happening next?

We’re most proud of our advancements in making technology a seamless part of clinical workflows, ultimately aiding doctors without distracting them from patient care. Gaps remain in the areas of technology adoption and personalisation of solutions for diverse user needs. Looking forward, we see AI, machine learning, and robotics reshaping healthcare, helping deliver precision medicine, and supporting remote consultations, especially in underserved areas.

How crucial and easy is ecosystem compatibility in initiatives like your international patient connect platform and international patient consultations? Do APIs help?

Ecosystem compatibility is essential for the smooth functioning of platforms like international patient connect and consultation services. APIs play a significant role in ensuring interoperability, allowing different systems to communicate effectively and share relevant patient data securely. This streamlines the process, making international patient care more efficient and seamless.

How far are Indian hospitals from complete robotic surgeries - what have you learned about the good side and the challenges of this area with Da Vinci Xi Robotic-assisted surgeries?

Davinci robotic surgery is available in a lot of hospitals and with a lot of our partners. Hospitals or clients were actually using it. But one thing which can’t be ignored is the cost part of it so it’s still not affordable. One thing which also needs to be kept in mind - How does the hospital monetise it because doing efficient surgeries doesn’t mean that they can charge high amounts. Or is it something that they can advertise which is an additional cost over the robotic surgeries - that they can say that we will be able to send the patient back - let’s say instead of four days in three days? Hence the idea to charge a premium. I don’t think so. Hence, even though robotic surgery is getting popular and requires a lot of training for the clinicians as well as the clinicians who get trained on these devices. It may become difficult to practice non-robotic surgeries and also restricts their move to another hospital where Robotic surgeries aren’t available. Hence this is a double-edged sword.

Surjeet Thakur

CIO, Rajagiri Hospital, Kochi

By Pratima H

punams@cybermedia.co.in