Despite the central government’s intentions of increasing its healthcare spend, the second wave of Covid-19 could not save the lives of thousands of people. Worldwide reports and experts say that digitization, with the help of technologies like AI and ML, can save developing economies as India.
What India hoped to achieve
In 2021, the Centre allocated Rs 2.23 lakh crore for healthcare, about 137% more funds than in the previous year. With this increased spending of Rs 64,180 crore through the Prime Minister’s Atmanirbhar Swasth Bharat Yojana, the country hoped to improve the healthcare sector and meet the national health policy target of 2.5% of the GDP by 2025. This new format was to run alongside the existing National Health Mission. The programme was to improve the primary, secondary and tertiary healthcare systems, strengthen the national healthcare facilities and create new infrastructure for new and emerging diseases.
The PM scheme planned to set up around 17,000 rural and 11,000 urban healthcare centers across the country. To enhance the pharmaceutical sector and attract foreign investors, the allocation to the Production-Linked Incentive (PLI) Scheme was also increased. All this was in line with the concept of Atmanirbhar Swasth Bharat.
But several questions remain
Yet, the second wave of Covid-19 scenario is forcing people to ask questions, such as: Are we Atmanirbhar? Is it enough to merely increase the budget for healthcare and set up new infrastructure? What about the overall ecosystem required for running a successful healthcare facility for a country of 1.39 billion people?
The world scenario
The world has witnessed how the healthcare systems of several developed nations broke down during the deadly Covid-19 virus spread. The US health system with its robust infrastructure, connected ecosystem and advanced technological tools failed to support the crisis adequately due to a marginalized payer system, lack of rural healthcare, unaffordable medical facilities, and systemic inequities.
The scourge exposed the weaknesses in the UK health system, too. People linked with the UK’s healthcare staffing industry witnessed a nurse shortage at NHS, an overburdened social care workforce and a widening demand-supply gap due to Brexit.
In spite of all the lacunae and existing inequities, the leadership in developed countries aligned their infrastructure and priorities to vaccinate their population. According to a USAIDS story dated March 10, 2021, developed countries are vaccinating one person every second.
Issues faced by developed economies during Covid-19
- Societal inequity
- Unaffordable medical facilities
- Shortage of frontline healthcare staff
Where exactly did India fail?
But India, despite being the largest vaccine producer, did not plan its production in large quantities. According to Dr Gupta of IIHMR, this was primarily due to a poor demand forecast and lack of anticipation of a severe second wave. During March, April and May 2021, India lost thousands of people to Covid-19 due to lack of oxygen, hospital beds, medicines and basic healthcare infrastructure.
The country did not have access to single-source information, but was forced to rely on scores of WhatsApp messages, self-help groups, corporates, and voluntary information. The country’s health systems—both private and public—worked in silos; the supply chain for health systems was disorganized; demand forecast for essential supplies like medicines, oxygen and consumables hardly existed… and the system crumbled!
Issues developing economies grappled with
- Shortage of most basic healthcare infrastructure
- Unplanned vaccination rollout
- Almost negligible access to real-time and authentic healthcare data
- Citizens scrambling to get access to real-time information on beds and hospitals since most of our health systems work in silos
- Supply chain management issues at hospitals to predict demand of essential infrastructure and consumables
- Lack of unified command chain or nerve centre to manage crisis
Digitization plan needs overhauling
Recognizing the need early on, India had constituted the National Digital Health Mission (NDHM) in August 2020 to develop the backbone necessary to support the integrated digital health infrastructure of the country. Despite enormous progress on digital transformation countrywide, long-term development has been elusive. With care shifting from Tier-1 cities to Tier-2 and Tier-3 cities while depending on Tier-1 cities for diagnosis, digital transformation becomes all the more vital.
The National Health Authority is the apex body responsible for the implementation of the NDHM and is headed by a seasoned bureaucrat who played a major role during the implementation of Aadhar as its CEO. The ambitious project, if implemented in its true spirit, can solve many of the issues that India faced during the pandemic. A project of such gigantic magnitude requires vision, strategy, and execution of the highest standards.
Expertise and involvement of executives from the private sector who have impeccable execution skills and can work with accountability is the key to the success of this project. Many of our large IT firms have robust digital transformation practices and healthcare verticals supporting the payer-provider ecosystem in the West. Most healthcare digital transformation projects in the US, UK and other leading global economies are led and executed by our IT firms. The NHA team should comprise leaders from some of our leading IT firms, pharma companies and healthcare startups.
The NDHM should be a mission running with tight deadlines and quick deliverables. Adoption of technologies like block chain for secure and decentralized data management, AI for population health management and accurate forecasting and data analytics on EMR, EHR data to improve healthcare operations is critical. Let us innovate, collaborate, and work as a matured ecosystem to deliver the world’s most ambitious digital health transformation project. It is time for the NHA and trade bodies like NASSCOM to collaborate and deliver this mission-critical project. Let the NHA not work in a silo but enable an ecosystem to execute NDHM. Our population expects us to predict—and prevent—and not just diagnose and treat.
‘Digital transformation a must’
“Post-Covid-19, India’s healthcare system must transform digitally. There are several ways in which India can take full advantage of its benefits, such as by ensuring robust and unified data policies that boost, rather than impede, tech innovations, and by having access to global markets, talent, and technologies to deliver value to clinicians and patients locally across varying markets.
India needs to invest in upgrading its research and knowledge technologies as the adoption of data and digital health infrastructure is accelerated during the pandemic. Implementing a knowledge-driven care model, driven by data and evidence-based knowledge at the point-of-care, will empower clinicians with reliable insights for safe and quality patient care.” Jan Herzhoff, President, Health Markets at Elsevier
Sumit Goswami is the Operations Leader, Global Growth Holdings.
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