Digital Health
An ideal country to test new technologies
India has become an ideal testing ground for innovations in digital health, and for good reason: with a foundation of preexisting technical capabilities – India is home to the second largest smartphone market in the world, for example, and boasts a strong IT presence worldwide – and a significant percentage of its population in rural areas beyond the reach of national healthcare infrastructure, it has both the resources and the need to enable the transformation.
“I see more people looking to leverage the digitization of patient care, such as through telemedicine or the creation of wearable technologies,” said Karan Singh, managing director of ACG. “In most cases, it is about pharmaceutical companies going beyond the hospital setting to connect with patients in a more comprehensive way that accounts for their lifestyles.”
Digital health, an umbrella term used to describe any tools or resources resulting from the confluence of healthcare and technology, has existed in India since before the pandemic. Recognizing its rise, the Indian government launched its flagship Digital India Campaign in 2015, including public health initiatives aimed at how digital technologies could be used to increase access to healthcare services in rural regions. Two years later, the Digital Health Mission in India was borne from the National Health Policy’s vision of a fully digitized healthcare system in the country. This laid the groundwork for market innovation and investment into digital health.
When Covid-19 hit India, the pace of development in the sector took off. This is particularly true for telehealth, the use of telecommunications tools to provide healthcare remotely.
Around the world, patients faced difficulties in visiting physicians due to extended lockdowns and unavailability, given the great numbers of people infected with the virus. The dichotomy that had already been present in India regarding access to healthcare in urban areas compared with rural regions became even more stark.
For years, members of the law firm Nishith Desai Associates (NDA) had pushed for digital health and telemedicine to be legitimized by the Indian government as tools to help overcome this uneven distribution of healthcare practitioners. Prior to Covid-19, digital health had been complicated by regulations preventing inter-state medical consultations; doctors in Mumbai could not treat patients in Bangalore, for example. After a considerable time encouraging such a shift, Darren Punnen, leader of the pharma and life sciences practice at NDA, watched as regulators quickly mobilized guidelines for the practice of telemedicine nearly immediately after lockdowns were announced. “Covid's impact on the industry was transformative as the government finally put a legitimate stamp of approval on the entire practice,” Punnen recalled. “At a central level, doctors could now consult with any person in the country.”
With regulations in place, adoption is now possible on a broad scale as the country already contained many of the required resources to build out telehealth infrastructure. “Many doctors who had retired or were not very active in their practice became very busy again, as all they needed was a laptop and strong WIFI,” said Milind Antani, lead of NDA’s pharma, healthcare, medical device and digital health practice. “We are at the tip of the iceberg in terms of what telehealth will come to offer India.”
“As an IT hub, India is seeing a rise of interest by startups and other IT firms leveraging concepts of artificial intelligence in the life sciences.”
Naresh Raisinghani, CEO and Executive Director, BMGI – India Division
MedPrime Technologies is perhaps the hallmark example of an Indian company putting a digital twist on a traditional practice to facilitate the goal of pan-Indian healthcare coverage. The Thane-based medical equipment manufacturing company was the first globally to create a digital microscope that can be used to run tests in a professional lab setting.
Traditional microscopes require users to note their observations by hand, and Greeshma Unnikrishnan, a co-founder of MedPrime, realized that this had been posing a limitation. “The sample and the observer (a pathologist) would have to be in the same physical location,” Unnikrishnan explained. “In places like India, pathologists can be found in cities but not in small villages. Additionally, there is a globally low pathologist to patient ratio because the number of patients is increasing as is the number of diseases requiring microscopy for diagnosis, yet the number of pathologists is not increasing accordingly.”
In India, it can take up to a week for samples from rural areas to be sent to a nearby city and analyzed. This, in turn, leads to delays in treatment, which can cause grave complications when dealing with diseases like malaria that require immediate treatment.
With the introduction of MedPrime’s digital microscopes, this issue becomes obsolete. “Digitization brings everything online,” Unnikrishnan said. “The need for physically transporting samples is diminished because you can send images over the internet or livestream instead. Now, you can look at a sample on a screen, capture images, record them, make measurements, run analyses, and project visuals. In the context of India, pathologists no longer need to physically go to each lab to sign off on diagnoses. Instead, they can work remotely, making the pathway to treatment faster for patients.”
In addition to emerging players whose business models center on harnessing the power of digital technologies in a medical context, large pharma companies are looking for ways to incorporate its benefits into their existing offerings. “We are exploring digital means to reach more people as face-to-face interactions can at times be very constrained,” said Sudheendra Kulkarni, CEO of South Asia & ASEAN for the multinational biopharmaceutical company Ferring Pharmaceuticals.
As a company focused on reproductive and maternal health, one of the fastest growing segments within the Indian pharmaceutical industry, the ability to reach broader swaths of the population to help treat issues such as death by postpartum hemorrhage (PPH) allows for more lives saved. “If the education at the point of care is appropriate and sufficient, it will allow people to make the right decisions. Those right decisions will eventually lead to the right interventions, and the right interventions will lead to the right results,” Kulkarni said.
Digital health remains one of the most exciting subsectors on the rise in India given the near boundless potential applications there are for incorporating digital tools into a healthcare context.
Image courtesy of National Cancer Institute from Unplash