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The healthcare sector in India is at a crossroads where the right policy action is significant to decide the future course of the healthcare industry. The industry faces significant challenges owing to the changing demographics of the country, the poor state of the public infrastructure, lack of financial resources, the paucity of human capital and poor governance.
Digital technology adoption is already gaining prominence in India’s healthcare industry, with efforts from both the public and private sectors. The government must launch several initiatives such as Digital India focus teams for healthcare and Aadhaar integration with support from the private sector, as these are feasible and approachable goals.
Digitalization is happening
The private sector has created mobile apps, adopted telemedicine, and set up Medtech innovation centres all around India. These initiatives have several digital health start-ups. M-health, Remote diagnosis, Telemedicine, Digital and social connectivity and affordable Wearables. Adoption to blockchain in healthcare and developing Artificial intelligence-based healthcare processes, to increase quality and efficiencies of the delivery systems.
We have seen, failure of Healthcare.gov and national programmes for IT in the US due to lack of relevant experience, schedule pressure to implement in affordable care act and lack of leadership. This could be taken as the benchmark in policy-making for a sophisticated and populous country like India. In US case employees and managers had much experience with insurance markets and processes and developing government projects, though expertise to deal with technology and data integration in healthcare was missing, which is not the case with India at present.
Indian decade of healthcare IT will be a challenge on multiple fronts, like policy designing, bringing all stakeholders on the same page and understandings, developing human resources, sourcing the technology and implementation, removing the thin line of political differences among centre and states. Under the proposed solution, the various state governments would have to lay out the most effective structures for their respective countries, hire the most competent individuals and layout comprehensive rules and regulations for the functioning of the corporation. Customised IT Policy making could take several years, but once the corporation is in place, the operation of the same would bring in many improvements in the system. Also, this improvement would require only moderate government expenditure. Firm leadership and continuity of thought leadership can be the change factor and can be a reason for failure if not appropriately considered.
Following steps should be considered for next decade policy-making to avoid potential failures:
- Government of India intends to introduce a uniform system for maintenance of Electronic Medical Records / Electronic Health Records (EMR / EHR) by the Hospitals and healthcare providers in the country. This can be done with bottoms up approach and involving states, PHC and private sectors as stakeholders.
- As variables are enormous in numbers, but there are live case studies from the developed world like US Canada and Germany, to implement a successful EHR initiative. Thus expert IT Healthcare task force with multiple expertise can be implemented in policy making.
- Standard Information Management Systems, The introduction of the Aadhaar number, can aid the feasibility of maintaining such vast amounts of medical records. Integration of the same with bank accounts as done under Pradhan Mantri Jeevan Jyoti Bima Yojana can lead to a more efficient, self-sufficient system.
- Integrated state & Private Healthcare Financing As costs involved are huge, i.e., the poor may not be able to pay into these accounts, the government can intervene by making payments into citizens accounts as DBT, especially for the more vulnerable sections of the population, with development of AADHAR and healthcare linkage, and direct benefit transfers. This system is beneficial for hospitals not mapped in PMJAY ambit.
- Traceable Preventive Healthcare Linking performance with delivery and mapping up to last-mile delivery can be the key attribute for healthcare planning for the next decade. Swacch Bharat Abhiyan with associated healthcare benefits could be the mission for the next couple of years.
Although the government is well aligned to the need to increase public spending in healthcare delivery systems, it is essential to know that our neighbouring countries like Bhutan, Srilanka and even Bangladesh are performing better, despite having lower healthcare budgets, healthcare spending is rationale and focussed. At the same time, direct comparisons with any country are not the practical idea as differences are many, including demographics, population and size. India healthcare needs our own designed solutions for healthcare IT, addressing our needs.