New Delhi: Dr Rajendra Pratap Gupta,Co-chair, Global Digital Health Summit, Founder, Health Parliament spoke to ETHealthWord’s Prathiba Raju on how going forward India needs a clear plan of action for digital health and elucidated how India is matching the developed countries in size and scope.
COVID-19 has ushered in an unprecedented digital health ecosystem but, as a country how should we carry forward this momentum?
Digital Health is now the default operating system of healthcare. As a country, India has currently been ranked at the top in terms of Digital Health programmes. The numbers speak for themselves. About two billion COVID vaccinations have been delivered and tracked through a digital system, about 180 million health records have been allotted, and more than 30 million digital consultations have been delivered through eSanjeevani. This is a big achievement for any developing country. When it comes to digital health, we are matching the developed countries in size and scope. Going forward, we need to have a clear plan of action for digital health, and we should avoid lobbying by vested interests, as that can derail our promising start.
How do we take the next steps when it comes to blending traditional healthcare models and digital approaches and how the central government missions like Ayushman Bharat Digital Mission (ABDM), CO-WIN and Make in India will help?
Luckily, India does not have many legacy systems, and we will be building a healthcare system with digital health embedded in it. So, by being late, we are lucky. CO-WIN platform must go beyond COVID and should be used as a mobile healthcare exchange (MHE) for providing a host of services. This should be both; mobile and web-based to serve as an exchange, a patient portal and a mobile digital record (MDR- A longitudinal health record for every Indian). CO-WIN can become the default template for digital health and leads the way for the world to see how India has adopted digitalisation across healthcare delivery. NHA – ABDM has the appropriate institutional structure and leadership for delivering digital health. It is time to do public reviews on various aspects of delivery so that we don’t have to do expensive technology rollbacks in future. Half-yearly reviews with beneficiaries will ensure the building of a future-proof system. Also, it is time to have a minister for public and digital health.
How is the 2022 edition of the Global Digital Health Summit different from the previous ones? What actionable outcomes are you expecting out of this summit? How do you think this summit will help push the digital health ecosystem?
This summit is truly global, with the world’s leading digital health associations joining hands to host the Global Health Connector partnership meeting in Delhi. This event is supported by the American Telemedicine Association, HLTH- USA, The Digital Health Society of Ireland, Africa Health Federation, International Society for Telemedicine and eHealth (ISfTeH, Switzerland), Dynamic Coalition on Digital Health- Internet Governance Forum, the United Nations, Commonwealth Centre for Digital Health, European Connected Health Alliance and Health Parliament.
This summit will release the world’s first multi-stakeholder declaration aiming at ‘Digital Health For All’. We are drafting the declaration, which will be released at the summit. This is aimed to galvanise all stakeholders to ensure we deliver digital health for all and reduce inequity in healthcare.
The outcomes report from this summit will lay the roadmap for the future of digital health. This is not just another summit; it will be answering some of the critical questions which have plagued the mass adoption of digital health like Return on investments for digital health, increasing the momentum for digital health amongst the small healthcare providers and clinicians operated practices/clinics, which constitute the majority of providers for healthcare in developing countries and how 5G, gaming and Metaverse will transform healthcare. This summit will have participants from major regions across the globe. The global awards will recognise and celebrate the ‘transformers’ in healthcare and are being judged by an international jury chaired by Brian O’Connor, Chairman, European Connected Health Alliance.
As we are having a conversation on building up a robust digital health ecosystem, I would like to ask about IBM Watson which was supposed to transform health care. Still, with a series of high-profile setbacks, the company was sold to a private equity firm. Where did Watson Health miss the mark, what are your thoughts on it?
Even if AI is 95 per cent accurate, it’s a failure. Will you go to a surgeon who says I am 95 per cent accurate? AI remains hype about leveraging its full potential until we sit down and thrash out the basics and set a clean practice baseline. Else, garbage in and garbage out (GIGO) will spoil the AI party in the long run for healthcare. So, why is AI failing in clinical practice? For decades we have had prescriptions, diagnosis and treatment malpractices, and the data of these are being used as a base to build AI-ML based solutions. So, if the primary data is corrupted or inappropriate, how can you build a reliable solution on top of it? First, we need to address the ‘three I’s of data- ‘Integrity’, ‘Integration’, and then ‘Intelligence’ will work. We need to ensure CMP (case management protocols) based healthcare practices, and then the AI applied to this CMP-based healthcare data will lead to a 99.99 per cent accuracy, disrupting healthcare.
Telemedicine though became a crucial tool during the pandemic, and the National Health Policy (NHP) lists it as an essential objective. Still, there is a missing gap regarding proper implementation of health technology as there is no set of guidelines available or standardised format to qualify patient-physician interaction or no accountability framework to tackle medico-legal negligence matters. So what are your thoughts on this?
If we review page 23 of the NHP point 12.1, mentions the mandatory disclosure of treatment and success rates across private and public healthcare facilities. This will be a game-changer for improving healthcare quality, which needs to be implemented through the NHA digital dashboard.
The NHP-2017 is radical in many ways and has addressed all such challenges. I think the time has come to review the progress of the NHP, as it has been five years since it was approved. At the Health Parliament, the think tank has started reviewing the NHP, and we will make the detailed review available by early 2023.
As India advances towards a $5 trillion economy by 2024–25, how important is the health domain for India? Why should it be seen as a national priority? What are the top priorities that should be planned and targeted?
India must think beyond a $5 trillion economy as our demographic opportunity will be lost by 2045 when every fifth Indian will be a senior citizen. So, we must march towards becoming a $32-40 trillion economy by 2047, which calls for laying a solid foundation of health and skilling. Within health, we need to move from a three-tiered healthcare system (primary, secondary and tertiary) to a four-tiered healthcare system (digital, primary, secondary and tertiary), and we need to embed digitalisation across the continuum of care. At the Health Parliament, we have completed a scoping document for digital health to be submitted to the Ministry of Health & Family Welfare (MoHFW) for the areas of action and investment in a phased manner. We will have to be asset-light and, yet, pre-emptive in our approach across governance, financing and delivery of healthcare; only digital health can help achieve it. So, digital health will remain a top priority action item for healthcare and the $32-40 trillion economy.