With over three decades of experience in clinical operations, medical administration, and healthcare management, Col Anuradha Sangal (Retd.), Head of Clinical Operations, Dozee is an expert in healthcare. A former Medical Officer in the Indian Army Medical Corps, she has extensive experience in managing and supervising medical care of army personnel and their families, as well as providing medical support during military operations. In an interaction with Kalyani Sharma, Col Sangal shares her journey from the Armed forces to health tech and throws light on digitisation of healthcare

Questions n answers-

Ques- What inspired you to transition from an armed force to a health tech sector? Please share your journey.

Ans- As a healthcare professional in the Armed forces, I had dedicated 30 years of my life towards optimising patient outcomes. But there was still a sense of unfulfilled potential; I felt that by leveraging technology, I could make an even bigger impact and reach a wider scale than what is possible working solely from within the Armed forces. This led me to explore how technology can be used to improve healthcare systems and lead to better patient outcomes. By leveraging my considerable experience and knowledge, I found myself well-positioned to contribute to the development and refinement of technology related to healthcare delivery. The exposure of having served in the army allowed me to develop a distinct perspective on providing care. I believe it has adequately equipped me to bring about change on a wider scale and observe improved standards of patient care delivery across the healthcare landscape of the country. Being aware of the existing gaps in our current healthcare system, I know technology can be the solution here and I want to play my part in helping with its adoption and implementation. Being given the chance to explore unfamiliar roles and responsibilities in the world of health care technology has been an invaluable opportunity for me. My passion lies in using technology to promote better health outcomes, which I have been able to do here with flying colors. With each new task I tackle, I become even more excited about the potential for innovation in this field. Moreover, it is a rewarding experience that helps me grow as a professional and a person.

Ques- How crucial was the role of the pandemic in accelerating the use of digital health? How scalable is it right now?

Ans- The novel coronavirus pandemic has been a major factor in driving the expansion of digital health, with governments and companies around the world implementing solutions to help reduce the risk of infection and keep people safe. The use of remote patient monitoring, for example, has skyrocketed during this time as hospitals look for ways to safely provide healthcare services. The sudden need to find innovative solutions that could ensure safety while still offering quality care has highlighted just how crucial digital health can be in providing efficient care at scale. As a step to riding the wave of change catalysed by the pandemic, the Indian government also took several steps to promote digital health. Initiatives such as the National Digital Health Mission (NDMH) and the launch of the Aarogya Setu app have helped increase the awareness and adoption of digital health solutions. While as a nation we are aggressively adopting technology to improve the accessibility of healthcare, the scalability of digital health in India depends on various factors such as infrastructure, regulatory framework, and user adoption. India has made significant progress in digital health, but there is still a long way to go in terms of reaching the masses, particularly in rural areas where factors such as internet connectivity and access to technology continue to be a challenge. However, with the increasing availability of smartphones and the government’s efforts to improve digital infrastructure, the potential for digital health to scale up is significant. Digital healthcare solutions truly have the potential to improve healthcare outcomes, reduce costs and increase access to quality healthcare services in the country and worldwide.

Ques- Which global technologies should be a part of the Indian healthcare system for better patient care?

Ans-India’s healthcare system is one of the largest and most complex in the world, serving more than 1.3 billion people. In recent years, technology has become increasingly important in healthcare, as it can facilitate faster diagnoses, smoother communication between health professionals and patients, and improved access to care for rural and underserved populations. To ensure quality care to all those who need it, India should consider implementing several global technologies that can improve its healthcare sector. However, the growing number of health tech startups and innovations in India are offering world-class healthcare solutions paving the way for an Atmanirbhar Indian healthcare system offering unparalleled patient care and safety. The day is not far when ‘Made in India’ technologies in healthcare will set an example for the world to follow.

Ques-Which all areas, according to you, are yet to be explored as far as digital health is concerned?

Ans-Digital health is a rapidly-expanding field with new innovations being developed on a daily basis. Medical technologies and applications that use digital resources to enhance patient care, monitoring, and treatment have been utilised by healthcare systems around the world. While these advancements have already accomplished great strides in improving the quality of care available to patients, there are still many areas in which further innovation can be achieved. One such area is the use of BlockChain technology to secure patient data and enable the secure sharing of information between healthcare providers. This can improve the accuracy and efficiency of healthcare delivery, without compromising patient privacy. The use of Virtual Reality (VR) and Augmented Reality (AR) can enable healthcare providers to simulate medical procedures and training, improving the quality of healthcare education

Ques- What are the major challenges and gaps faced by the healthcare system while going through the process of adapting a technology?

 Ans- The healthcare system today is facing many challenges and gaps in the process of adapting technology for the betterment of patient care. Since its inception, this transformation has been fraught with difficulties ranging from financial constraints to legal restrictions. Moreover, the complexity of the systems and processes involved in bringing new technology into a healthcare setting can be daunting. In order to make progress toward developing a more efficient and effective healthcare system, it is essential for organisations to identify these challenges and gaps in order to develop solutions that are tailored to their particular situation. One of the main challenges is the lack of infrastructure and resources in many parts of the country, particularly in rural areas. This hinders the adoption of technology and makes it difficult to provide healthcare services to disadvantaged communities. The lack of standardisation and interoperability of digital health systems makes it difficult to share patient information between healthcare providers across different healthcare facilities. Moreover, the Indian healthcare system faces a shortage of skilled healthcare professionals who can effectively use technology to improve patient care. Data security and privacy concerns are also a challenge, with the need to ensure that patient data is kept confidential and protected from cyber threats. Further, the cost of implementing and maintaining technology infrastructure is a significant challenge for many healthcare providers, particularly for those operating in resource-limited settings.

Ques- How do you see the current skill development scenario in India especially now that new technologies are being used?

Ans- Healthcare is rapidly changing as new technologies are being developed and utilised to improve patient outcomes. The skill development required to keep up with these advances has become increasingly important in order to maintain quality care. Whether this be through extra education, additional online courses, or hands-on experience through shadowing a colleague, staying current is imperative for healthcare professionals. As the industry evolves, so must its practitioners – understanding both trends and technology are key when it comes to providing the most effective treatment today and into the future. However, the healthcare sector in India is still facing a shortage of skilled healthcare professionals, particularly in rural areas. The adoption of innovative technologies in healthcare, such as telemedicine, requires healthcare professionals to have specialised skills and training. Therefore, there is a need to develop a workforce that is equipped with the necessary skills to use and implement these technologies effectively. In recent years, there has been a growing focus on digital skill development in India. The government has launched several initiatives, such as the Digital India campaign, which aims to provide digital literacy and skills training to people across the country. There are also several private sector initiatives, such as Corporate Social Responsibility (CSR) programs and public-private partnerships, aimed at promoting digital literacy and skill development. Initiatives such as healthcare-specific training programs, continuing education programs, and targeted government policies aimed at promoting healthcare skill development can also help equip healthcare providers to better adapt to a healthcare system that is gradually integrating itself with technology.

2. THERE IS A NEED FOR FRUGAL INNOVATION -BASED HEALTHCARE SOLUTIONS TO ACHIEVE AFFORDABILITY

What are the major shifts in India’s healthcare sector?

The contours, the context, and the contents of healthcare ecosystem are rapidly evolving across the world. There has essentially been a fundamental shift in the imperatives for the policy makers, providers, and the public, leading to the emergence of ‘Health Outcome’ and ‘Cost of Care’ as the key performance indicators of the health system. The major shifts in India’s healthcare context are: Preference towards quality beds Post-COVID, there is a greater momentum towards “organised quality private healthcare care” with expanding middle class and unlocking of demand for the bottom of pyramid through increasing social and private insurance penetration. This momentum is expected to continue, and we are seeing a K Curve – on one end while we are seeing the organised / larger chains becoming stronger, at other end there will be gradual weaning out of smaller players to create healthcare platforms thereby driving consolidation in the segment. Predicting the unpredictable The power of data that can be unleashed by digital capabilities which can be consolidated, analysed, and leveraged for sharper intelligence and help answer questions like who will respond to which treatments, which disease will spread, what therapies work best and most economically etc. Hence it is this data which will be the bedrock of the health system that will revolutionise advancements in the sector. Shift to “Health Care” from “Sick Care” Overwhelming focus on sick care rather than true healthcare has been the cause of burgeoning health expenditure and increasing disease burden across the world. It is here that technology has the potential to revolutionise the possibilities in enhancing speed and accuracy of diagnosis and treatment, remote access, and real time monitoring. Shift from an incremental to a design to cost approach in healthcare delivery While the cost agenda in the global context is largely focussed on life cycle cost through better outcomes and less on transaction cost, in Indian context the focus is more on reducing the transaction cost given the vast multitudes inability to absorb the prevailing cost of care. Hence in the Indian context, there is also a strong need for frugal innovation-based