As per a latest EY-NASSCOM survey, 47 per cent of the surveyed healthcare companies are yet to begin a planned AI journey. Kaivaan Movdawalla, Partner and Healthcare Sector Leader, EY India in an interaction with Kalyani Sharma explains why healthcare is still tech wary and also emphasises on the major shifts in India’s healthcare sector
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 healthcare solutions to achieve affordability agenda. Technology can play a vital role to drive efficiency.
How are digital technologies powering a transformation across the healthcare continuum?
The last two years of COVID-19 pandemic have accelerated the growth of digitisation and technological innovation in the healthcare sector in India. From the ambitious healthcare initiatives of the Union government like the Ayushman Bharat Digital Mission (ABDM) and the National Health Stack to technological innovations like healthcare omnichannel platforms by many private players, telemedicine consultations in the public and private sectors, artificial intelligence-based IoT tools for diagnosis, targeted treatments, and remote monitoring, the healthcare sector is moving from in-person care only to phygital (physical + digital) care. Along with these, trends like 5G, generative AI, digital twins, and metaverse are all set to create an entire range of new channels for delivering care that have the potential to lower cost of care and vastly improve access, affordability, clinical outcomes and patient experience.
As per a latest EY-NASSCOM survey, 47 per cent of the surveyed healthcare companies are yet to begin a planned AI journey. Why is healthcare still tech wary? What can be done to increase the rate of AI adoption in healthcare?
AI will take its own time to reach a stage of maturity and a tipping point in healthcare where it starts bringing in significant measurable benefits for the organisations leading in its adoption. Some of the key challenges in adoption of AI in healthcare are as follows:
Data protection and privacy
With an accelerated pace of digitisation in healthcare, there comes an increase of risk of cyber-attacks and data loss. Recent cyber-attacks of medical institutions have alerted the healthcare stakeholders to reassess and bolster their defences as they open up their applications and databases to the internet. It is critical to have comprehensive data privacy regulations and cyber security requirements in India for all industries including healthcare, which will encourage deployment of resources by organisations in this area and enable faster adoption of digitisation and AI.
Resistance to change coupled with perception of job replacement by AI
Healthcare is complex with multiple stakeholders involved in provision of services including the caregivers (nurses/technicians), clinicians, payors, etc. Their understanding of AI is synonymous with replacement of human resources by technology fuelling resistance to adoption. It will be important to continuously educate the key stakeholders on how digitisation and AI can help improve their efficiency and effectiveness in their daily jobs and hence enabling them for delivering better outcomes.
Limited availability of skilled manpower
Understanding of how AI can help in improving delivery of healthcare is still a boardroom discussion at present. Including understanding of digital technologies and AI as part of the curriculum of healthcare courses is important to create digital and AI ready healthcare workforce of the future. Simultaneously, companies looking to adopt AI much invest in training their teams for using the technology in the intended manner and drive adoption.
AI and digitisation are behind other investment priorities
Given the investment focus of most healthcare providers in India has been on capacity expansion (given high demand supply gap) and improving ROCE (faster revenue/volume ramp up and cost reduction), AI and digitisation has lagged behind on the priority list given its evolving phase and limited visibility on ROI from digital initiatives. It is critical for healthcare players to continue to maintain a positive momentum towards investing in digital technologies and AI with clear objectives around making healthcare more affordable, accessible, trusted, and patient centric.
What are the major learnings that can be incorporated from other sectors in terms of use and scalability of AI and other emerging technologies?
There are multiple learnings and use cases of AI and other emerging technologies in other industries which can be looked up by healthcare sector. Some of the examples could be as follows:
Pharma sector has made significant strides into adoption of digital and emerging technologies to transform their engagement models with the doctors and patients. Today’s pharmaceutical companies are sharing information on new formulations through digital channels and enabling their in-person interactions with digital tools to make them much more effective.
Similarly, retail and e-commerce platforms use analytics and AI for understanding consumer behaviour and preferences and providing personalised recommendations and engagement. With the availability of right data sets, the same can be applied to healthcare for personalised health and wellness advice.
Financial services sector has re-imagined the customer journey and making it fully digital and seamless by adopting AI and data analytics at scale, dramatically improving service delivery and customer’s experience. In healthcare, while there has been some progress in digital enabling appointment booking, access to reports/medical records, etc, there is a need to rethink the end-to-end patient journey – spanning across wellness, emergency care, outpatient care, in-patient care and at home care – and bring in an integrated ecosystem of digital interventions at each step to help the patient navigate through seamlessly.
E-commerce and manufacturing sectors have adopted emerging technologies including analytics, robotics and AI for end-to-end supply chain planning and management while bringing in significant cost efficiencies, predictability, and visibility for all stakeholders through the process. As healthcare has the same key resources – man, material, machines, and infrastructure – comprehensive supply chain planning and management can be achieved across all of these through use of emerging technologies and AI.
How can use of AI in healthcare generate better economic value add? How big is this opportunity for India?
According to an article by World Economic Forum (WEF), ‘India could add $1 trillion to its economy by integrating AI in healthcare’. India is the most populous country in the world today with limited healthcare resources – both in terms of manpower (doctors and nurses) and infrastructure. Integrating AI into diagnostics platforms will enhance screening and timely identification for communicable diseases such TB and Non-Communicable Diseases (NCDs) like cancer and cardiovascular diseases. Government think-tank NITI Aayog has started testing AI applications in primary care for the early detection of chronic complications and is currently validating the use of AI based tools for screening. Further, AI and Analytics on top of anonymised public health data can also be a powerful tool for analysing disease patterns across the country and guide targeted policy intervention measures in the future.
