The Indian Healthcare sector expected to reach the US $280 billion by the end of FY2020 (pre-COVID-19 estimates). With a CAGR growth rate of 16.28% (FY2008 – FY2020), the healthcare industry is on the rise. The population of India is 1,326 million and is expected to touch around 1,400 million by the end of FY2026. An extreme burden on the healthcare industry is seen and it is imperative to equip with the necessary measures to meet the future demands. This industry is one of the most regulated industries of all; there are many compliances and stringent laws need to be followed.

Figure 1: Healthcare Market (Accessible in PDF Version) 

Figure 2: Population (Accessible in PDF Version) 

The Indian Healthcare Industry comprises of five broad segments, namely:

• Healthcare Delivery Segment comprising Hospitals, primary, secondary, and tertiary healthcare segments.
• Pharmaceuticals
• Medical Equipment
• Health Insurance
• Diagnostics

Figure 3: Revenue Spit (Accessible in PDF Version)

Demographics and Population Health Profile

The percentage distribution of the estimated population gives us a brief idea that there should be a shift of focus from treating diseases on a broad coverage to treating non-communicable diseases.

The percentage distribution of the estimated population gives us a brief idea that there should be a shift of focus from treating diseases on a broad coverage to treating non-communicable diseases. Non-communicable diseases are not transferable from one person to another. E.g. autoimmune diseases, most cancers, diabetes, etc. Direct correlation in a person having a non-communicable disease and the person’s age is observed. From the data, we can also observe that the population of India is aging. In 1990, the median age of the population was around 21 years whereas by 2040 it is forecasted that the median age of the population would be around 35 years.

Figure 4: Median Age (Accessible in PDF Version) 

Increase in income levels denote there would also be a decrease in the dependency ratio of the population. In 2013, the dependency ratio was 53.4% and by 2019, it was 49.2% indicating potential demographics benefiting the sector in the near future. The population would be able to pay for better healthcare services and products. This is would be gradually been seen as the population would be slowly coming into the second bracket of Maslow’s law of hierarchy where the physiological needs have been met.

Mentioned below figures related to the Indian’s Healthcare Sector:

Figure 5: Human Capital Figure (Accessible in PDF Version) 

The above two table highlights the gaps that need to be bridged for a better healthcare system that the country should have.

The Increase in Digital Connectedness: the usage of technology has increased over the years; it is used right from accessing the patient’s health records and reports to real-time monitoring of a person’s pacemaker. The penetration of technology in the healthcare sector has brought in more operational efficiency, an increase in penetration of healthcare products, and services using a digital platform, automation of redundant tasks.

Figure 6: Consumers (Accessible in PDF Version) 

M-health is definitely one of India’s main digital healthcare sectors. The increase in the usage of smartphones has resulted in an increase in the usage of healthcare apps over the years. This has also been because now the population is more aware and digital literacy is more than compared to as it was in the past. A study showed that 68 percent of doctors in emerging markets are already recommending m-health and 59 percent of patients are already using it. Mobile apps, particularly those that link doctors to patients and enable remote consultations, are a major segment of m-health.

Figure 7: M-Health (Accessible in PDF Version) 

Figure 8: Smartphones in Millions (Accession in PDF Version) 

Telemedicine

Getting the possible healthcare diagnosis services at the consumer without him traveling much distance is the concept of telemedicine. Telemedicine is using the technology for remote diagnosis, monitoring, and education. Helps in getting down provider & patient costs, provide care in remote areas. Providing a point of care diagnostics, teleconsultation, and e-prescription facilities.

Electronic Health Record

Electronic health records (EHRs) are a distributed system of documentation that improves the efficiency and effectiveness of a workflow. To be effective in implementing EHRs among healthcare professionals and customers, four components need to be developed to promote wellness, strengthen disease prevention, provide evidence-based treatment, and prevent disease.

1. Patient Medical Record: The patient medical record is a lifetime data collection tool that records the medical history and contains all the information usually contained in a patient chart (e.g., patient details, progress notes, drugs, vital signs, immunizations, laboratory results, radiology reports). The system allows order entry management which allows clinicians to enter treatment and medication-related orders and encourage the collection of data. The importance of its shared knowledge would help make informed decision-making easier.
2. Decision Support System: The Decision Support System (DSS) provides healthcare practitioners with a valuable tool to improve the range of viable alternatives through warnings, reminders, and appropriate practices for treatment, based on existing best practice. It may also apply to administrative processes that directly affect care, such as scheduling, billing, and claim management. This type of framework provides clinicians with detailed knowledge that is smartly filtered to make the most educated choices that will eventually improve patient care.
3. Drug prescription component: Allows clinicians to measure drug dosages; to minimize the potential for errors; to avoid drug interactions; and to enable approved healthcare professionals to access, monitor, and safeguard the history of the patient’s medication. It also speeds up and guarantees quality medical care, and monitors the enforcement and success of the patient.
4. Interface with patient portal accessed through the Internet: A variety of self-monitoring systems have been developed to provide patients with safe access to different health information including their health records, resources such as scheduling appointments, or requesting refills for prescriptions and immersive computer-based patient care. This will allow safe methods for bidirectional communication, exchange of information, and improving the quality of care.

Previously, the link of the stakeholder was more at an individual level and there was always a probability of absence of the particular record. Now the digital health systems being powerful enough it can automate redundant tasks like billing and alert during patient monitoring system, as well as connect all stakeholders and improve the operational efficiency of the system.

Figure 9: DH System and Stakeholders involved (Accessible in PDF Version) 

The digital transformation in Digital Healthcare Systems has given a new boost to this sector.

• Increased transparency
• Accurate drug delivery to patients
• Improved patient care
• Better health management for individuals

Expected outcomes from implementing digital transformation in the healthcare sector.

• All people should have convenient access to their electronic health records, preferably within 5 clicks
• Citizens must undergo any diagnostic test ONLY once during an episode, despite obtaining treatment from multiple health care providers.
• People can receive comprehensive health care at one stage, although there are many agencies/departments/service providers involved.
• Continuum of Care to the citizens in PHC, SHC, and THC; and across private and public service providers.

The main challenge in the healthcare sector is the extraction of real-time insights on a national level.

Solution for extraction of real-time insights: 

• Implementation of Electronic Health Records
• With Electronic Health Records functioning at a national level, the entire country’s population data can be accessed and can be used for further insights. This will help in the proper allocation of funds at the required place in a timely manner, predicting disease outbreaks, understanding the health profile of the population.

National Digital Health Mission takes into consideration the implementation of EHR. EHR would play an important role in applying artificial intelligence and machine learning algorithms for performing prescriptive and predictive analysis of the real-time data for extracting useful insights.

The below diagram highlights the component in the electronic health record model. The four pillars form the base for the EHR system and it is from this strong base we would be able to exploit the true potential of an EHR system.

Figure 10: Components in Electronic Health Record (EHR) adoption (Accessible in PDF Version) 

From the above model, we shall be concentrating on the infrastructure part to solve the problem. The Cloud-based solution is the best as the cloud has many benefits as compared to the traditional setup of the IT infrastructure. Although the basic access infrastructure like laptops, desktop, etc. would be required to access the core system or software. The drill-down view for the EHR infrastructure has been shown in the below figure.

Figure 11: Infrastructure  (Accessible in PDF Version) 

Initial capital investment can be minimized when cloud computing is used for IT operations. According to the requirement, one can go for pay per use model, and providing the complete solution can be outsourced for managing and maintenance so that the efforts are focus on the main goal of the healthcare machinery.

The benefits of Cloud Computing are scalability immediately: Cloud computing allows the infrastructure able to be instantly flexible depending on the business needs. It is like getting an infinite IT resource that can be scaled up and/or down to satisfy user requirements. This is an important feature as patients for the OPD and IPD can be predicted but in an event of an outbreak of a disease, there is a surge of patients for OPD and IPD.

Access is location neutral: Cloud enables the distribution of their applications anywhere to support the business operations at a lower cost. Because of lower latency, the same user experience is provided while using the applications.

Increased pace and agility at work: Such a skill increases organizational resilience, competitiveness, and performance, making it possible to experiment with new concepts and thus deliver competitive advantages.

Reduction in expenditure: The healthcare machinery should concentrate on developing their products and services with the cloud, rather than investing in hardware infrastructure and data centers that either sit idle or are underused. But cloud costs are based on usage — a variable cost.

Disaster Recovery: Cloud is capable of disaster recovery; it also saves time and effort.

Flexibility: Regardless of system type and/or global location, the cloud provides tremendous versatility and empowerment.

Highly Secure: Cloud services, product, and companies are available that are HIPAA compliant and adhere to stringent regulations which need to be followed in the healthcare sector.

Enterprise Collaboration: Business information is no longer accessible in silos (except, of course, classified ones). Centralized data control on cloud-based, file-sharing, and social media apps (such as Slack, Yammer, etc.) provides clarity and accountability in work processes, streamlines the flow of information, and facilitates greater coordination between teams, departments, and employees sitting in different time zones — all of which contributes to enhanced efficiency and performance.

Hosted CRM: CRM software on the cloud provides reliable and secure Internet access to customer information. CRM stores information about clients, such as names, phone numbers, and addresses. It also maintains track of consumer behavior such as visits to websites, phone calls, email, etc. The easy sign-in, availability 24X7, reliability, high security, scalability, and user-friendly features on the cloud help businesses get rid of IT-related issues. Cloud CRMs are also compatible with multivendor products and applications, which increase the efficiency of their operations.

Cloud service providers are:

• Amazon Web services
• Microsoft Azure
• Google Cloud Platform
• Oracle Cloud
• IBM Cloud

Conclusion

95% of the decisions are made on the data received during tests, which are considered as evidence for further treatment. Big data plays a big role in the healthcare sector and would be one of the driving factors for this sector. The amount of Healthcare data is growing annually at a rate of 48%, also it is estimated that by 2020 end the data generated per year globally would be around 2,314 exabytes per year. Hence, complete adoption of cloud computing to all systems in the healthcare sector would align the objectives towards one goal that is health management.