When I look at the future of healthcare and the changes that we are witnessing, or are likely to witness, there are multiple directions and factors at play. While some of the changes are applicable to India, some have a global application too. There are several aspects that will define the future of healthcare at an intersection with technology which I will explore through the course of this discussion. The first section here will focus on the scope, drivers and key areas of attention for the future of healthcare, followed by some of the top challenges and essential guidance for CXOs to navigate their way at the intersection of healthcare and technology.
Chief Information Officer
Apollo Hospitals
Healthcare and technology: Understanding the convergence
I will start the discussion by exploring some of the key aspects of the future of healthcare with respect to the scope of activities and landscape along with the impact and focus on digital interventions.
Digital solutions to expand scope of public healthcare
The first angle that I see is that the Government is gearing up on health missions, and expanding the scope of what healthcare entails. Interestingly, this change is not limited to merely public health measures. If you look closely, conventionally, the focus of public health earlier was kind of restricted to women and child welfare and other areas like malaria or such diseases. However, a major change we see today is the expanding focus of the Government on overall health related activities.
A focus on overall health related activities requires getting as many people into the realm of the ability to get any type of secondary or tertiary healthcare. This requires scale and scale means capacity building which can be achieved only by the Government using excessive digital solutions for the staging of this activity. The population segment we are dealing with is far too large as compared to the capacity they are capable of dealing with. Therefore, the ecosystem of digital health technology will be excessively leveraged and it has to live up to the expectation in terms of size, scalability, support, and the consistency and the quality. Keeping these factors in mind, simply creating an app that works between four people will not be enough. The healthcare digital ecosystem will need to ensure sustainability. This entails a focus on quality services, care outcomes, leveraging automation to ascertain that secondary and tertiary healthcare can be delivered, administered and monitored effectively.
Convergence of technologies for monitoring
Monitoring is another very big part of the whole delivery mechanism and technology interventions. I believe that a convergence of the Social, the Mobile, the Analytics and the Cloud (SMAC) along with IoT will play a transformational role in the future of healthcare. Together, they will be able to deliver a confluence of quality clinical outcomes that are measurable, automated clinical practice guidelines and care pathways that emulate best practices which are not dependent on individual pockets of excellence. Within monitoring, a focus on preventive healthcare and connected health outcomes will define the future of healthcare
- Focus on preventive healthcare
Most companies today provide employees with healthcare benefits and insurance, which is prevalent in both the public sector and the private sector. However, increasingly organizations are adopting a proactive approach to the health and wellbeing of their employees, rather than a reactive approach. The major objective is to ensure a healthy workforce with adequate levels of productivity. This focus on health and wellbeing often extends to the family members of the employees. They intend to keep their employees away from secondary and tertiary healthcare challenges which are avoidable with a preventive focus.Monitoring on a large scale can help prevent non-communicable diseases with health and lifestyle changes, diet, exercising, good advice, and all that. The idea is to prevent them with early intervention and avoid advanced medical care, hospitalization, and secondary and tertiary care. However, such interventions require scale which is heavily possible by the digital world. Technology can enable aligning the chronic care management programmes or non-communicable diseases care management programmes to ensure that people are monitored and kept healthy by a combination of healthcare interventions like health and lifestyle counseling, mental health counseling, etc. This requires bringing together SMAC and IOT sto administer these services, monitor these services, work at scale, keep the levels of quality and clinical outcomes, etc.
- Connected health outcomes
Leveraging connectedness via fitbits or wearable and monitoring through an App, bluetooth, phone etc, is an important aspect of the future of healthcare. This is what I call the chakra of health or the chakra of wellness, which requires staying wholly connected not just when you are not well but monitoring your health even when you feel fine. Thus, this is a huge sector for digital interventions.
Efficiency and effectiveness with digital solutions
The next focus area for digital interventions in the future of healthcare will revolve around leveraging technology for augmenting efficiency, effectiveness and ensuring sustainability by removing wasteful practices, which tend to have huge financial repercussions. This will involve turning to electronic health records, automation, effective integration, at all levels, right from small scale providers to very large healthcare systems. The digital interventions will add to efficiency not only from financial aspects but also reduce administrative overheads to augment operational efficiency. Therefore, when it comes to better outcomes for the healthcare sector, digital interventions will impact both the core (clinical outcomes) and the periphery (operations).
Privacy and security
The next focus area at the intersection of technology and healthcare is privacy and security. With an increase in consumerism, there is a rise in awareness around areas of patient privacy and security. This requires the right tools and techniques to monitor, and the corresponding education to facilitate security and privacy by leveraging technology. The healthcare organizations will take an active interest in augmenting their cybersecurity practices to ensure strict monitoring, especially when it comes to handling patient information.
Education and skills building
The last area I see of critical importance for technology and healthcare revolves around education and building skills. Starting right from medical school and allied health school, there needs to be a focus on continuous learning using digital tools like augmented reality and virtual reality for effective training techniques and add on training at a higher level of maturity. It is important to focus on digital health education and skilling not just at the high-end but also at the entry level segment to logically minimize the burden of lack of resources in the healthcare industry. The use of technology in learning, development, education, and skilling, is therefore another area where I see technology helping the healthcare industry.
Challenges in the future of healthcare
While we have talked in detail about the opportunities that the future of healthcare holds with the adoption of technology, there are a few challenges that CXOs will have to address.
Design, architecture and governance
The first challenge is in terms of design, architecture and governance. This involves understanding what you need to do, how you need to do it, why you need to do it, and how much you need to do. Invariably, this is an inside out aspect. Therefore, it requires the key stakeholders to collectively decide on what they seek to achieve for the organization. On policy making and governance, the challenge lies in self regulation vs regulation. Regulations in terms of penalties will automatically come into force as we start looking at the layers of it and the severities of it. So that’s another area where I am definitely expecting a lot of tug of war. Unfortunately I also see that this is an area where each person is expecting the other person to take the first step, which is not a very desirable behavioral pattern.
Cost of technology
The second major challenge is the cost of technology. I definitely feel that the Indian technology industry can do much better in terms of bringing down costs to the scale of the economy of India. Therefore, one of the challenges that stands in the way of aggressive digital interventions talks about affordability and the need to make such interventions sustainable in terms of cost. We cannot invest in a one-time cost without an action plan to sustain the interventions. Similarly, we cannot rely on a perennially high cost, where providers start backing out due to financial constraints. There needs to be a focus on sustained affordability.
Talent management
The third challenge comes in the form of talent management, which includes the talent to execute and talent to sustain. This involves both technology related talent and healthcare related talent and a mixture of both. Therefore, it is not just bringing in technology professionals, it is not going to work that way. It is going to be a mixture of everything put together, where existing healthcare professionals also need to align themselves and their skills with a digital focus.
Change management
The fourth challenge that I feel in the way of technology adoption is the whole notion of change management. However, in the last two years, most organizations have taken positive steps towards this. I feel that we are in a stage where people understand the need for it and the benefits of it. People understand that it is going to take a bit of acceptance and mending their practices. While efforts are being put in place, change management and acceptance of technological interventions will be a key challenge. This would require training and continuous education on several aspects. There will be some pressure on time to achieve, urgency of execution, etc.
Navigating the technology adoption in healthcare: Essential for CXOs
With a few challenges along the way, there are several practices that CXOs and organizations can leverage as a starting point. Some of these include:
- Take inspiration from others: Learn from the industry, learn from other competitors and also spend some time learning from other industries. There is a lot that we can learn from banking, automobile, and hospitality industries that we can adopt into healthcare. So definitely learn from other industries.
- Know your own business landscape: You also need to focus on your own business landscape, not generic healthcare. One shoe does not fit all. This requires partnering with business leaders in understanding business problems and business realities. They may be operational, or financial, but you need to ensure close collaboration as transformation is not simply an IT initiative. Thus, it is important to strongly your business landscape, design for it, partner with leaders, understand your own constraints and opportunities and smartly execute in this perimeter.
- Keep the bar high: One aspect that I will always recommend is to keep the bar high and not be content with mediocrity. Let’s achieve, let’s not just be happy with mediocre outcomes. Every achievement is good, deserves celebration, and should be commended but we must strive for excellence to thrive as a collective society.
Way forward
As I conclude, there is one point that I would like to emphasize when it comes to powering the future of healthcare with technology and that is the need to bring everything together. This includes bringing together stakeholder management, financial management, operational reality and business process, costs, sustainability, and technology to unlock the true digital potential. Technology adoption with effective execution and sustainability requires time. Many organizations believe that they can skip the time required for execution and end up t putting undue pressure on execution, leading to unsatisfactory outcomes around design, preferences and priorities.
Therefore, you need to have a realistic view on programming, execution, talent, etc. It is important to have an aggressive focus and aim higher, but it is equally critical to have a realistic, executable plan of everything put together. Not merely technology. It is also vital to ensure the applicability of the technology solution to the business landscape. Sometimes there are technology solutions that are ahead of time. In such a case, applicability will be poor. So spend some time on applicability and planning effectively. I think that’s an aspect that is normally side stepped. Finally, any approach to technology adoption must be guided by a focus on good quality, sustainability and scalability.
About the author
Arvind Sivaramakrishnan is the CIO of Apollo Hospitals Enterprise Ltd, India and is based in Chennai, India. He is responsible for the IT strategy and implementation across the Apollo Hospitals group. Arvind has extensive experience in management consulting, architecting, and building solutions for enterprise-wide applications. He has led Apollo Hospitals in achieving the prestigious HIMSS Level 6 Health care IT maturity model certification which is a rare maturity level attained in Asia Pacific.
His experience in the domain of health care IT has spanned geographies across the world. Prior to his current assignment, Arvind was with the Healthcare Practice of Computer Sciences Corporation, in Michigan USA. Apart from ICT solutions in the Healthcare domain, Arvind has keen interest in IT solutions that aid Quality and Service excellence in service industries. He is a certified project management professional from the PMI,USA and Six Sigma Black belt from ASQ,USA.
