There is an increasing expectation from the healthcare industry to provide accessible, affordable, efficient, and effective solutions to disease management. Today, technological innovations - like IT tools, artificial intelligence, telemedicine, and even robotic-assisted surgery - have emerged to be important enablers to deliver on these expectations. For example, the COVID-19 pandemic was a stark background against which the usage of telemedicine and telementoring gained broad acceptability, highlighting how technology can improve the ease of healthcare delivery, access, and knowledge dissemination, especially during challenging times. Breaking barriers - be it the availability of digital infrastructure or changing mindsets to remove technology hesitancy - can transform our health systems into robust, sustainable, resilient ones, accessible to all Indians, especially the underserved.

Many healthcare professionals see technology advancing at an extremely fast pace raising concerns that a combination of robotics, virtual reality, artificial intelligence, metaverse, and now chatGPT, has the potential to replace human medical professionals like doctors, nurses, and allied health workers. There are a few fundamental questions that have arisen in the minds of the healthcare fraternity - Who would say “no” to robotic surgery, performed with high precision eliminating any possibility of human fallibility? And on the other hand, Will the oft-quoted importance of the “human touch” in the medical profession lose its relevance?

Technology and human interventions, both have their pros and cons, however, a holistic approach taking the best of both worlds is the way forward. There is a growing need for changing mindsets amongst healthcare professionals and policymakers so that they can shun hesitancy towards acceptance and adoption of innovative technologies that can improve healthcare outcomes.

Adoption of digital technology for capacity building of the healthcare workforce

One of the areas in which the adoption of digital technology is playing a game-changing role is health system strengthening through capacity building of the healthcare workforce.

A critical challenge facing health systems globally is that a very large number of patients are dying of diseases for which viable treatment is available. Even treatable diseases are proving fatal for a very large number of patients, especially in rural areas, because they don’t have access to the right healthcare expertise in their own communities. Specialist medical knowledge is almost exclusively based in urban centers, therefore, the right knowledge doesn’t exist at the right place at the right time.

ECHO (Extension of Community Healthcare Outcomes), developed by Dr. Sanjeev Arora at the University of New Mexico Health Sciences Center, is a model for sharing critical, timely (as they occur), lifesaving information and data with healthcare workers at different geographical locations. The ECHO Model of capacity building is based on four core principles – referred to as the ABCD principles. When all of the following four principles are applied, a learning community comes together leading to measurable improvements in learning outcomes and creating lasting impact:

(i) Amplifying scarce resources by leveraging technology (ii) Best Practices sharing to reduce disparities (iii) Case-based learning to master complexity, and (iv) Data analysis to monitor outcomes

The ECHO Model of learning follows a ‘hub & spoke’ structure; hub being a group of experts who regularly mentor the learners (spokes); and it uses an open digital infrastructure, called iECHO, to enable capacity building at speed and scale in a sustainable and cost-effective way.

Backed by a rigorous evaluation, published by the New England Journal of Medicine in 2011, universities and medical centers around the world have adopted the ECHO Model for their own local challenges. ECHO has been used to improve healthcare outcomes in countless disease areas, from diabetes and bone health to rheumatology and perinatal health.

Health tech driving efficiencies across healthcare providers to improve patient care outcomes

As India’s health sector faces its major challenges - growing population, gaps in healthcare infrastructure, rising instances of Non-Communicable Diseases (NCDs), and systemic stresses posed by the ongoing COVID-19 pandemic - technology solutions are coming to the rescue by improving performance across systems and managing costs.

For instance, in hospital administration healthcare technology streamlines cross-functional processes, improves workflows, and automates tasks at a pace that is not possible for humans alone. The providers of health systems and hospitals are therefore embracing the value addition of systems to improve patient care, reduce burnout and create better experiences for patients.

Healthcare technology is giving new dimensions to medicine and treatments, enhancing hospital and administrative productivity, or improving the overall quality of care provided. WHO aptly defines health technology as the “application of organized knowledge and skills in the form of devices, medicines, vaccines, procedures, and systems developed to solve a health problem and improve quality of life.”

Healthcare providers are increasingly adopting newer and innovative technologies for day-to-day practices such as record keeping and care delivery. Paper-based medical records are being digitized and converted to electronic health records (EHR), making health data much more accessible, easier, efficient, and secure. It has now become standard practice to use electronic health records and other technologies when it comes to engaging with patients and creating treatment plans. Computers, mobiles, tablets, and laptops have become just as common as stethoscopes.

Technology transforming public health space

The Government of India, which is the largest healthcare provider in the country, has been focusing on the adoption of technology for the health system strengthening. The National Digital Health Mission (NDHM), announced on 15th August 2020, the 74th Independence Day of India, is a big step in this direction. As per the NDHM policy document, “The current digital infrastructure of the country that identifies and connects people while simplifying their day-to-day life through digital means includes Aadhaar Unique Identity (UID), JAM trinity (Jan Dhan-Aadhaar-Mobile) and Unified Payments Interface (UPI). This strong digital infrastructure base acts as a launcher for NDHM to further develop and enhance healthcare in the country through digital management”. As per a December 2022 report by the MoHFW, eSanjeevani, Govt. of India’s free telemedicine service, has crossed an astounding milestone by clocking 8 crore teleconsultations. The last 1 crore consultations were recorded in a remarkable time frame of around 5 weeks, signaling a wider adoption of telemedicine.

The health sector has witnessed many innovations over the last few decades. However, only a few have had an impact that is as comprehensive and far-reaching as digital technology. Advances in computers and networks have increased treatment options and helped clinicians perform their jobs better. We are in an exciting new era where the advances being made in digital technologies are improving the quality of healthcare while drastically reducing costs. All cadres of healthcare professionals need to embrace these emerging technologies to stay relevant and achieve the dream of cheaper, faster, and more effective healthcare solutions.

Dr. Sandeep Bhalla is a seasoned public health specialist and is working with ECHO India as Associate Vice President. Dr. Bhalla earned his MBBS from the Armed Forces Medical College (AFMC) Pune and MD, DNB in Community Medicine. With around 20 years of experience in the public health arena, he regularly shares his insights on public health topics and has over 50 articles published in national and international journals.

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