Second day of FE Digital Health Conclave 2021: Development of digital health need to be governed through proper regulatory framework

The health sector has been immensely benefited by the accelerated use of digital tools like Aarogya Setu for contact tracing, CoWIN App for digital vaccination certificate and e-sanjeevani for telemedicine

FE Digital Health Conclave 2021, digital transformation, public health, WHO, SDG, Covid-19, TB
The second day of FE Digital Health Conclave 2021 covered relevant topics under the theme – “Building The Digital Healthcare Ecosystem”.

Digital transformation of health sector can lead to better public health outcomes. Therefore, development of digital health sector should be well governed through a proper regulatory framework to help take steps and mitigate risks through monitoring, evaluation and measuring the outcomes, said Dr Soumya Swaminathan, Chief Scientist, World Health Organisation (WHO) while delivering her inaugural address on the theme ‘The WHO approach to digital health’ on the occasion of FE Digital Health Conclave 2021 which started yesterday on December 9, 2021 and concluded today on December 10, 2021.

“The health sector has been immensely benefited by the accelerated use of digital tools like Aarogya Setu for contact tracing, CoWIN App for digital vaccination certificate and e-sanjeevani for telemedicine,” Dr Swaminathan added.

“Covid -19 badly impacted low and middle income countries and brought in slippages in terms of livelihood and increased global poverty rates, under-nutrition and hunger indicators. There were slippages in SDG targets for TB with 2020 seeing an increase in TB deaths. The pandemic had side effects on essential health services also,” she explained.

Digital health strategy implementation

“Member states of WHO approved global strategy on digital health in 2020 and endorsed certain strategic objectives and framework for implementation and action for global collaboration and transfer of technology, resources and investments at the national, regional and global level. This will help in aligning resources and investments to ensure sustainability and growth of digital health. Global collaboration of private public partnerships, researchers, doctors and scientists have led to development of new tools, diagnostics, vaccines, oral drugs for Covid-19,” Dr Swaminathan informed.

“There have been rising cases of anemia, obesity and under-nutrition in India. The focus should therefore be on prevention rather than on management of disease and for that digital tool should be put to full use. A case in point is the evaluation of the e-sanjeevani project. There are plans to develop a hub and spoke model by the health and family welfare centres so that the centres can be connected to the public health centres (PHCs), Community Health Centres (CHCs) and district hospitals towards accelerating digital healthcare for effective public health outcomes,” Dr Swaminathan added.

Manoj Kapoor, Vice President, Technology, Optum Global Solutions (India) Pvt. Ltd, while delivering his keynote address said, “With advancement and convergence of technology, healthcare is becoming one of the most transformational industries of our times. Covid -19 has accelerated the adoption in digital in various ways. All the stakeholders in healthcare today like consumers, payers, providers and government have adopted digital health in an effective way.”

United Health Group (UHG) is a healthcare and well-being company and its mission is to make people lead healthier lives and help health systems work better for everyone. The company is working to provide improved access and affordable healthcare aided by technology to ensure health benefits, affordable health package, simplified healthcare experiences to customers.

“As healthtech professionals, our endeavor is to create a more equitable future as to how people receive and access care. I believe with shifts in the policy framework and digital infrastructure will go a long way in promoting health equity in the country. We aim to help people live their healthiest lives by ensuring they achieve optimal health by eliminating inequalities based on race, ethnicity, language, income, disability, gender and many more social determinants. In order to achieve the quadruple aim of affordability, accessibility, quality and patient experience, we should use modern digital technologies to standardize care pathways and offer personalized care on a real time basis,” he concluded.

The second day of FE Digital Health Conclave -2021 covered relevant topics under the theme – “Building The Digital Healthcare Ecosystem”.

While speaking on the panel discussion on “Reimagining Public Health in India”, The Digital Way, Prof Dorairaj Prabhakaran, Vice President – Research & Policy, Public Health Foundation of India (PHFI) said, “Digitization in healthcare can play an important role in a country like India where healthcare accessibility is a major issue due to shortage of doctors. The digital tools and interventions can play a bigger role in surveillance of the disease pattern considering the fact that two thirds of deaths in India are happening due to chronic diseases. Therefore, modalities like electronic decision support systems can help in informed clinical decisions and telemedicine in remote patient care.”

“Since there is a major issue of digital illiteracy amongst the masses, challenges related to interoperability in health systems also need to be addressed,” he added.

Dr B. Viduthalai Virumbi, Nodal Officer (Technical), Population Health Registry & State Digital Health Mission, National Health Mission, Government of Tamil Nadu said, “Covid-19 has made us realize the importance of digital transformation in healthcare to effectively redesign programme management, data management, remote patient monitoring through accelerated use of technology. Today, we are equipped to assess the pattern of infection spread by capturing footfall of patients in hospitals through online tools with the help of standardization of data, facility and data capturing methods.”

Jaspreet Singh, Partner & National Leader – Client and Markets (Trust and Transformation),Grant Thornton, Bharat LLP moderated the session on panel discussion on “Healthcare Cloud: Benefits, Compliance, Possibilities”.

While speaking on the panel discussion on “Healthcare Cloud: Benefits, Compliance, Possibilities”,  Dr Sujoy Kar, Chief Medical Information Officer & Vice- President, Apollo Hospitals said, “Cloud based healthcare is collaborated and connected healthcare to provide secured, meaningful and longitudinal patient data which is unbiased, inclusive and insightful for better adoption and workflow integration. It is an ecosystem concerning patient data which can be built with a collaborative approach for better health outcomes. Today, we are seeing digital platforms where we are getting patient data on a real time basis.”

“Apollo hospital has been using cloud storage for quite some time now in different forms.  We are sourcing high velocity, high variability data – which means we are not just collecting EMRs but also collecting images and also videos, putting them in a cloud in a way which is scalable. Most important aspect is to harmonize this data – provide source, codify and use their lineage as to how they flow over a period of time and finally enrich them by AIML models to look into the longitudinal patient records,” he added.

Sunil Kumar, Deputy Director General, National Informatics Centre, Government of India informed, “National Informatics Centre (NIC) started developing hospital hospital management information system (HMIS) in 2007. All our installations in 50 big government hospitals which had their own premise servers are today connected through cloud computing. In 2017, NIC onboarded 500 hospitals which are today utilizing HMIS software.”

Government focused on cloud computing in 2015. So most of the hospitals migrated applications from their own premises to cloud based applications utilizing HMIS software. Since 2010 all the applications are in cloud technologies and all 400 CGHS dispensaries are on health cloud infrastructure equipped with secured health network, health cloud, security and privacy operations.

Government is focusing on a separate cloud for the healthcare sector. It involves huge data processing, power, secured network, transmission of videos and images, radiological reports and images to provide telemedicine. This requires a separate network, health cloud and security of data and privacy of operations with consistent monitoring for secured data.

“Consent of the patient is the most important and required as the patient is the owner. Infrastructure is required towards sharing patient centric information in a secure manner. This has been the practice in NIC to ensure consent management practice and also every aspect related to health to have security audits of applications, networks and infrastructure,” Kumar concluded.

While speaking on the panel discussion, Arun Goyal, CIO, Sir Ganga Ram Hospital said,  “As part of Ayushman Bharat Digital Mission, consumer or patient health data will be managed through health exchanges in a secured way with the help of health providers which will fetch the information from the respective health ID cards. This will follow the concept of consent based management which follows the principle of security of design and privacy by design taking consideration of the security of the patient’s data.”

Neeraj Jain, Country Director – India, PATH moderated the panel discussion on “Digital Diagnostics: Towards A Holistic Digital Health Ecosystem”

While speaking on the panel discussion on “Digital Diagnostics: Towards A Holistic Digital Health Ecosystem”, Dr Kamini Walia, Senior Scientist & Program Officer, antimicrobial resistance (AMR), Indian Council of Medical Research (ICMR) said, “For a long time our approach towards digitization in public health has been treatment centric. There is a need to push it to diagnostics. Covid -19 has brought the spotlight on diagnostics and importance of information technology (IT) infrastructure to share the findings on a real time basis. Encompassing all aspects of IT and digitization are very important but this has not panned down to all socio-economic strata. Now the time has come to add all aspects of digitization and the IT infrastructure system to the whole ecosystem of diagnostics.”

Dr Walia further explained, “IT has been restricted to urban settings and not been able to percolate in rural areas and in low socio-economic strata. Many public health sector hospitals have no health information systems which have led to gaps in evidence generation in antimicrobial resistance (AMR). We don’t have any clue what is the history of patients with past hospitalization and burden of hospital acquired infections (HAIs). We are today facing the key challenge of connecting trends and patterns of drug resistance with anti-microbial consumption. Diagnostics which are available today cannot be utilized today due to lack of algorithms and guidance on the same.”

“We are conducting a project with FIND in 4 sites on how you can utilize the commercially available diagnostics to create a clinical diagnostic algorithm preferably an electronic algorithm and how effective it is on the ground to rationalize AMR prescription. This will help us develop confidence on how electronic clinical diagnostics can help in rationalizing AMR prescriptions,” Dr Walia informed.

During the discussion, Dr Debkishore Gupta, Director Medical Affairs, Cepheid India, said, “Digital health is the way forward. This will help in overall simplification by keeping quality of care intact. This will further revolutionize overall implementation of patient data and disease management.”

Sharing his experience, Dr RaghuRam Rao, Joint Director (Public Health), National Tuberculosis Elimination Programme, MOHFW, Government Of India said, “NI-KSHAY, the web enabled patient management system for TB control under the National Tuberculosis Elimination Programme (NTEP) has evolved since 2012. It is the largest programme in terms of case based information and shares a huge volume of information to facilitate mother child tracking systems and high risk pregnancy programmes. It is one of the largest public health programmes to help track epidemics. It helps to assess transmission dynamics, clinical management, enables patient and doctor communication on lab results, comorbidity testing and adherence patterns with the help of digital tools.”

“With digital tools coming in, it is remotely observed treatment as compared to earlier when it was intermittent therapy or directly observed treatment (DOT) and this has changed the dynamics so much so that I can efficiently use my public health system and staff to prioritize patients based on their medical condition and treatment modalities,” he added.

Andrew Cross, CEO, Everwell Health Solutions Pvt Ltd said that there needs to be training and capacity in order to better utilization of digital intervention in healthcare.

Panel discussion on “Future of Radiology & Imaging with AI” was moderated by E Kumar Sharma, Deputy Editor, FE Digital, The Indian Express Group

As part of the panel discussion on “Future of Radiology & Imaging with AI”, Dr Namita Sinha Verma, Head Global Teleradiology, Aster Medical Imaging, Aster DM Healthcare said, “AI immensely helped during the pandemic to facilitate much better understanding of the increasing radiological data in the form of images and scans.”

Echoing similar views, Dr Deepak Patkar, Director, Medical Services & Head, Department Of Radiology, Nanavati Max Super Speciality Hospital said, “AI can help in managing better diagnostics in radiology when there are thousands of images and  aids in pattern recognition of common disorders and rare disorders.”

“Talking about tackling potential TB cases, the challenge remains in terms of integration of other information about patient diagnostics to enable clinicians and algorithms to be more powerful which currently is only based on elementary algorithms. TB which is a public health issue, we need to factor in how TB spreads in a different way in a sparsely populated community as compared to densely populated community. This information also needs to be fed into algorithms to be able to provide public health officials relevant information for intervention on an active case if it is identified,” said Pankaj Sahni, CEO, Medanta Group (Global Health Ltd).

In her special address on the subject – “Digital Transformation – The way ahead – challenges faced in conversions”, Dr Sangita Reddy, Joint Managing Director, Apollo Hospitals Group, said, “As part of the digital health transformation, we have to move from sick care system to a proactive healthcare system which is personalized. Today, computing has enhanced the reach of healthcare and has led to connected healthcare with a doctor in a tertiary healthcare center to be able to remotely connect to a patient in a rural setting.”

“Our hospital has 4, 700 doctors onboard who are digitally connected with the Apollo 24X7 platform to provide healthcare on a real time basis. Patient health records can be easily shared in the digital form through this platform in a secured form based on consent of the patient. Precision medicine and population health data are two other avenues which can empower digital healthcare to offer effective patient health outcomes,” Dr Reddy concluded.

 

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