Smart Health for Smart Cities

By: Vikram Thaploo, CEO- TeleHealth,Apollo Hospitals Enterprise Limited.

India contributes to 16.5% of the total global population and 1/5th of the world’s share of diseases. But the true import of this statistic becomes clear when you consider the pre-existing inequality in healthcare services provisioning; this skew is further compounded by geographical, socio-economic bottlenecks.

The primary issue that ails Indian healthcare is the delivery gap – a burgeoning disease burden is placing a massive strain on our limited infrastructure. Several factors contribute to this situation - the inadequate number of trained healthcare professionals, disproportionate number of doctors when compared to the huge population, aging infrastructure, ever increasing population, regional inequalities, lower levels of efficiency, effectiveness and accountability of the health programs implemented and responsiveness to the general public healthcare needs.

The Public Health System in India is overloaded with the coexistence of infectious/communicable diseases and non-communicable immunological diseases. In a study conducted by NHM (National Health Mission), cases of Cardio Vascular Diseases, Hyper tension, and Diabetes are estimated to be double, in the next 10 years.

Environmental pollution, child under nutrition, unimproved sanitation, employment conditions and gender inequality are priority areas for public policy related to Social Determinants of Health (SDH). These factors coupled with aging population, , urban rural health divide, lop sided distribution of secondary and tertiary healthcare increasingly necessitate the institution of smart, preventive and cost effective measures using appropriate future ready technology. It is the need of the day to devise alternate techniques to improve the healthcare systems in India and make healthcare accessible to all.

A cost-effective and sustainable healthcare system relies on the ability to collect, process, and transform healthcare data into information, knowledge, and action. However, implementation of such systems involves a wide range of expertise in healthcare, engineering, software, social sciences, public health, health economics and management.

In order to bring about sustainable and inclusive development, the Government has initiated the building of ‘Smart Cities’. These cities can be characterized as a developed urban areas that create sustainable economic development and high quality of life by excelling in multiple key areas; economy, mobility, environment, people, living, and government. Smart cities provides core infrastructure and give a decent quality of life to its citizens, a clean and sustainable environment and application of ‘Smart’ Solutions.

As compared to other major cities of the world, major cities in India have reached peaks in terms of Air Pollution, Noise Pollution and Water Pollution. It is the mandate of such ventures to not only monitor the pollution levels but also educate the citizens regarding the hazardous health impacts. With smart real time data, appropriate corrective measures can be focused exactly where it is required most, rather than just have general policies. Today it is more important to establish a scientifically valid reproducible nexus between pollution levels and health hazards by deploying mHealth, Digital Health or to use a current term meHealth (where mobile and electronic health is personalized). The “Green” movement needs to be promoted through development of more parks & planting of trees. Smart systems can be deployed to provide clean water retrofitted with sensors that monitor different parameters of water quality.

In addition to availability of clean strategically located public toilets, water and transportation management, “Healthcare” is an inherent and major component, which must be an imperative while planning a smart city. Today we see increasingly complex healthcare systems all over the world that are driven by the fact that modern medicine is turning into a data intensive science. Traditional approaches for handling this big data can no longer keep pace with demand, and are increasingly plagued by unsatisfactory results. Consequently to cope with this rising flood of data, smart approaches are vital.

This new ‘smart’ era ushered in by the wide adoption of ubiquitous computing and mobile communications has brought opportunities for governments and companies to rethink their concept of healthcare.

Simultaneously, the worldwide urbanization process represents a formidable challenge and attracts attention toward cities that are expected to gather higher populations and provide citizens with services in an efficient and human manner. These two trends have led to the appearance of smart health and smart cities.

Though there are many long term plans which are in various stages of implementation - innovations like smart health are the need of the hour. Smart Health, covering intelligent, networked technologies for improved health provision, is recognised as one of the most promising remedies to the rising per capita healthcare expenditure and challenges with Indian healthcare system. Smart Health innovations allow healthcare providers to cure afflictions more effectively, to care for patients more efficiently and to prevent frequent occurrence and re-occurrence of illnesses. Smart health involves the use of computational technologies, smart devices, computational analysis techniques and communication media.

This multi-disciplinary domain involves many stakeholders, including clinicians, researchers and scientists with a wide range of expertise in healthcare, engineering, software, social sciences, public health, health economics and management. Smart Healthcare presupposes DIY (do it yourself), POCD (Point of Care Diagnostics),promoting wellness pro-actively, Staying Smart the eWay and is a combination of eHealth, mHealth and IoT (Internet of things) to provide continuum of care.

In order to implement smart health in smart cities it is important to reach out to huge masses with limited investment and innovative technology. One of the ways of doing so is through mobile devices. This can be mainly attributed to the fact that India has the second largest mobile phone user subscription base in the world with over 1 billion mobile phone users. Mobile devices have good penetration even in rural areas where other sophisticated infrastructure components do not exist.

With regard to eHealth, India has made reasonable progress with milestones like National Health portal. Many IT applications in the National health portal of late are also available through mobile apps.Various dimensions of eHealth are Healthcare portals, digitization of healthcare records (Electronic Health Records/EHR) and creation of a centralized IT infrastructure for healthcare information access.

Apollo Hospitals believes that in order to provide continuum of care, an integrated system of care is required which will guide and track patients over time through a comprehensive array of health services spanning all levels of intensity of care.

An effective and innovative use of medical technology, supported by IoT, as a Connected device has the potential of increasing access, significantly reducing the burden of disease and the load on healthcare delivery services. This is achieved  through early diagnosis, better clinical outcomes, less invasive procedures and shorter recovery times. While Point of care testing devices improves access to healthcare, integrating in vitro diagnostic machines and smartphones allows self monitoring. The use of medical technology enabled devices empowers the patient to keep a track of his health on a more regular basis avoiding frequent hospital visits and alerts the patient to see a doctor when necessary, thereby enabling continuum of care and promoting good health.

With the rapid increasing burden of Non Communicable Diseases, mass screening for prevention and control will promote the concept of ‘wellness’ not ‘illness’. Low cost tabs in an intelligent connected ecosystem with point of care devices will enable better population health control.

Apollo Hospitals was the first to create a digital patient health record in the country; the group pioneered preventive health checks and actively promotes the concept of wellness through its large network of Clinics, Hospitals & TeleClinics. As the path-breaking innovator of Technology based healthcare delivery and Telehealth in India and South Asia, Apollo is technologically and clinically equipped to be at the frontier of smart health solution design and delivery. By leveraging infrastructure and IT capability of smart cities, Apollo now aspires to provide continuum of care through Smart health solutions….

An ever growing disease burden for a large scale and evolving population demands fast- paced health reforms.Globally, we are seeing old paradigms give way to the new. What peer nations have achieved across three to four decades needs to be achieved here in much lesser time. Indian healthcare has been a microcosm of all the metamorphosis we are seeing around us. Therein lies the importance of the next decade. In this day and age, it is critical that healthcare systems and healthcare providers adapt.  It is only synergistic multisectoral thinking between the Government, Private players in Healthcare, Medical Technology Industry that will bring about this transformation in Digital Health delivery.