A rainbow like collection of vibrant innovations and sky-high investments are enabling theÂ healthcare sector in India to grow at a scorching pace
By Dhirendra Pratap Singh, firstname.lastname@example.org
As George Bernard Shaw once said, âProgress is impossibleÂ without change, and those who cannotÂ change their minds cannot change anything.â TheÂ last year, defined by innovations and new technology trendsÂ in healthcare, one word that dominated the global vocabularyÂ was âchangeâ.
Healthcare has emerged as one of the most progressiveÂ and the largest service sector in India. The sectorâs share inÂ Indiaâs GDP is expected to reach 8 percent by 2012. In 2009,Â it was 5.5 percent. At present the sector is estimated to beÂ around US$ 40 billion and will grow to US$ 78.6 billion by 2012.Â The Indian healthcare sector is expected to become a US$ 280Â billion industry by 2020 with spending on health estimated toÂ grow 14 percent annually.
The year 2011 can be considered a year of technologyÂ advancements. This was the year when innovative businessÂ models using IT ensured reach out of healthcare facilities toÂ the masses. The year 2011 has been like no other for healthcareÂ IT, not just in terms of the revolutionary and ground-breakingÂ technology advancements, but also in terms of innovativeÂ business models.
As Anthelio Business Technologies, Vishwanath SivaswamyÂ explains, âIn 2011, Telemedicine – remote diagnosis, monitoringÂ and treatment of patients via videoconferencing or the InternetÂ – was seen as a fast-emerging trend in India. TelemedicineÂ was supported by exponential growth in the countryâsÂ information and communications technology (ICT) sector,Â and plummeting telecom costs. Several major private hospitalsÂ have adopted telemedicine services, including those thatÂ have developed Public-Private-Partnerships (PPPs), such asÂ the AIIMS. There are approximately 120 telemedicine centresÂ across the country, and the government has pledged supportÂ for hundreds more.â
He adds, âA booming healthcare insurance scenarioÂ is paving the way for hospitals to be able to afford use ofÂ technologies such as HIS and EMR. With the introduction of 3G,Â the possibilities of remote treatment and diagnosis of patients Â through mobile phones have been strengthened. In 2011, theÂ number of cell phone users in India stood at approximatelyÂ 600 million, with a projected increase of 20 million each month. Â In 2012, some telecom operators and value-added serviceÂ developers are considering usage of mobile phones forÂ diagnostic and treatment support, remote disease monitoring,Â health awareness and communication.â
With the introduction of 3G ready devices like iPads, SamsungÂ Galaxy Tab, Dell Streak etc., which have much biggerÂ screen to facilitate content and application placement theÂ mHealth space is poised to get even more expansive.
The global healthcare IT market is forecast to exceed $24Â billion by 2015 with a CAGR of 11 percent. The market isÂ expected to be driven by governmentsâ financial incentivesÂ and regulations requiring automation in healthcare practices. Â The market growth is also expected to be driven by increasingÂ need for hospitals to attain cost efficiencies and growingÂ evidence of use of IT in healthcare practices.
âIn 2011, Telemedicine – The remote diagnosis, monitoringÂ and treatment of patients via videoconferencing or theÂ Internet – was seen as a fast-emerging trend in India.Â Telemedicine was supported by exponential growth in theÂ countryâs information and communications technology Â (ICT) sector, and plummeting telecom costs.â
MD, Anthelio Business Technologies
The concept of Remote Diagnostics is picking up in India.Â More and more experts are interpreting digital images ofÂ MRI, CT scans, X-rays, etc and sending their interpretationsÂ to doctors practising not only in various parts of the countryÂ but also abroad. This innovative solution is simply a newÂ paradigm of seeking medical expertise.
Similarly, Telemedicine is fast becoming an integral part ofÂ healthcare services in several countries including Canada,Â Italy, Germany, Japan, Greece, Norway and now India. InÂ India, Karnataka has become the role model for implementing Â telemedicine in all its districts. The market penetration ofÂ Picture Archiving and Communication Systems (PACS) inÂ India is gaining momentum owing to the growing popularityÂ of digitisation at the level of hospitals and healthcare deliveryÂ centres.
Medical Technology over the past ten years has transformedÂ the healthcare sector with several cutting edge technologiesÂ in the areas of molecular diagnostics, molecular imaging,Â minimally invasive therapies, implantable medical devices Â etc. The world today needs technology related innovation fromÂ the emerging world to ensure that the new technologies areÂ affordable to a larger section of the population.
The size of the Indian medical technology industry mayÂ touch US$ 14 billion by 2020, up from US$ 2.7 billion in 2008.Â The increased market share is on account of strong economicÂ growth, higher public spending and private investments inÂ healthcare, increased penetration of health insurance and Â emergence of new models of healthcare delivery.
Kaustav Banerjee, Country Manager, India- St. JudeÂ Medical Devices, says, âThe medical technology spaceÂ is diverse, and there are various therapies currently beingÂ offered for an array of diseases and ailments. This diversity Â makes it difficult to point towards one or two specific medicalÂ technologies.â
“With increase in awareness, growing income level,Â rapid increase in health infrastructure, gradual increaseÂ in state level reimbursement, and the enhancementsÂ of institutional and private medical insurances, India isÂ now one of the fastest growing healthcare markets inÂ the world.â
Country Manager, India- St. Jude Medical Devices
He adds, âWe offer technologies that help achieve costÂ reduction benefits, including our fractional flow reserve (FFR)Â PressureWireâ¢ technology. FFR is a physiological index thatÂ helps physicians to identify the severity of blood flow blockages Â in the heart. This information helps guide decisions asÂ to whether stenting or optimal medical therapy would be theÂ best course of treatment for each individual patient. The FAME Â study demonstrated that use of FFR prior to coronary stentingÂ resulted in superior outcomes for patients â including a 28 Â percent reduction in major adverse cardiac events â as well asÂ a reduction in cost.â
Dr Bhaskar Krishna Arumugam, Chief Executive Officer,Â Granules India Ltd., says âOver the next several years, companiesÂ will focus on generics for biotech products. This sectorÂ will become the next big growth driver for Indian healthcare Â companies. Indiaâs biotech sector is relatively small, but it willÂ continue to grow over the next few years as more companiesÂ focus on this space.â
Evidence based medicine tools
As the healthcare industry matures in terms of infrastructureÂ and innovative technologies, the next goal of care delivery demandsÂ clinical excellence through evidence based medicineÂ tools and benchmarks. Evidence based medicine is alreadyÂ being promoted globally and has been proved to be beneficialÂ for all the stakeholders- clinical teams, hospital management Â as well as the patients. Evidence based medicinal tools,Â like clinical protocols and clinical pathways, provide explicitÂ and well defined standards of care for the clinical teams andÂ support multi-disciplinary care planning.
From a management perspective these tools reduce healthcareÂ costs, reduce patient documentation, optimise managementÂ of resources and help continuous clinical audit. They improveÂ clinical care by delivering superior outcomes, improvedÂ clinical effectiveness and patient satisfaction. These tools canÂ also be integrated with the existing EMR for providing decisionÂ support to the clinical teams.
A study by Ernst & Young says that India will require another 1.75 million beds by the end of 2025. The public sector is likelyÂ to contribute only around 15-20 per cent of the required US$ 86 billion investment.
Healthcare sector in India, at present is estimated to be around US$ 40 billion and will grow to US$ 78.6 billion by 2012
The size of the Indian medical technology industry may touch US$ 14 billion by 2020 on account of strong economic growth,Â higher public spending and private investments in healthcare
The global healthcare IT market is forecast to exceed $24 billion by 2015 with a CAGR of 11 percent
The government has proposed to step up the plan allocations in 2011-12 by 20 percent amounting to Rs 26,760 crore
With a world average of 3.96 hospital beds per 1000 population India has only 0.7 hospital beds per 1000 population. TheÂ country will require another 1.75 million beds by the end of 2025
Clinical protocols and pathways based on evidence availableÂ from the Indian sub-continent are now available and needÂ to be adopted in healthcare settings to achieve the next levelÂ of quality. The right amalgamation of modern infrastructure,Â innovative technologies and clinical skills guided by evidenceÂ based tools will go a long way in bridging the gap in the IndianÂ healthcare industry.
The Government has proposed to step up the plan allocationsÂ in 2011-12 by 20 percent, amounting to ` 26,760 crore. ThisÂ was announced by the Union Finance Minister Pranab Mukherjee Â while presenting Sixth Union Budget 2011-12. The boostÂ provided to healthcare is welcome and shall continue to support Â the industryâs need to reach a larger population, includingÂ the people in the remotest districts. The reassurance shall provide Â the push for further growth. In India, the increased budgetÂ can further be fruitful as it will ensure good progress at theÂ technological aspect.
The Rashtriya Swasthya Bima Yojana (RSBY) has beenÂ extended to cover unorganised sector workers in hazardousÂ mining and associated industries, like slate and slate pencil,Â dolomite, mica and asbestos. The Yojana has emerged as an Â effective instrument for providing a basic health cover to poorÂ and marginal workers. Presently it is being extended to MGNREGAÂ beneficiaries, beedi workers and others.
Government of Maharashtra is using ICT as a tool to enhanceÂ their ability and bring more professionalism in healthcareÂ services. Tripura has initiated Tripura Vision Centre Project,Â a Tele-ophthalmology project aimed at offering primary Â and preventive eye care services to rural citizens. The projectÂ has adopted the latest ICT related advances in medical sciencesÂ and bio-medical engineering.
However, there are lot of challenges ahead. India faces theÂ huge need gap in terms of availability of number of hospitalÂ beds per 1000 population. With a world average of 3.96 hospitalÂ beds per 1000 population, India stands just a little overÂ 0.7 hospital beds per 1000 population. Moreover, India faces a Â shortage of doctors, nurses and paramedics that are neededÂ to propel the growing healthcare industry.
Wish-list to the government
Says Vishwanath Sivaswamy, âI believe that India can leverageÂ its prowess in computer technology, along with its highlyÂ skilled medical fraternity, to enable and augment technologyÂ in healthcare. With spending in the industry likely to touch `Â 200,000 crores by next year, policy initiatives by governmentÂ will go a long way in ensuring effective penetration of healthcareÂ technology.â
To support and nurture the growth of healthcare technology,Â the Government should provide incentives to hospitals to seekÂ NABH (National Accreditation Board for Hospitals) accreditationÂ and IT enablement by allowing 100 percent tax exemptionÂ for expenditures related to accreditation and IT enablement.Â Such initiatives will not only pave the way for a sustainable futureÂ for healthcare, but will also give rise to a nation where advancement in technology can truly be leveraged for prosperityÂ and change.
Indian pharmaceutical companies will benefit if the governmentÂ takes steps to modernise the infrastructure, includingÂ roads and ports. Modern infrastructure would reduce transportationÂ time and costs, which and enable the healthcareÂ leaders to create more value for customers.
âOver the next several years, companies will focusÂ on generics for biotech products. This sector willÂ become the next big growth driver for Indian healthcareÂ companies. Indiaâs biotech sector is relatively small,Â but it will continue to grow over the next few years asÂ more companies focus on this space.â
Dr Bhaskar Krishna Arumugam
Chief Executive Officer, Granules India Ltd
A booming healthcare insurance scenario is enabling hospitalsÂ to afford technologies such as HIS and EMR. With theÂ introduction of 3G, the possibilities of remote treatment and diagnosisÂ of patients through mobile phones has been strengthened. Â In 2011, the number of cell phone users in India standsÂ at approximately 600 million, with a projected increase of 20 Â million each month. In 2012, some telecom operators andÂ service developers are considering to use mobile phones for diagnostic and treatment support, remote disease monitoring,Â health awareness and communication.
In the healthcare sector, Electronic medical record (EMR)Â services have a high growth potential and is expected to becomeÂ the most popular in 2012. According to Reuters, EMRÂ growth is pegged at an estimated compound annual growthÂ rate (CAGR) of 13.5 percent from 2009 to 2016. The spate ofÂ new private hospitals that accounts for more than 80 Â percentÂ of the countryâs total healthcare spend is likely to boost thisÂ further, with investment in EMR being seen as a Â necessity.