Healthcare technology in India and APAC, as in worldwide, is reaching an inflection point where it is poised to disrupt an industry that has stubbornly avoided getting disrupted. As old industries like retailing, books, music and television have been disrupted, the healthcare industry is facing its moment where technology driven disruption is at its doors. Surprisingly, this time the disruption might not start in North America! It might happen right here in Mumbai and Hyderabad!
Many industries that were disrupted by technology continued to think that they could not be disrupted. Even technology products like the early smartphone (BlackBerry etc) thought they were on top of their game and failed to see trends already visible in their industries (like touch interface and apps) that were ultimately going to disrupt them.
Most disruptions do not happen overnight; they show enough presence and trends that are not picked up by the incumbents. Countries like India are ripe candidates for disruption due to three main reasons: 1) An educated and technology aware critical population mass. 2) Economic imperative to shortcut and leapfrog the incremental growth process, and 3) A reasonably well developed non risk averse entrepreneurial ecosystem.
I present two proofs of the above: 1) Bharati AirTel investing $ 1 billion on a mobile billing and CRM system, when the industry was still looking at cordless phone options, and 2) The explosion in app delivered food retail.
Healthcare has defied disruption forces for the simple reason that the key stakeholders (the doctors) are uniquely averse to change. As part of their professional training they are taught to take all new things with a huge pinch of salt, as it might hurt their patients.
The status quo is the norm for them. They’re following age old Aristotlean wisdom that change in the way you treat patients, unless well proven through collaborative studies that last SEVERAL DECADES, can hurt the patients.
That’s the reason today you can book a lovely mattress on an app and get it delivered at home, whereas to see a physician you need to stand in a physical queue to pay the consultation charges! Yet, three things are happening that will very soon force the doctors’ hands into changing the way healthcare is delivered:
1. The economic imperative – as healthcare becomes private it becomes loss averse and keeps looking for innovative ways to reduce costs through whatever means. A big cost on society is hospital infections and treatment side effects. Are we willing to wait for decades before the next incremental gains come or we use big data analytics to get actionable pointers in a few years?
2. The increasing movement towards fixed price payments by all payers, including those paying out of pocket. This ensures that the costs mentioned earlier are all borne by the hospitals, and 3) Patients are increasingly getting frustrated by the paper-based eco system of hospitals. They struggle to get their own data, struggle to stand in a queue, or talk over phones to book appointments, struggle to get prescriptions dispensed in a pharmacy queue etc. The list is endless, and typically VERY IRRITATING for a populace which has got used to click based consumption of services.
We will now look at a few technology trends, some of which are decades old and available, which are very likely to disrupt the healthcare delivery space over the coming decade in India and Asia.
EMR/EHR AND BIG DATA
Without getting into the semantics of how they are different (I will call both as EMRs), this is an industry whose time has come. Earlier it was great technology which was however VERY EXPENSIVE. A million dollar (minimum) sticker price was a strict no-no for hospitals struggling to nudge their EBITDA into two digits. Besides, the desktop based interfaces were depriving the clinician from valuable eye contact time with his patients. Luckily Indian tech entrepreneurs have a fix now: a mobile based EMR, as powerful as the desktop based one, infinitely more usable by the doctors (its another app among the 100s that he/she already has on her phone) AND available on a very reasonable subscription fee.
These EMRs will also have virtual ICU and patient portal functions enabling the doctor to view critical patient data remotely (and give treatment orders) and the patient to book his visit remotely, and even conduct a doctor’s consultation, remotely via video conference, and pay for ordered lab (with home sample collection) and ordered medications (with home delivery).
Suddenly, the million dollar costs have evaporated and the EMR has become affordable, usable, and converting the hospital/doctor interface closer to Amazon’s retailing experience. Through the patient portal, the patient carries on his smartphone his ICD coded clinical problem list, diagnostic results, images, medication lists, allergies, and past discharge summaries. His whole healthcare experience gets simplified, and the smartphone becomes the centre of his healthcare experience, like in retail. I see a huge spurt in adoption even by mid-tier hospitals and a spurt in providers of such technology. As adoption increases, over a few years Indian patient algorithms will be able to guide us into newer treatment paradigms and shorten the treatment evolution cycle from few decades to few years.
I rest my case. This will begin re-imagining the chronic diseases management industry as soon as some business savvy investor releases hardware in India at Indian price points with huge volumes.