Dr Anjali Bhutani

The shift in lifestyle, rise in awareness of preventive testing coupled with digitization of the healthcare sector will be the core focus area of diagnostic centers. India is emerging to be one of the leading markets for high-end diagnostics services. Home diagnostics emerged as a silver lining during pandemic times. While it is still flourishing, it will indeed be the future of the sector. It will also drive the acceptance of preventive healthcare as people will become more cautious and aware of their health.

Strengthening diagnostics services at these primary health facilities can significantly improve utilization of these facilities and patient outcomes. The government must continue to partner with the private diagnostics industry players to create and successfully run these diagnostic services, as was done for India’s COVID response. But the big challenge is how to evaluate these diagnostic functions. The quality of services and care is adversely impacted as half of these labs aim towards testing only without any concern for quality and accuracy. Technological advancements have reduced medical costs, made healthcare available in remote locations, and completely changed processes as they pertain to research, innovation, and education.

It should be enforced for all accredited diagnostic labs to collect accurate and real-time data for disease surveillance, healthcare research and policy planning.

The potential of diagnostics in low and middle-income countries is not fully realized, and diagnostics are not necessarily available, accessible, or affordable to those in need. Government or bigger players should set satellite labs and it can be run remotely but by keeping a strong vigil on day-to-day quality parameters. Ensuring broader access to diagnostics also requires a seamless supply chain and a strengthened health system with absorption capacity for diagnostic innovation. Innovation processes need to include end-users and service innovations, the local evidence base needs to be expanded, and guidelines and evaluation processes need to be harmonized.

Major challenges faced in any diagnostic sector are cost, staff capacities, irregular supply, transportation delays, inconsistent funding by governments and donors, poor forecasting and stock management, quality assurance, as well as problems with infrastructure, access, and end-user utility.

It should be emphasized that endusers (clinicians) are aware of tests and able to use them, overcome widespread empirical treatment, and ensuring test results are linked to care .Low demand of new diagnostics by end-users is, due to lack of knowledge .Other important point is that physicians and patients need to have trust in the test results and the quality of laboratory work. Diagnostic confidence can be low in settings with inadequately funded laboratory infrastructure, short testing menus and reputations of questionable accuracy, Currently diagnostics are provided in a top-down manner, ‘from tech companies and their agents to government agencies or hospitals, to laboratories, then clinicians, and then patients,’ instead of stimulating demand for diagnostics from patients and provider. Things will be better if end users are included in design and discussion of Diagnostics.

Training and competence is another big challenge. This involves training laboratory technicians and ensuring all healthcare workers along the diagnostic process understand their roles and responsibilities and building organizational capacity.

Manufacturers should be called to improve and invest in training of the workforce on their instruments. Global guidelines and training schemes need to be adapted to fit national and local settings, because they tend to address technical laboratory details and intended use in general terms.

In the end, looking for solutions on how to address the importance of diagnostics in strengthening health systems, where innovation is needed in the production and financing for diagnostics, expanding the evidence base guidelines, and evaluation processes, strengthening the supply chain and the quality and capacity of human resources for health.

Dr Anjali Bhutani Director and Head Lab Medicine Max Hospital, Mohali

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