At a high level, this article summarizes the existing times of changes in Healthcare.

1. FEATURE
HEALTH - IT
Suchismita B,
Emerging Healthcare
Leader in Digital / loT
Transformation across
India, Europe. and North
America
42 December 2017
HEALTHCARE COSTS are experiencing
a very fast rise, and ah11ost 17% of US GDP
is spend on healthcare, the rate is expected to
increase to 20% by 2020, 111aking healthcare
aln1ost 4.6 Trillion USD1
• On top of the esti-
n1ate,750 BUSD is estin1ated as waste in the US
Healthcare systen12
.Con1ingcloser to Indian or-
ganized Healthcare nlarket size is estin1ated to
be IOOBillion USD (655,000 Cr INR), translat-
inginto technologyspend of4000 Cr INR.
The Indian healthcare ecosysten1, faces an
overall challenge of rising cost, din1inishing
returns, low custon1er satisfaction, challenge
fron1 new technology entrants, andprotecting
health inforn1ation fron1 cyber-attacks. Pa-
tients in turn face a plethora ofdifferent issues,
these range fr0111 the traditional long tin1elines,
to nlake an appointn1ent or to coordinate care.
In addition, rising costs are an issue,while the
new set of technology advances has not been
totally harnessed to in1prove caredelivery.
India has a unique problen1on hand. How
to en1power healthcare in the hands of its pop-
ulation? The growth ofs111artphone sector and
internet connectivity is very closely connected
with the growth of healthcare digital. India has
a huge and growing sn1artphone base, with an
annual growth of36%.This translates into 65-
70% penetration in 2018 (85-90%penetration
level by 2020'). These in1ply two out of three
adults have a nlobileconnection, and one out of
three adults has a sn1artphone. There is a good
prediction of the re111aining nlobile and non-
n1obile user getting a sn1artphone in the next
couple ofyearsa.
Health coaching /mentoring
through digitization of health-
care data
Increasing the Digital Healthcare Experience-
Digital healthcare is becoming popular across
nlultiple areas of healthcare in 2017. The rise
in popularity of fitness wearables increases
the scope of self-diagnosis. Additionally, the
rise ofs111artphones also allows the user to be
nlore involved in healthcare decisions.There is
a huge potential for tele-n1edicine (virtual doc-
tor), as it reaches ren1ote patients, save costs
and collect detailed data points. However, tel-
e111edicine,has not really taken off in India,but
it is too early to cut it off. Initial investn1ent in
telen1edicine is high,especially in connectivity
infrastructure. >Vith the advent of 4G across
the country at the cost of a postcard (Thanks
to RelianceJio!!), there is tren1endous scope for
telen1edicine over 4G. The capital and operat-
ingcosts would bevery nlinin1al.
Asuccess of telemedicine would also bring

2. a higher level of participation fron1 1ne1nbers
fron1 rural and far-flung areas; additionally,
n1ultiple other stakeholders including phar-
n1acy and insurance cmnpanies would then
get into the tele1nedicine bandwagon.Though
there has not been n1uch groundwork laid for
tele1nedicine revolution in 2017, but there are
chances of renewed interest in this line, as the
4G costs start to drop. Nlass adoption of tech-
nology is an ensuing success factor as well.
Many s1naller players are also con1ing up
with a plethora of healthcare apps that 1neas-
ures exercise levels/ food and allows to record
blood pressure or blood sugar reading. Ad-
ditional healthcare coaching tips for nutrition
effectively acts as healthcare n1entor.Additional
apps in pay1nents or care coordination is under
develop1nent or early stages.
Avalanche in the Healthcare
Technology Investing
Digital Healthcare ecosysten1- in 2017, Digital
healthcare funding was to the tune of $3.67
Billion USD towards the end of May, 2017, in
USA. This was an upstart fron1 6+Billion USD
for 2016, across healthcare start-ups and VC
world. The start-ups ranged fron1 enabling
easier access to healthcare to end users,
additional data to users for self- healthcare
decisions to data analysis and payn1entoptions
across n1ultiple levels.
One of the virgin areas of healthcare tech
is the participation of Indian start-ups in the
healthcare tech. There have been s01ne start-
ups in seed stage, but thereis no clear patterns
or growth.There is no clear healthcare unicorn
across the country as yet, there is no health-
tech unicorn in sight in 2018 either!
Indian healthcare is at a ripestage for seed-
ing healthcare tech startups, there is an1ple
niche areas in healthcareacross patient require-
n1ents, connectivity across care continuun1 or
apps in local languages across the country. Of
particular in1portance would of apps in local
language, or apps'hyper-localized with global'
know-how.
Additionally, there is a vast opportunity in
this sector in tern1s of wearable ranging fron1
fitness to specialized functions.Cardiac Design
labs deploys a wearable device called MIRCaNI
which acts as Nlobile inteUigent device capable
of providing cardiac diagnosis in re1note set-
ting~.
Linking theiadhar Card'to the collection of
healthcare data is very important for creat-
ing datasets
www.indiamedtoday.com 43

3. FEATURE
HEALTH - IT
Indian and international VC:s are willing to
invest in strategic start-ups; about 350-400 Cr
INR are up for healthcare technology invest·
n1ent in 2018.There are son1e chances ofstart·
ups in advanced stages, and son1e seed start·
ups in healthcare tech e1nerging towards the
latter half of 2018, as the healthcare policy, 4G
and higher n1obile proliferation becon1es n1ore
wide-spread.
"Practo' - an online doctor appointlnent
app was lauded as a Indian healthcare unicorn.
However, a IOOK doctor base is in urban areas
across 25 Jil patients/year i1nplies the applica·
tion has a lot of scaling up to be done. Consid-
ering the healthcare ecosysten1, there is a lot of
growth that'Practo' can target!!
I
44 December 2017
About INR 350-400 Cr are up for healthcare
technologyinvestment in 2018
Stakeholders come together to
automate
Data Analytics and Intelligent Agents -Clini·
cal Decision Support Syste1ns enables the
decision 1naking based on evidence based
knowledge;data analysis is persistently used to
diagnose chronicconditions, help public health
surveillance and n1onitor drug-drug interven·
tions in a larger publicsetting.
Gates Foundation is runninga pilot in son1e
Indian states targeting pregnant won1en/new
1nothers versus infant growth tracking. This
is a con1bination of date frmn smartphones,
n1etadata analysis and assess1nent for interven·
tionstrategies.5
Medical Drone delivery is in nascent stages
of con1n1ercialization, it is used in Rwanda to
deliver HIV n1edication faster to far flung areas
at a lower cost. This pron1ises to bean interest·
ing n1ode of last 1nile connectively for n1edica·
tion to Indian villages either in regular or dis·
aster conditions.1
Thecollection ofdata sets across the popu·
lation is not very established, but is the need
of the hour. The establish dataset are the foun·
dation for genotypic datasets for analysis and
reporting across various de1nographic paran1·
eters. Linking the 'Aadhar Card' to the collec·
tion of healthcare data is very i1nportant for
creatingdatasets.This is not likely to happen in
2018,but likely in the horizon.
Intelligent agents consist of n1tiltiple plat·
forn1s to collect preferences, actions, transac·
tions buyingpatterns to predict the preferences
of a group of consun1ers under study.Shopkick
Beacon technology can allow to flag and alert
the usersagainst a specific buying patterns.Per
n1y understanding, this buyingstratification is
also likely to extend to healthcare buying and
healthcare transactionl. There is a likely to be
a retail-healthcare hannony along higher levels
ofstratification of buying patterns of consun1·
ers.
Artificial Intelligence involves n1achine
learning and deep learning; Google DeepMind,
isdevelopingsoftware in partnership with NHS
hospitals to diagnose kidney deterioration.Vir·
tual reality companies allow 1nedical si1nula-
tion cases for teachingand therapy,augn1ented
bots are being developed for delicatesurgery.

4. In the Indian context, ForusHealthcare~, is
an in1aging platforn1 connecting ren1ote diag-
nosis across cloud.Thein1agingplatforn1 called
3nethraoffers screeningofeye problen1s,being
portable,this spansacross artificial intelligence
and telen1edicine.
The extensivedevelopn1ent ofdata analytics
and intelligence artificial intelligence and aug-
n1ented realitywould enable the accurateprog-
nosis and diagnosis of diseased conditions,
enable targeted care to thepopulation segn1ent
and reduce errors.
Upward Mobilization of Health-
care Resource Pool
India has a huge resource poolof n1edical doc-
tors, nurses, para 111edicals and technicians.
Changing require111ents and advanced technol-
ogy would bring about additional retraining of
existing resources, and advanced training for
new resources.
+
India is a said to be a young country with
the average age being 29 years; India becon1es
a huge potential for digitally trained n1edical
resources, as well as advances in technology to
serve the population. Trained Indian resources
has led technological econ0111y across n1any
countries in the world, and going forward, a
well-trained digital healthcare workforce can
also lead theway for 111anyother countries.
Conclusion
The need of the hour for Indian healthcare
is to ren1ove geographic and socioeconon1ic
barriers, enabling a higher level of access to
n1ultiple levels ofservices and additional edu-
cational and inforn1ational enablers for both
n1en1bers and providers to for faster uptake of
healthcare technology. This in turn is likely to
increase levels of self-diagnosis and preventive
care,and lead to higher levels ofqualityhealth-
careand equitable outcon1es.E
Reference
1https://khn.org/news/health·care·spending-
to-double/
'https:J/www.theatlantic.comjhealth/ar-
chive/2012/09/how-the-us-health-care-sys-
tem-wastes-750-billion-annually/262106/
3https:j/www.shopkick.com/shopbeacon
4https://www.ibef.org/industry/healthcare-
india.aspx
'https://health.economictimes.indiatimes.com/
news/diagnostics/india-spends-less-on-heaIth-
than-any-country-with-middle-income-status-
bill-gates/61698218
6 http://www.livemint.com/Consumer/zxupEOY-
0560LJrnoRxcn4L/Mobile-phone-penetration-
in-India-set-to-rise-to-8590-by-2.html
7https://www.technologyreview.
com/s/608034/blood-from-the-sky-ziplines-
ambitious-medical-drone-delivery-in-africa/
' http://money.cnn.com/2017/09/26/technol-
ogy/india-mobile-congress-market-numbers/
index.html
' https://www.forbes.com/sites/
suparnagoswami/2017/02/22/3-healthcare-
startups-tapping-into-indias-soon-to-be-boom-
ing-iot-market/#4e8e4ee5504o
www.indiamedtoday.com 45