Think about every time you had to go to the doctor and were prescribed a diagnostic test. You took the prescription to the diagnostic centre, got the tests done, collected the reports, and went back to the doctor. If you were lucky, the doctor had a diagnostic service in his clinic, and saved you a trip. If not, chances are, by the time the reports came back and (maybe) you were referred to another doctor, you had to get some (or all!) of the tests done all over again. Now imagine this scenario in a remote village, and it gets a lot worse!
In 2017, The National Health Policy in India called for an upgrade of 156,000 sub-centres spread across the country. These sub-centres the designated first point-of-care for patients, would be redesigned and rebranded as ‘Health and Wellness Centres’, and provide a more holistic primary care offering. In practice, this means converting largely defunct one-room clinics (c.90% currently do not meet the Indian Public Health Standards) into functional health centres with preventive, diagnostic and curative facilities all under one roof. To support this the government allocated 1,200 crore (USD ~171 million) in the last budget, and another c. INR 1,600 crore in the 2019 Union Budget. While some question whether the government allocation is enough, there is definitely much more thinking required around the services and innovations that are needed to deliver on this mandate.
An upgrade in infrastructure of this size and scale needs a significant systems level change on both the demand and supply side. The shift requires significant manpower, technology and innovation, which cannot be delivered by the public sector alone.
A platform approach which brings together stakeholders who have different commercial interests, but a common goal is the need of the hour. The Ayushman Bharat program and Niti Aayog’s vision of a National Health Stack (NHS) provides the perfect gateway to build this collaborative platform.
The NHS is a digital framework that will integrate the centre and state across public and private sectors, in terms of a holistic platform that supports a multitude of health verticals and their multiple branches and is capable of integrating future IT solution. It is being developed by the Niti Aayog in consultation with industry experts and stakeholders and envisions a unique health identification (similar to Aadhar) that will combine all patient data in one place.
Ayushman Bharat aims to improve service delivery through private sector engagement – The national insurance program, allowing millions to get treatment in empanelled private hospitals – and improvements in public-sector clinics – upgrading sub-centres to provide comprehensive primary care. The NHS will support this by improving data collection, aggregation and patient analytics
The confluence of both programmes provides a tremendous opportunity to bring innovations such as digital diagnostics to sub-centres that feed data into the NHS; or digital tools (e.g. wearables) to track patient journeys and health outcomes, that can create better services for patients.
In a nutshell, an initiative such as this one can change the very experience around healthcare, especially last-mile diagnostics, for India. Every time you went to your doctor or a clinic, in the city or a remote village, you can get your tests done real-time, the doctor has your reports ready when you reach, along with your history which saves you valuable time and money. Now that is worth the investment.
Insights Advisor, Xynteo