SUSHRUTA
Journal of Health Policy & Opinions
Can Artificial Intelligence be a Solution for the Challenges Faced by
Indian Health Care?
Buddhdev Pandya MBE
Policy Director, British Association of Physicians of Indian Origin;
Ex-Editor, Asian Age
cite as: Pandya B. Can Artificial Intelligence be a solution for the challenges faced by Indian
India with a population of nearly 1.3 billion has unimaginable challenges in planning for a
health care system. While accessibility in geographical terms is challenging for a huge country,
the rich and affluent can access state of the art services, while lower- and middle-income
population are left to face cruel choices, as the state health infrastructure remains sparse and
grossly under-funded. The evolution of new quantum computing and its capitulation with
robotic or molecular technologies is creating faster diagnostic and treatment algorithms. With
the availability of satellite communications for remote areas and advances in accurate sensing
gadgets, the possibility of providing rapid healthcare via artificial intelligence is becoming
closer to reality.
There is an emerging paradigm shift in how health conditions are diagnosed and treated.
Advances with portable and simple to use medical devices/ technologies may provide the
answer in reaching-out to communities living in geographically remote and economically
deprived areas. One of the main challenges of India’s health care provision has been severe
limitation of financial resources. This is further compounded by many others such as waste of
resources, limited training opportunities for healthcare staff and ineffective delivery of plans.
culture change of policy towards ‘patient- centric solutions’ is needed if Indian health care
is to take advantage of the new opportunities that innovations in artificial intelligence (AI) has
to offer. In the search for answers, India must first integrate affordability as well as
accessibility when addressing healthcare challenges!
The net worth of the Indian health care sector is expected to rise threefold from US$ 110
billion in 2016 to US$ 372billion in 2022. This growth driven by medical tourism, a burgeoning
hospital sector, and increased affluence of a segment of the population, makes India an
attractive prospect for medical device companies looking for partnerships. The Indian medical
device industry has an opportunity to leapfrog innovations combining physical devices and
integrated digital networks for far reaching benefit.
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Indian in-vitro diagnostics (IVD) market consists of many different segments. There is an
urgent need for affordable, portable, easy-to-use solutions in low-resource settings. The
growth of the medical device industry is largely driven by the level of the healthcare
expenditure, advances in technology and the need to serve an ageing population with chronic
diseases. For India with diverse inequalities in accessing basic healthcare, AI offers a unique
opportunity. The health care industry presents a gap in trained clinicians and inadequate
infrastructure that is compounded by low government spending. Yet, it a country with the
most room for innovative, sustainable and scalable healthcare technology solutions. In its last
report (2019) telecom regulator revealed that India has 1.16 billion mobile subscribers, a
notable penetration. This is indeed one of the most vantage points where the population
equipped with smartphones can access digital technologies.
We are witnessing a surge of smart wearable (wristwatches) devices that can track vital signs
and alert the wearer/ provider, when the condition reaches set parameters. In developed
nations, many aspects of remote monitoring of patient’s wellbeing and treatment outcomes
are already established. The rise in diabetes, heart and kidney disease in addition to the
traditional scourge of infectious diseases provides a fertile substrate for AI solutions.
Centres (HWCs) would be created by transforming existing Sub Health Centres and Primary
Health Centres to deliver Comprehensive Primary Health Care and declared this as one of the
two components of Ayushman Bharat. These centres would benefit from a network for the
integration of information; managing patients and their follow-up using AI. In local health
planning such information would be invaluable and mobile units would be able to reach
remote areas powered by portable technology.
The Ayushman Bharat - National Health Protection, also intends to provide support for
secondary and tertiary care hospitalisation for many poor and vulnerable families. A well-
designed AI algorithm would help improve efficiency and provide basic healthcare to a larger
cohort. India has a history of embracing ‘pilot schemes’ of public-private partnerships that
appear to be successful but eventually, few of them have been scaled up to meet India’s
health challenges. In the last decade products for tuberculosis medication adherence
monitoring and vital parameter monitors in the primary healthcare places with the
telemedicine programs medical expertise has been providing without doctors the doctor
being present. AI applications being developed and deployed in India include algorithms that
analyse chest x-rays and other radiology images, read ECGs and spot abnormal patterns,
automatically scan pathology slides and assess fundus photographs for signs of retinopathy.
In many countries, the healthcare systems are often slower to adopt change than their
counterparts in other industries and insist on a higher rigour of testing for patient safety. But
in India, it is not only regulation that stifles innovation. Most healthcare is provided by the
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private sector and paid for by the individual, hence affordability is huge challenge in adoption
of new technologies.
Already in the USA Outcome-Based Contracts (OBC) are being implemented which is
proposed as a measure to award innovation, based on the actual performance of treatments
and interventions in real patients. This can be challenging as outcomes are often difficult to
measure or quantify. AI has the potential to fill this gap. Developments in this area may
support reimbursements under the proposed ‘Modi Care scheme’ (ref) consisting of an
insurance cover for the poor.
• India needs a leap through innovative, sustainable and scalable AI technologies with the
potential to improve outcomes through remote access, screening, prevention, and
treatment for the deprived segments of population.
• The private providers and cutting-edge innovators need to be incentivised in shaping the
advanced medical sector that India needs to attract medical tourism.
• AI and integration of outcomes data can support a culture shift towards patient safety and
restore trust in the healthcare system.
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