Posted on Monday, April 22, 2019
India’s unparalleled challenges and capabilities afford an opportunity to secure a world-leading position in telehealth. The potential prize is enormous – the twin wins of accessible and affordable healthcare and the economic dividend from global leadership in health-related telecommunications applications. This will not be easily achieved. It will require a new conversation between government, the tech and healthcare sectors, the higher education and research community, and civil society. India has all the ingredients for success and has made significant progress already.
What is telehealth? The California Telehealth Resource Center captures it well: ‘Telehealth is a collection of means or methods for enhancing healthcare, public health and health education delivery and support using telecommunications technologies’. Telehealth harnesses mobile, satellite, terrestrial network and broadband communications in combination with state-of-the-art data and information science. Other terms such as telemedicine, e-health and digital health broadly cover the same area.
Applications of telehealth include online medical consultations, transmission of medical images from remote areas to specialist centres, and remote monitoring of blood pressure, heart rhythm, blood sugar and movement through wearable devices and sensors. It has the potential to seamlessly integrate mobile healthcare units, rural primary care centres, regional hospitals and large specialist centres.
Why should India aspire to global leadership in telehealth? Arguably, the size of its population, its geographical distribution and its socioeconomic spread demand it. The limitations of traditional clinician and hospital-centric models of healthcare have been exposed in Europe and the US – more mature and better resourced systems catering for more concentrated populations. These limitations are greatly amplified in more rural and geographically-distributed communities. India has the opportunity to plough its own furrow – to develop a system that is fit for India’s purpose – a system that the rest of the world can learn from.
As a clinician-scientist and university vice-chancellor, I have visited many of India’s esteemed medical institutions and worked with first generation Indian graduates in Ireland, Canada, the US and UK. It is clear that India has highly talented health professionals at home and abroad who are up for the challenge. I use the term ‘healthcare professionals’ deliberately as nurses, radiographers, social workers, public health specialists, and healthcare managers will be as important as doctors if India is to lead in this area.
Crucially, India is also producing highly talented telecommunications graduates, researchers and entrepreneurs. This was brought to life for me recently during a University of Bristol delegation to C-DOT – one of India’s flagship telecommunications R&D centres with which we are developing strong research links in 5G communications. The technological ingenuity of C-DOT’s researchers is replicated in India’s impressive private telecommunications sector.
India has already established significant momentum in the area of telehealth. Notable initiatives include the National Rural Telemedicine Network, National Medical College Network and the proposed National Digital Health Authority. Many of India’s private healthcare facilities and networks have incorporated telehealth applications into their care pathways.
Telehealth, despite all its promise, has proven difficult to mainstream into national healthcare systems. This is perhaps not surprising given the multiple actors involved – health, education, telecommunications, private industry, regulators and policymakers to name but a few. Sustained success in this rapidly changing field will necessitate a paradigm shift in medical education and research with a particular emphasis on collaboration across disciplines. The healthcare system of the future will require a new generation of technology savvy healthcare professionals working collaboratively with healthcare savvy telecommunications and data science graduates. Leading edge technological and clinical advancement will require unprecedented collaboration between researchers in medicine, engineering and science as well as collaboration with the social sciences, economics and law which consider the broader human and societal issues associated with new technologies. While some of this is happening organically, history tells us that such paradigm shifts are accelerated by judicious use of funding incentives and supportive government policy.
Some key issues for consideration. Could India better configure its medical education system so that budding health professionals are nurtured in a vibrant multidisciplinary environment with the scientists and engineers of the future? Are India’s research institutions and funding programmes designed optimally to incentivise multidisciplinary research spanning medicine, science, engineering and the social sciences? Are new R&D schemes, tax incentives and policy initiatives required to boost collaboration between India’s research institutions, the telecommunications industry and healthcare providers? What form of high level oversight is most appropriate to coordinate the national effort given the complexity of the challenge and the number of sectors involved?
If India succeeds, the results could be transformational for its citizens, economy, and wider society.
(The author is president and vice chancellor of the University of Bristol)
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