The Indian Healthcare market is expected to grow at a CAGR of 23% to USD 280bn1 by 2020 from USD 100bn in 2015. This growth is being driven by lifestyle diseases, an ageing population, rising income levels, increasing access to insurance and growing health awareness. This rapidly increasing need and demand for healthcare services puts immense pressure on various stakeholders to efficiently manage the scarce human resources and inadequate infrastructure while controlling the increasing cost burden on consumers and simultaneously providing better quality care and increased accessibility. 

Some key issues which stakeholders have to solve in addition to efficient and effective utilization of the scarce resources are:

Accessibility: In addition to scarcity of doctors and hospital beds, 60% of hospitals, 75% of dispensaries and 80% of doctors in India are located in urban areas servicing about 28% of population3 causing severe accessibility problem. Over 48% of Indians in rural areas need to make overnight trips for Health & Medical reasons4. Accessibility is not just a rural, tier II or tier III issue. Even in Tier 1 cities, it takes an average of one to two hours to consult a good doctor due to heavy traffic and long wait times at the clinic or hospital. This leads to postponing or neglecting one’s health issues which over time get exacerbated into serious diseases.  

Affordability: Out-of-pocket expenditure in rupees per episode of inpatient and outpatient care in India has increased by 11.4% and 9.5% CAGR between 2004 and 20145. Also, unhealthy lifestyle / large drop-off from prescribed therapy / late diagnosis are leading to serious diseases that cost over 10 times more  and lost productivity than if handled at a very early stage. Going forward, India cannot afford to spend billions of dollars on curing lifestyle diseases like the USA owing to its huge population and very low annual per capita income (In 2015, India’s GNI per capita, PPP basis was 38% of World average and 10% of the USA6). So, focus should shift towards prevention of serious diseases and use of Telemedicine/virtual clinics to address this problem.

Quality of Care: A shortage of qualified general physicians in India has resulted in crowded waiting rooms, short visits and a chance for spreading infection. These factors eventually snowball into lack of comprehensive medical records of the patients, wrong prognosis and prolonged illness.

The need of the hour is to explore how we can address these issues most efficiently using innovative and disruptive digital health solutions. Convergence of biology and technology now offers unique opportunities to increase accessibility and quality while reducing the cost of healthcare. It is India’s unique opportunity to build Global Telemedicine companies while solving the 21st century healthcare problems for both the developed and emerging worlds.

Telemedicine can reduce the time it takes to consult a doctor to 10-15 min in both rural and urban areas by cutting wait times through optimal utilization of doctors and by avoiding the need to travel to a clinic or hospital, at a fraction of the cost of current healthcare systems. Electronic Medical Records (EMRs) can digitalize patient’s information coming from various sources at one place helping doctor to make an accurate prognosis in a shorter time

Smart health monitors can collect personalized vital signs and test results in  real time, which will help with rapid diagnosis, timely & proper treatment at an early stage, eliminating travel & wait times for diagnosis. It also increases operational efficiencies for doctors and provides assurance for the patients with improved support and feedback.

Human DNA analysis enabled by increased computer processing will enable truly personalized genomic testing and treatment options for certain genetic diseases. This could vastly improve effectiveness and safety profile of the treatments.

Mobile health apps can help in preventing serious diseases by increasing patient engagement, providing health education & expert guidance from one’s care provider

Celes Care, India’s first virtual health clinic for women is a good example of how a combination of best-in-class technology and clinical best practices can help fill the “primary care void” that exists today for Indian women. Over 70% of health issues can be resolved with telemedicine without going to clinics or hospitals. Medical consultation is offered via an app, using chat, audio and video platforms.

The convergence of genomics, digital devices and precision medicine is going to revolutionize the future of healthcare delivery around the globe. This improves access to care, patient outcomes and at less than half the cost. It also makes medical care more personalized by making use of insights generated from processing data collected from both digital as well as traditional practices. The next few years will see more advanced efforts to use technology to deliver the right health care services to the right people when and where they want to receive them.”

With ~USD 6 bn invested in 2016 alone, globally Digital Health investments have grown at a CAGR of 28% in the last 5 years7. This trend does not appear to be subsiding as even in 2016, ~40% of investments were into seed stage deals4. While, US contributed a lion’s share of the total investments in this space, proportion of digital health investments outside US mainly from emerging markets have been steadily increasing. Amount of digital health investments outside US increased from less than 10% in 2013 to ~25% in 20167. There is a strong momentum in India’s nascent digital health sector in the last 2 years with a good number of digital health companies getting funded at Seed or Series A level. We feel that it is now the right time for India to embark on a futuristic journey to fix its heavily burdened healthcare system with new digital healthcare models that have the potential to improve accessibility, affordability and quality of care. 

Sources:

1. CII KPMG Indian services sector, April 2016 

2. OECD 2014 data 

3. OPPI KPMG Report on Healthcare Access Initiatives Report

4. National Sample Survey Office

5. Lancet calculations based on analysis of unit data on NSS 71st round on health and NSS 61st rounds

6. World Bank, International Comparison Program database

7. CB Insights