On World Health Day, A Look At Trends That Restore Control To Patients — With A Little Nudge From Technology

The World Health Organisation (WHO) celebrates World Health Day every year on 7 April and draws attention to a specific health topic.

This year, when the Organization celebrates its 75^th anniversary, it has chosen a more general theme: “Health For All”, highlighting the challenge of bridging the global divide that exists in matters of health: 30 per cent of the global population is not able to access essential health services.

One major concern has been the creeping commercialization of the health business: the Covid pandemic exposed this in poignant ways, with leading corporations loath to let go of the royalties and stiff pricing of their products, even in the face of a global catastrophe.

In Delhi yesterday (6 April), one small step was taken to address this challenge — and flip industry-centric healthcare to a new patient-centric regime.

An International Patients’ Union (IPU) was launched in the presence of many respected and service-minded medical practitioners.

IPU will attempt to to address the challenges faced by patients across India related to accessibility, affordability, and quality of healthcare.

It promises to connect patients with top doctors, policy-makers, regulators, industry leaders, and other fellow patients, providing them with a platform to put forth their opinions, contribute to policy formulation, and learn from each other how to better manage their disease conditions.

Says the new organisation’s prime motivator, Dr Rajendra Pratap Gupta: “The patients, whom the healthcare sector is supposed to serve, have no say in the discourse on healthcare. The doctors are organized, and the industry is organized, but no one has ever thought of organizing the patients.”

IPU aims to do just that. For starters it will initiate user ratings for care providers and start ‘patient-reported outcomes’ for improving the quality of care and making it value-based care.

It remains to be seen if the wider healthcare profession in India will welcome this initiative. The recent protests of sections of the medical profession in Rajasthan (since called off), in response to a Right to Health bill, points to a fundamental lack of trust in critical patient-doctor interfaces.

Technology, The Tool?

Many health industry watchers suggest — especially after the first two years of the Covid pandemic forced both doctor and patient to innovate — to find new ways of bridging the physical chasm created by a world in lockdown mode.

Leading data and analytics company Global Data, in a 24 March study suggests that OpenAI’s ChatGPT and its latest avatar, GPT-4, has the power to change healthcare.

“ChatGPT can be used to assist doctors with bureaucratic tasks such as writing patient letters so doctors can spend more time on patient interaction…. AI integration into chatbots and virtual assistants can motivate and interact with patients, review a patient’s symptoms and recommend diagnostic advice and different options like virtual check-ins or face-to-face visits with a healthcare professional. This can reduce the workload for hospital staff”, suggests Tina Deng, Principal Medical Devices Analyst at GlobalData.

But she suggests, there may be dangers: “Usage of chatbots in patient care and medical research raises several ethical concerns. As massive patient data is fed into machine learning to improve the accuracy of chatbots, patient information is vulnerable.”

But regardless of the risks, artificial inteliigence (AI)-powered chatbots will be used widely in the healthcare industry, concludes the study.

Indeed, there is speculation that advanced technologies may replace doctors in some roles.

A New York Times article last month reported on some success with AI software to spot breast cancer in women, even as doctors debate whether the technology will replace them in medical jobs.

Hungary was said to be a major testing ground: Two radiologists had previously said an X-ray did not show any signs that the patient had breast cancer. But artificial intelligence software had flagged several areas of the scan as potentially cancerous. 

“Advancements in AI are beginning to deliver breakthroughs in breast cancer screening by detecting the signs that doctors miss”, says the article.

Made-in-India AI-Based Breast Cancer Detector

Interestingly, the use of AI assistance in the detection of breast cancer, has been pioneered and improved upon over the last seven years in India. 

A Bengaluru-based startup, NIRAMAI (for Non-Invasive Risk Assessment with Machine Intelligence) co-founded by its principal inventor, Dr Geetha Manjunath has pioneered a radiation-free, automated and non-invasive breast cancer screening test.

It uses a computer aided diagnostic engine powered by AI. The solution uses a high-resolution thermal sensing device and a cloud hosted analytics solution for analysing the thermal image of the breast that detects cancer at a much earlier stage than traditional screening methods.

NIRAMAI has won many international prestigious awards including World Bank instituted Global Women HealthTech Award 2022, and its services can be accessed in over 150 installations at hospitals and diagnostic centres across 29 Indian cities and in a dozen countries abroad.

NIRAMAI has now received the US FDA clearance for their first device called SMILE-100 system (having earlier gained the equivalent European CE Mark) which opens up world markets for this quintessential Made-in-India technology. 

The Covid years pushed many people into monitoring their own health to the extent possible: and in a canny response to this opportunity, the wearable device industry has built basic health parameter checks into almost every smartwatch now in the market — with varying degrees of functionality.

It is no longer news that a smart watch has sensors for monitoring pulse rate, blood pressure, oxygen level, even some elementary form of ECG.

Such devices let joggers and exercisers keep track of their exertions, even their sleep. The Amazfit GTS2, Apple Watch series 6, Fitbit Versa 3, Garmin Venu Sq, Playfit Slim and Samsung Galaxy Watch Active 2 are current models with health-assessing capability.

No, the news this World Health Day 2023, is how many purely Indian brands are into the wearables device niche — and how they have opened up a vast entry-level market for customers with modest means, by their aggressive pricing.

One of the most recent, that has come to our notice, is Delhi-based Tempt India which specializes in wearables, chargers and Bluetooth audio devices.

Its range of four smart watches has been heavily discounted and the best of the lot, is the Tempt Edge Pro, a Bluetooth calling watch with a 1.51 inch AmoLED display device, with an interesting rotating button to change the menu options. 

It monitors heart rate and SpO2 (blood oxygen levels) and tracks all stages of sleep. A blood pressure measuring sensor would have been useful to complete the basic health parameters — but at the current price of Rs 4,999, this is still a useful and affordable addition to one’s self-health-check arsenal.

The ability to keep tabs on one’s basic wellness parameters — and to share critical parameters, particularly related to cardiac conditions (BP, ECG) with one’s doctor — is possibly the single biggest advance in patient care since the pandemic.

Internet Of Medical Things

Scott Lundstrom, Senior Industry Strategist for healthcare at OpenText, a leading information management company, points to an interesting global development whose waves are lapping Indian shores: the emergence of IoMT, the adoption of Internet of Things (IoT) specifically for medical devices.

“This is one of the fastest growing IoT sectors and is showing promising efforts at eliminating some of the strain currently facing our global health system, by providing connections and access for healthcare professionals and patients alike”, he says.

The IoMT global opportunity is estimated to reach $176 million by 2026, according to a report from Fortune Business insights, with smart wearables and remote patient monitoring adding impetus to the market. 

Clearly, the burgeoning smart wearables (including health tracking) manufacturing business in India is in line with this global trend.

Virtual Health Challenges

A 16 March 2023 research study by tech monitor, McKinsey entitled Virtual health for all: Closing the digital divide to expand access, highlights the disparities in access to broadband service — and, by extension, virtual-care access — as well as the opportunity for states to facilitate access to e-health for all.

While based on data from the US, the writers list seven actions that could help state and local leaders unlock virtual health for underserved communities. This could be a useful template for India as well.

A few weeks ago, Siemens Healthineers, theFrankfurt (Germany)-based healthcare outreach of the Siemens group and the NASSCOM Centre of Excellence, announced a strategic partnership to boost India's healthcare through an accelerator programme.

This will focus on six major domains: access to care, networked care and digitally enabled services, radiology imaging, in-vitro diagnostics, advanced image guided therapy to improve care in cardiology, neurology, oncology, and infectious diseases.

Needed: Fact Checker For Health Information

The Health India Project (THIP), a health portal, conducted a survey this week with help from Cyber Media Research (CMR), on the critical need for health fact checking in India.

Its findings, released this week are sobering:

• At least three out of every five Indians (62 per cent) admitted to not knowing how to identify trustworthy health information on the web, leaving them vulnerable to misinformation and potential harm.

The message is stark: As more and more healthcare options are offered, patients and lay citizens may face an information (and misinformation) overload. 

Sifting fact from fake news may yet be the biggest challenge yet.

Stay well-informed — and healthy!