Technology has been at the heart of the healthcare revolution for years. The evolution of the internet, mobile networks, smart devices, etc., have significantly changed the process of delivering patient care. Gone are the days when people had to wait for hours for a 15-minute doctor consultation. Today, doctor consultation is just a matter of a phone call. Patients can now have physician consultations from the convenience of their homes. And this is just one example of how much technology has transformed healthcare. Digital health and AI is one of the hot topics that people within and outside of the healthcare industry have been talking about recently. This article discusses how AI and digital health is fuelling the next healthcare revolution while redefining healthcare delivery.

What is digital health?

Digital health is a multidisciplinary concept that uses communication and information technologies to help health systems deliver affordable and good-quality care. Digital health also enables healthcare institutions to be efficient and sustainable. Telehealth, mhealth, and wearable devices used to monitor patient status are some of the real-time examples of digital health.

AI or Artificial Intelligence

AI is one of the greatest breakthrough technologies that is changing our everyday life experiences, right from avoiding traffic and online shopping to hospital experiences. While we are already experiencing AI-induced changes in our lives, like personalized movie or music recommendations, and voice-controlled personal assistants such as Alexa and Siri, let us dive in to understand how AI and digital health is transforming the healthcare industry and patient care.

AI can ease the process of detecting invalid claims and accelerate the pace of claim – assessments, processing, approval, and payment through automation.

How AI and digital health is transforming healthcare

1. Optimized workflow scheduling and case prioritization

Workflow management and case prioritization are highly critical in the healthcare domain, as a patient’s life is at stake. The sooner the diagnosis, the earlier the treatment. AI and ML algorithms can aid in optimizing workflow, prioritizing cases, and managing patient flow. Healthcare professionals can navigate hundreds of medical records and identify critical and non-critical cases within seconds using AI and ML algorithms. This will help physicians and radiologists to focus on critical cases on priority and create workflows and patient flows accordingly. Furthermore, AI can also help in automating time-consuming manual tasks like patient data entry, medical claim scrubbing, etc. AI can also facilitate personalized responses to EHR searches.

2. Quick drug discovery

It takes years, or even decades, to synthesize the appropriate drug for an illness. Chickenpox, for instance, was identified in the 1950s. But it took almost four decades to discover the right vaccine for the illness. With AI, drugs for contagious diseases can be discovered and synthesized within months, if not days. A real-time example of how AI can speed up the drug discovery process is the recent pandemic, COVID-19. Almost within a year of the COVID-19 outburst, a relevant vaccine was developed and distributed across the globe with the help of AI. 

3. Quantitative imaging analysis and reporting

Have you ever got a different diagnosis from different doctors for the same problem? If yes, then you probably might have thought which one of the diagnoses is correct. Such different diagnosis from different doctors is primarily due to subjective analysis and reporting. Almost all medical images are studied in a subjective manner – based on the radiologist or physician’s personal opinions, point of view, and interpretations – and have often led to diagnostic errors and incorrect/unnecessary treatment. The shortcomings of subjective analysis and reporting can be overcome only through quantitative imaging analysis and objective reporting.

Quantitative imaging analysis, as the name suggests, is the process of measuring all the elements in a medical image and comparing it against anatomical values to identify deformities and determine the severity of illness. Reports generated from quantitative imaging analysis are known as objective reports and hold detailed information about every element of the scanned body part, including their measurements. However, performing quantitative imaging analysis and generating objective reports is a time-consuming task, which is why most health centers are unable to perform them. But AI can help health institutions perform quantitative imaging analysis quickly and accurately. 

4. Robot-assisted surgery & Virtual nursing assistant

Robot-assisted surgery enabled by AI can help surgeons to perform complex procedures with increased precision, flexibility, and control as compared to conventional techniques. Robot-assisted surgery is gaining more prominence in healthcare and the market size of robotic surgery is expected to cross $7 billion by 2025. Similar to robot-assisted surgery, AI-powered robots can serve as virtual assistants to provide 24/7 support for chronic conditions, monitor patient status, check medication intake, and schedule doctors’ appointments, just the way a nurse practitioner would do.

5. Fraud detection

AI can help in ensuring the security of patient data, which is highly sensitive and at the heart of providing secured and personalized patient care. Also, AI can ease the process of detecting invalid claims and accelerate the pace of claim – assessments, processing, approval, and payment through automation.

According to a report, AI adoption can help US healthcare providers save nearly USD 150 billion by 2025.

6. Precision medicine

Precision medicine, also known as personalized medicine, is a medical model where healthcare is customized according to the genetics, lifestyle, and environment of a person. Precision medicine is the exact opposite of the one-drug-fits-all medical model. Numerous studies and experiments have been carried out to understand the potential of AI in precision medicine. And in most cases, AI has been able to classify and solve precision medicine problems in aspects like disease detection and prediction, treatment optimization, etc. Most healthcare providers and professionals believe that AI will take precision medicine to the next level and improve the levels of accuracy and prediction in patient outcomes. They also believe that AI can help in making precision medicine affordable and available to people from rural areas.

Summing Up

AI and digital health are not only beneficial for patients but also providers. Many stakeholders and industry leaders posit that the digital health and AI market is growing with a great potential for ROI. According to a report, AI adoption can help US healthcare providers save nearly USD 150 billion by 2025. Not just that, with medical imaging data growing abundantly and projected to double by the next decade, AI will be the only solution to handle the healthcare data explosion.

Studies state that the growth of AI in healthcare will be driven by the increasing volume of data. Matter of fact, numerous health systems have started embracing AI applications not just in patient-facing clinical processes, but also in diagnostic workflows and tasks associated with medical images. According to a KPMG survey, 89% of respondents stated that AI is already enhancing the efficiency of their systems. 

Many health tech firms are moving from cancer diagnosis and focusing on creating AI algorithms for other health issues like chronic neck and back pain. Synapsica, for instance, is a leading AI health tech firm that has successfully built AI tools for spine problems and injuries. Using Synapsica’s AI tools, Spindle and SpindleX, radiologists can perform quantitative imaging analysis and generate objective reports within minutes. The healthcare industry is one of those industries that transform almost every decade. The current healthcare industry is highly different from what it was a decade ago and will be highly different from what it is now in the next decade. And AI and digital health will be the key drivers of the next healthcare revolution.

Composed by: “Dr. Cherian is presently associated with AIIMS, New Delhi. He is leading all medical operations, research and product vision for Artificial Intelligence. He has established many startup teams for pan-India operations.”

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Among all the other deadliest diseases, cancer is the most lethal cause of death, which may occur in various types and regions inside the human body. It arises due to uncontrolled cellular functionality that happens when cells start working independently and performing odd behaviors compared to their surrounding structures. When it occurs in the lung region, it creates a severe condition, as lung cancer’s survival rate is lowest compared to other types of cancer. According to the report published in 2021 by global cancer statistics, the world’s new cancer cases have reached 19.3 million, and lung cancer is the second largest cause of cancer after female breast cancer. In various research studies, it has been found that early cancer detection may increase the chances of long-term survival.

Furthermore, studies have indicated that a low dose CT scan and its automated analysis can be the best way of early cancer detection. It works without putting the human body in harm compared to other invasive procedures. Analyzing CT images to get insights into internal structure and abnormality has been vastly carried out by experts and radiologists in previous days. But due to the consistent efforts of researchers, artificial intelligence (AI) based disease detection systems have been gaining the direct attention of clinical practitioners and medical institutes for the past two decades. With increasing structured data in the medical field, more opportunities for finding precise and straightforward methods of diagnosis are opening. The modern world where we live now is just embarking on the long and exciting data science journey that can lead us towards unimaginable peaks of automated technological solutions. It is yet unclear how precise the medical technology would be in detecting and diagnosing diseases at their early stage. Perhaps, the advanced algorithm defines the upcoming health issues before their occurrence in the human body. It allows someone to take corrective feedback in an ongoing lifestyle to prevent the forthcoming critical situation. Everything we imagined today may be possible in the near future but that requires consistent efforts to develop efficient techniques and algorithms.

With the collaborative or individual efforts of various scientific and research groups, algorithms are rapidly getting advanced by adopting the most trustworthy and less time-consuming methodologies. Deep learning and fine-tuned neural networks play an essential role in that context as they open new ways to modify existing techniques to obtain promising results. Inside the deep neural network, it’s hard to know how they behave and interact, but by employing systematic hyperparameters and fine-tuning, outcomes and performance can be improved. Some key hyperparameters are learning rate, optimization algorithm, activation function, number of hidden layers, number of activation units, kernel size, pooling size, batch size, and number of epochs.

Apart from the hyperparameter, the most crucial point is to decide a number of layers for the optimal and best performance of the network. Creating balance with all these parameters is complex and requires multiple testing and experiments. It takes a lot of effort and time to maintain a balance between two different quantities for the increased performance of a deep learning network. This problem can be addressed by employing an additional algorithm responsible for performing the required analysis to choose the best hyperparameter and values to establish a fully automated and self-improving deep learning network. Maybe the better strategy is to implement the most adaptive and high-performance AI algorithm, which helps detect and diagnose diseases on the individual and societal scale.

With this article, I would like to propose a “partial naturally randomized deep learning layers (PNRDL)” for the advanced performance of an automated detection system. The procedure is not tested yet, but the inclusion of optimization with a little bit of relaxing parameter in the form of partial naturally randomized weights may provide better human-level performance for the analysis of CT images to detect lung cancer or its early signs. In general, relaxing situations are when someone takes a break from the process to achieve the desired goal and spends some time doing other activities. Many philosophical studies discuss this period as the best period for finding new innovative, astonishing ideas that revolutionize the actual path of moving towards the desired goal. Sometimes it gives better outcomes than expected results that someone never imagined. I considered this not a coincidence but a part of natural computing through which anyone and everyone are connected. Billions of neurons continuously acquire weights inside the human brain by taking insights or parametric values. These values or parameters are generated by nature that add up with the brain as essential insights for the computation of various tasks, which sometimes reveal exceptional outcomes.

I believe it is a substantial phenomenon that is seemingly random but not actually random as everything inside nature runs by natural computing. To introduce a relaxing period inside the machine, I propose a relaxed parameter-based, “partial naturally randomized deep learning layers” that takes random values for deep learning weight updation. Random values used in these experiments will be directly obtained from the naturally randomized numbers that are randomized and obtained during individual image analysis. After such procedures, it may be possible to get a deeper connection to the automated detection system through natural computing, where the randomization of parameters works as a relaxing situation in the case of the human being. By going through this procedure, I believe the development of automated disease detection systems has become more realistic and precise. Maybe the idea of making this type of system works fine, and the procedure discussed for disease detection render outstanding results if employed in other research and development purposes. Figure 1 below is showing a short description of the development of the proposed algorithm.

The experimental scope of this research focuses on taking a machine into the time-space where some of its weight functions process the very subtle event of the natural parameter to extract essential values.

However, the proposed model is still under exploration as the procedure to obtain an utterly randomized number is still in the experimental stage. The first few tries to generate random values are conducted by taking never-repeating decimal digits of “pi”. Although, they are also finite at any given period. Further trials to generate a natural randomized number to introduce relaxation sessions inside machine-learning operations are ongoing. The study aims to take insights from nature, always trying to say something to us regarding any event and situation. An American biologist, Barry Commoner once said that “everything is connected to everything else”.

It means the present case, past conditions, and future outcomes are not distinct. It is just our inability not to process the subtle insights of the surroundings and ignore them by considering them as random non-valuable information. Processing every element of information is not possible, but taking a small piece and extracting valuable insights is the way to achieve desired outcomes. The experimental scope of this research focuses on taking a machine into the time-space where some of its weight functions process the very subtle event of the natural parameter to extract essential values. The outcome of this process will generate a piece of information that helps to implement all-inclusive nature-driven algorithmic results. Unlike the existing computation system, it performs its task by combining insights of input data and instincts of current surroundings. It is an entirely radical approach to using AI techniques that can be time-consuming but taking a chance to develop and work upon this methodology may undoubtedly be helpful. After its successful implementation, it may be possible to implement a deeper bond with nature and harness the power of robust natural computing or actual computing. 

Deep learning in AI also suggests that deeper and closely connected nodes are the one who dominates the outcomes. Similarly, the more dominant one around us (nature) should be deeply and strongly connected to every possible node (eg. deep learning algorithms and layers) to obtain the best possible results today and in the near future.

Composed by: “Mr. Resham Raj Shivwanshi is pursuing PhD at the Department of Biomedical Engineering, NIT Raipur. He is currently working upon medical imaging, CT scan analysis,Machine learning and AI methodologies.”

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There is a very intriguing relation between the two where a peaceful mind gives the solutions to a problem and a sustainable environment can only thrive with a balanced mindset. The amount of pollution created by us, the humans, has invariably led to the rise of various diseases and thus a chaotic situation as witnessed through the COVID-19 pandemic. The sedentary lifestyle, surrounded by concrete jungles and unhealthy consumption of food is often making a person sick, people are now in dire need for a healthy living and through Yoga this is often controlled. The self created environment of man has become the root cause of diminishing his very existence and one cannot escape the present lifestyle but a new lease of hope can be culminated through the practice of yoga. 

The best part of yoga is its existence in the environment. Meditation calms the mind and it gives the option to hear the music of nature (chirping of birds) which is otherwise lost in the honking of the horns. Research has shown that touching the soil with your hand elevates your mind as the microbes present in soil have effects on the brain in the same way as any antidepressant drugs. Our five senses as depicted in Yoga are connected to Nature and one of the most vital role is played by Water. The first pollution was witnessed in water and through the book ‘Silent spring’ written by Rachel Carson on the spread of harmful pesticides like DDT in water, this problem was known to mankind. The reason behind the celebration of June 5 as Environment day is the starting of the Stockholm Conference in 1972 for awareness about the environmental pollution to all the 152 and more participating nations. The first environmental law was the Water Act that came in force 1974. Water thus is the most integral part of our existence.

Yoga also depicts water in various forms like ‘touch’ witnessed by cold water therapy which controls the anxiety, improves the circulation, enhances the immunity and provides better emotional and physical resilience, uplifts the mood and clears the toxins from our body. The ‘taste’ of sweetness or salt is enhanced by the digestive juices secreted in our body and they are controlled by the drinking water. After a heavy shower the earthy smell of soil known as ‘Petrichor’ comes which enriches our smelling senses and uplifts our mood. After rainfall the trees and plants also liberate beneficial natural chemicals known as Phytoncides which have a very positive impact on our immune system and mood upliftment. Researchers have found that there is a strong correlation between the sound of the waves and serenity in the mind. 

The intermingling of both gives a clear picture that if we are causing harm to the environment it will cause an impact on our physical and mental well-being. The world Yoga day as witnessed on June 21 is also the same day when the sun appears at its highest elevation to mark the solar solstice and there are so many yogas related to sun hence this day was unanimously declared by the United Nations as ‘Yoga day’.

The five elements of Yoga like Air, Water, Fire, Earth and Space are connected to the Environment. The imbalance in any of them will cause problems for mankind. We need to preserve our earth by leading a sustainable lifestyle where the importance of Yoga is known to everyone. The answer to our good health lies in our environment and this reminds me of the lyrics of Bob Dylan that  says ‘The answer, my friend, is blowing in the wind. The answer is blowing in the wind’. 

Composed by: “Dr Debleena Bhattacharya is presently Assistant Professor in Marwadi University (MU), Rajkot, Gujarat. Prior to joining MU, she has worked as Project coordinator for BIRAC-SRISTI PMU, a joint venture of Govt. of India and NGO located in Gujarat. She received her doctoral degree from IIT Dhanbad and her area of interest is wastewater treatment, environmental biotechnology, and molecular genomics. She has authored a book published by CRC Press, U.S.A alongwith scientific papers & book chapters.”

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It is said that the first yogi or ‘ADIYOGI’ was Shiva, and he is also the king of dance Nataraja. Maybe that’s why the Classical dances of India have their roots in Yoga, and their goal is union with the supreme consciousness through bodily transcendence. Thankfully, most of the reputed performing arts institutes and gurukuls have incorporated yoga in their curriculum.

I was drawn to yoga right from childhood as both my parents were classical dancers. It is hard for me to pinpoint when I started Yoga as it has always been there for as long as I can remember. But my formal introduction to Yoga (as it was a mandatory subject) was when I joined National school of Kathak, fondly known as Kathak Kendra, New Delhi under the tutelage of Nisha Mahajan.

So my first formal yoga session was as a Kathak student. We were told to sit in “Nispanda bhava” which is sitting with legs stretched out, taking support of a wall, hands resting on the thighs, and just passively listening to any sound. Gradually I started to feel that my senses were getting heightened.

Interestingly, though I was sitting in a passive state I was actively aware of the minutest movement, faintest of the sound, smells, and even touch. So, when I came out of it I was completely rejuvenated, fresh, and ready to go.

“In today’s time when most of us are getting consumed physically, mentally and emotionally, Yoga provides the much needed servicing of our body and more importantly conditioning of our mind.”

Nispanda bhava, as I got to know later is a conditioning method introduced by Shri Yogendra ji of “The Yoga Institute”. In which all the basic five senses( Jyanendriyas/ ज्ञानेंद्रिया) gets highly activated and you are conditioned to start your YOGA practices.

Recently, when I was doing this Advance teachers training course, from the yoga institute, I could finally understand its relevance with the first sutra (code) from the book “YOGSUTRA” written by sage Patanjali. The first sutra “ATHA YOGA ANUSHASANAM” (अथ योग अनुशासनम) means “Now begins the instruction on the practice of Yoga.” One has to be absolutely present in the moment (i.e. NOW) to initiate and understand the lessons of Yoga. However, Nispanda bhava can also be practiced to relax when you are tired. In today’s time when most of us are getting consumed physically, mentally, and emotionally, Yoga provides the much-needed servicing of our body and more importantly conditioning of our mind.

The similarities between a classical dance regime and yoga session

The final talk during my Advance teachers training course (ATTC) in yoga was on the similarities of dance and yoga. It is hard for me to put it in a nutshell here. But let me try. Before going further let me tell you that Patanjali’s Yoga has eight limbs or stages called ASHTANGA Yoga. They are further divided into two groups – Bahiranga (external or physical state ) and Antaranga ( internal or emotional/ intellectual state).

The very foundation of Indian classical dance begins by following a strict timetable or routine, which includes regular practice or ‘RIYAAZ’. The ‘Riyaaz’ is only possible when you follow a code of conduct towards yourself first (health and hygiene), secondly your conduct towards others (behaviour, attitude), and then of course respecting Space and valuing the Time. There is a similarity to the first two stages of Ashtanga yoga  (the eight limbs of yoga) i.e. YAMAS, the ethical and moral values, and NIYAMAS which is virtuous habits and observances. The dance form which I am currently pursuing is Odissi, which incorporates postures and movements that find their base in KARANAS. 

The Karanas are co-ordinated movements or actions of the body. 108 such karanas or units of dance are named and defined in the Natya Shastra, the most ancient text on the performing arts composed by Sage Bharata Muni. The unit of dance is defined by the stringing of postures (angahars), movements, hand (Hastak / हस्तक or Mudras/ मुद्रा) and feet positions( pada bheda / पाद-भेद) etc. This is somewhat similar to Vinyasa yoga which is a flowing sequence of specific asanas co-ordinated with the movement of the breath. So here one can correlate dance movements and ASANA, which is the third limb of Ashtanga Yoga.

Indian classical dance movements are complex and tough. A very highly efficient neuromuscular co-ordination is required to carry out complex choreographies, not to forget that an average solo dance recital might last from 30 minutes to an hour duration. It is a fact that to last 30 minutes on stage a dancer should at least practice 2-3 hours daily. And to sustain that long on stage you need immense stamina and consistent flow of energy. This can be achieved by practicing different breathing techniques which comes under Pranayama or the fourth stage. Regular practice of Pranayama helps a dancer to maintain a steady flow of energy throughout the performance.

The above four stages described comes under Bahiranga Yoga, which enable or help the dancer to master the technical aspects of the art form i.e. Nrittya or pure dance. Then comes the interesting transitory phase, PRATYAHARA or the ego detachment. The word Pratyahara means “to withdraw”. In Ashtanga Yoga, it is known as the bridge between the Bahiranga yoga and the Antaranga yoga.

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“This entails personal integrity and is the foundation of eco-innovation. It’s about embedding authenticity, personal integrity, empathy, agility, and inclusion in innovation.”

The new normal requires sustainability in innovation. The first rule of sustainability is to align with yourself, to continuously perceive what you do, and be aware of the influence of your behavior and actions on human beings, animals, plants, and the environment. This entails personal integrity and is the foundation of eco-innovation. It’s about embedding authenticity, personal integrity, empathy, agility, and inclusion in innovation.

“Incremental Innovation, Radical Innovation, Open Innovation, and Disruptive Innovation are all part of Corporate Innovation.”

Eco-innovation is a holistic approach of innovation that makes the link to personal innovation, corporate innovation, and social innovation, as shown in this figure. Three types of innovation as follows:

• Personal Innovation – the process of unleashing your creative potential, creating new personal opportunities, disrupting your existing target market, that lead to a significant social impact.
• Corporate Innovation – the application of new ideas to create new products, processes, or services, that lead to increased corporate value. Incremental Innovation, Radical Innovation, Open Innovation, and Disruptive Innovation are all part of Corporate Innovation.
• Social Innovation – the process of developing and implementing new ideas and solutions that aim to meet social needs and strengthen civil society.

This figure shows how in this model personal innovation, corporate innovation, and social innovation are interrelated and associated with self-learning, organizational learning, and community learning, respectively..

“Especially in the Corona era you need to be able to develop great ideas during these difficult times while you are in social isolation.”

The core of eco-innovation is a new way of thinking, which I called eco-design thinking. Remember what Einstein said: “We cannot solve our problems with the same thinking we used when we created them”. The difference between traditional way of thinking and eco-design thinking. Eco-Design Thinking is the creative process of empathizing with yourself, the end user, and the environment.

Traditional design thinking approaches are mainly process-driven, focused on analytical thinking and they follow design steps, cozy meetings, how to complete related tasks in certain order and how to use design tools.

 They do not inspire imagination effectively. Cozy meetings are not always needed to generate great ideas. The best ideas come when you are alone. I have developed many great ideas in the past thirty years when I was alone. Nikola Tesla generated tons of innovative ideas when he was alone. Stephen Hawking made great discoveries from his wheelchair and Sir Isaac Newton discovered gravity while in social isolation. Especially in the Corona era, you need to be able to develop great ideas during these difficult times while you are in social isolation.

Innovative designs and successful implementation of these designs need an authentic, holistic, cyclic, iterative, and concentric approach. An approach in which personal innovation, personal disruption, and personal integrity are embedded. You need to understand that all knowledge starts with self-knowledge, all learning starts with self-learning, all innovation starts with personal innovation, and design thinking without personal integrity is not empathic. And without empathy there is no sustainability.

This is the eco-design thinking model that is more suitable for a sustainable circular economy. It entails an iterative, incremental, cyclic and concentric process of exploring, ideating, prototyping, and executing. In the new design thinking model you iteratively create a rough product or process piece in one iteration, then review it and improve it in the next iteration and so on until it’s finished.

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We are in a state of distress. Trapped in our houses, not knowing what time of the day it is and wondering when will this suffering end. Staying in all day, working from home in pyjamas, binge-watching our favourite movies and TV shows and having all that we need to be delivered at our doorstep; surely was a dream for some people in the early days of the pandemic. It’s different now. Things have gotten monotonous and all that once appeared euphoric has become daunting. Most necessarily, the freedom to go outside that kept us moving is not there anymore. This might not appear as serious a threat as it is, and I wish to address the gravity of this major lifestyle change though this article.

“We aren’t living normally anymore and above all have adopted a more casual approach to life.”

Reality Check

A usual day for an average person has regularity to it. One thing is followed by another and that pattern elicits uniformity. When this is repeated day after day, our biological clock or circadian rhythm gets synchronised. There are also times when the release of hormones in our bodies result in specific desires, much like there are codes and algorithms in computers for particular actions. Leptin, for example, diminishes hunger. 

Sadly, we aren’t living normally anymore and above all have adopted a more casual approach to life. Sleeping when we want, snacking when we feel like it and procrastinating for most of the day. This has taken a toll on not just our habit of doing regular chores but has specially derailed our willingness to be more physically active. Now, this can have some serious consequences as Jeffrey A Woods and colleagues said ‘humans evolved as physically active animals and regular physical activity is in our genes’.

“Many studies have shown that physical inactivity exposes our bodies to life-threatening diseases.”

Thinking of sitting on your bottom all day in one place until your legs turn to jelly? Well, I would recommend otherwise. Many studies have shown that physical inactivity exposes our bodies to life-threatening diseases. And if that doesn’t scare you, do remember that COVID-19 is better off in bodies that are preoccupied fighting other illnesses. Also, bodies that fail to fight the coronavirus require ventilator support, where the less efficient respiratory system is artificially supported to maintain the exchange of respiratory gases. This life-saving intervention has an unavoidable downside; weakening of the respiratory muscles or ventilator-induced diaphragm dysfunction (VIDD). The reason for mentioning this is because it separately inhibits the weaning of patients from the ventilator, and contributes to a substantial number of deaths. Surprisingly, studies have shown that endurance training for as few as 10 consecutive days can result in protection against the weakening of respiratory muscles and VIDD. This not only reduces the chances of adverse events but can also possibly prevent the worsening of preliminary covid symptoms that usually require medical assistance. 

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“History itself shows that crises or extreme conditions can be useful for directing individuals, a country, and even the world to a solution.”

A very famous speech by John F. Kennedy in 1959, defined the crisis in an altogether different perspective. He pointed that if “crisis” is depicted in Chinese characters 危机 (wēi jī), it translates to danger (wēi) opportunity (jī). Even though it is not an exact translation, his thought-provoking words have deep connection even in the present world crisis. 

During World War II nuclear energy in the form of destructive bombs caused catastrophic damage to the humankind. However, we have also witnessed its tremendous benefits in various sectors and transforming industrial development. This race of crisis and human evolution is a continuous process. History itself shows that crises or extreme conditions can be useful for directing individuals, a country, and even the world to a solution. Ironically, evolution on earth is also a result of disasters. The cold war between two major world powers led to the invention of “internet” and converged the world into a global village.  This connectivity across global villages with enhanced ‘Air Travel’ in the last six decades showed exponential potential of epidemics converting into global pandemics. Thus, it’s cyclic and progressive i.e. emergencies put human life at risk, technological innovations provide solutions yet in longer term become causative factors for another emergency.  Coronavirus disease 2019 (COVID-19), first identified in December 2019, became a global health threat by March 2020. The pandemic, together with the extensive lockdown measures introduced by most countries in response, resulted in an unprecedented global socio-economic crisis. As countries grapple with the serious impacts to public health systems and socio-economic development caused by the COVID-19, innovation and emerging technologies have come to the rescue on both fronts – providing solutions to health challenges as well as enabling people to adapt during lockdowns and activity restrictions.

“The cold war between two major world powers led to the invention of “internet” and converged the world into a global village.”

On March 24, 2020 India also decided for lockdown measures. The challenges were no different from other countries but population density and unequal distribution of resources among different states triggered a quest to resolve multiple issues. The lack of decision support system is one of the first challenges to ensure optimal usage of resources and workforce. In such scenarios, predictive dynamics such as the Susceptible Exposed Infectious Recovered (SEIR) model developed by DRDO, INMAS can be very useful. Shortage of Personal Protective Equipment (PPEs) and testing facilities was another hurdle. Multi-use PPEs can provide tremendous support in such situations. “Protection” and “India 365” Masks developed by DRDO in compliance with NFPA 1999:2018 global standards are example Multi-use PPEs which can be washed and used again. This innovation can reduce PPE waste by 30-50 times in higher risk zones (isolated wards) and up to 100 times in moderate risk zone operations (disinfection drives). Snood mask with anti-viral coating by Virustatic Shield and Indigenous N95 masks by various industries, also introduced during 2020. Indian industries in these sectors started evolving for bulk manufacturing and some even started exporting to other countries, which never happened earlier. 

“Another revolutionary development was digital transformation of contact tracing methods globally. Aarogya Setu (India), Samparc (DRDO, India), ArriveCan (Canada), all are examples of country specific apps for contact tracing.”

Another revolutionary development was digital transformation of contact tracing methods globally. Aarogya Setu (India), Samparc (DRDO, India), ArriveCan (Canada), all are examples of country specific apps for contact tracing. “Spot Robot” by Boston Dynamics introduced in Singapore to maintain social distancing at streets. “Colivery platform” in Germany provided the most efficient route for delivering essential goods. AI supported video conferencing “Krisp” removes all background noise during online meetings. “Cabana mobile” hotel services allow travel along with isolation within the USA. “Thermal Rebellion” helps in screening temperature while passing through gates and its holographic scanning view of air with pollens and multiple particles and helps in detecting safe environments. UV-C, once used as primary sterilient into HVAC systems gained popularity in neutralizing microbial load. Ventilator(s) by DEBEL Bangalore; ATMAN (AI based system for identifying patients by using X-ray inputs) by CAIR are also examples of novel R&D achievements. Diagnostic capacities increased rapidly across countries during the first six months of the pandemic, based on the application of a technique called reverse transcription polymerase chain reaction (or RT-PCR). Rapid Antigen based testing kits, Paper based kits for indication of infection and RT-PCR based diagnostic kits added new dimensions to plethora of innovations. “Cowin application” for vaccination program is a new introduction for reducing wastage and targeting maximum population coverage in India. 

“India, as a country has potential to become a major supplier for such products.”

Sanitization practices became the new norm in 2020. From work places to household premises sanitization/ sterilization of surfaces at multiple times using alcohol based solutions, raised another issue of multiple exposure induced toxicity and potential fire hazard. A self-sustainable, cost effective sanitation mechanism for household supplies including fruits and vegetables, vehicles, shoes became a new necessity of COVID times. Some of the technologies launched by DRDO target these requirements. Ozonated Radical Confined Space Sanitization (ORCS) Unit “Poorn Swachh” sanitizes both commercial/ domestic spaces and vehicles. It utilizes 33% of global acceptable limits of ozone (0.01 ppm X 8h) i.e. 0.03 ppm and in combination with Triyogani (fumigant) neutralizes microbial load even in hidden spaces. Ultra-swachh and Ati-swachh are innovative and cost effective cold sterilization technologies for PPEs, heat sensitive healthcare equipment and biomedical waste.

Tech-savvy hospitals in the metros not only have sophisticated medical devices, MRI machines but also fully interactive websites and online platforms. Technology and digitizations have enabled error-free online appointments, consulting, video consulting and conferences, and telemedicine. Apart from these the highly sophisticated medical devices that modern hospitals across the country use for detection and curing mean that hospitals have up-skilled themselves via integration of medical knowledge with  Al-enabled medical devices and electronic health records.  In a nutshell, this summarises the whole doctor-patient relationship and communication that has culminated a huge transformation via timely decision making in regards to planning treatments schedules, operation theatres for optimal use,  data sharing and outcomes to bring in the “patient is the king” mindset. 

Thus data integration is being actively used in extending medical services and for the increase in data aggregation that can assist in the activity of preventive care, proper staff allocation and monitoring the reduction of medical errors to provide a high level of care.  Of course, the medical expenses have also increased with inflation. Today the focus of hospital management is to build loyal patients. Nowadays, hospitals are using technology to conclude the patients’ predictive analytics via medical records data,  family history, health insurance cover via cashless treatments.

When applying predictive analytics to the data generated by each patient and combining this data with those points collected from medical health records, healthcare providers will be able to build loyalty with their patients, manage their health intelligently and provide them with the seamless healthcare experience as per their expectations. Some digital enablers also could be rapidly expanded, scaled up, or deployed to support the effort. For example, strengthening and expanding the coverage of foundational ID systems, working with governments and private sector service providers as well as expanding access to the internet with a provision of mobile devices for program delivery, or rapidly expanding capabilities of existing information systems through private, secure cloud-based service providers. The current scenario is addressing challenges and rectification via the use of technology. 

“Even after a product qualifies for “export quality” it fails the cost challenges from bulk manufacturing countries like China, Bangladesh etc.”

Some of these novel technologies are not only important for managing pandemic within India but also have export potential to provide economic boost for the country. There is huge demand for such innovative products all over the world. India, as a country has potential to become a major supplier for such products. However, these products need to qualify stringent standard systems to gain access in the International market. National Registry of Goods and Standardized Quality Parameters both for indigenous and imported goods require databases/ innovative digitized solutions. The framework for stringent quality testing functional in developed nations is still evolving in our country. The disparity in framework results in cascading challenges for Indian manufacturers in the domestic market, thus limits domestic production. This raises production cost for Indian manufacturers. Even after a product qualifies for “export quality” it fails the cost challenges from bulk manufacturing countries like China, Bangladesh etc. Support from the policy framework of Govt of India can provide required solutions, which will benefit not only India but also whole world as evident in case of Vaccine production and supply management.

“Composed by: Dr. Sarita Jaiswal is an experienced plant biochemist working at the University of Saskatchewan and Ex Chief Scientific Officer Carpere, Canada. Her area of specialization is carbohydrate structural chemistry, metabolism and nutrition. She has sixty research publications inclusive of R&D articles, books, manuals/ modules, and book chapters. She has worked in many academic and industrial research projects. She also has keen interest in cosmetic formulation development and working on her own brand development.”

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