The meeting saw some very eminent and important speakers from around the healthcare industry. The first keynote was given by Dr. Vibha Jain, AGM IT, Max Healthcare. The keynote was about how AI improves the patient doctor communication?

The rise of the Internet of Things and Artificial Intelligence is critical to the digital transformation of modern healthcare as far as healthcare monitoring and delivery are concerned. The aim of patient and doctor communication is to create a good and caring relationship, facilitate exchange of information for accurate diagnosis and treatment, and including patients in decision making and counseling. But whether  the doctors are able to create a caring relationship or whether the patients are satisfied with the care, is the point of concern With the evolving technology, can Artificial Intelligence empower healthcare and improve patient doctor communication? There can be endless possibilities in medical imaging and diagnostics, patient care, RnD and management.

One of the patient doctor communications medium is voice. Companies like Google and amazon are out with devices which are voice based and are betting heavily on voice based skills. As these companies are market movers, the question arises: Are we investing in making voice  one of the skills needed to help the patients?

People with chronic conditions are often advised to follow detailed treatment plans; end-of-life care often requires many complex (and emotionally draining) decisions; options for treating certain diseases are increasing drastically. How much could health outcomes be improved with more effective communication between patients and healthcare providers?

One of the panelists brought light on how the voice is substantial to the patient doctor communication. Voice as an input is a useful tool as it gets us more data to refine our systems and algorithms. Voice as an output have some issues in the current scenario, as the synthesis is not real, it is hard to deploy the voice based system. Also there is a language barrier, as the systems are mostly deployed in English, there lacks trust and empathy. There is a vast opportunity to make these systems demographically viable. The question now arises is, if we use a chat bot or a bot service, can we have an authentication that it is a bot speaking not a human being.

Countries like Sweden have a white label application which helps the patient to communicate to the hospital or doctor by the help of a virtual appointment. This makes the environment conducive. In India, big hospitals like Max healthcare can also come up with the same system to improve the patient interaction with the hospital. Government can also come up with a plan to incentify the hospitals and doctors to use this kind of application.

As we are heading towards connected health, efficient communication between doctor and patient is just a small step towards faster healthcare delivery. The pace and evolving changes in the segment of healthcare extend right across the spectrum – from the development of new treatments and medicines to the front line delivery of innovative and paramount outpatient and emergency care. Surprisingly, it is at the front line where the most amazing advancements are happening and where the advantages are registering in the biggest volumes.

With this much advancement in connected health technology we have silos in the process. Healthcare providers apparatus needs to dismantle silos to usher in jointness communication between the doctor and patient. Can we leverage digital tech to manage patient life-cycle for convenience and safety? Max healthcare is also working on many measures to help the patient such as, billing transparency and estimation of the cost, bed allocation, risk assurance etc. Implication of all these is the journey/life-cycle of the patient improves. It gives a holistic care to the patients.

The core is to maximise value for patients: that is, achieving the best outcomes at the lowest cost. In this scenario the AI is helping the healthcare providers to move away from a supply-driven health care system organized around what physicians do and toward a patient-centered system organized around what patients need.

Growing demand for out-patient and at-home care along with connectivity advancements are also driving the use of devices powered by the IoT and AI. Today, privately-based medical insurers are making use of two-way smartphone applications for smartly connecting general practitioners with customers when it comes to initial consultation and diagnosis.

This serves as a cost-efficient option for avoiding a probably unnecessary in-person consultation for a minor ailment. The next steps ahead for this is to accurately and completely share vitals with medical practitioners on a real-time basis. This will be beneficial to enable multi-faceted tele-health services by making use of affordable devices for interfacing users together. It also proves useful for data transmission through connected devices like monitors, pacemakers, and other devices.

It is evident that the core of the connected health is made of technology, but we are not talking about just tools and devices here. This topic is relevant also from a philosophical, ethical and business point of view.

Government and private payer policies are shifting toward the use of connected health; We will likely see increasing adoption of connected health services by hospitals and providers as health care systems move towards holistic care to patients. It is the innovation and execution of information-based technologies that are likely to be transformative in improving health in a world of increasingly restrained resources. And in that effort, the newly empowered consumer is likely to lead the way.

This is a growing area of health care, and despite current challenges, presents significant opportunities for health care improvement. If you are not considering connected heath and Artificial intelligence in healthcare, now is the time!

The need to change the way of delivering care/service should be our priority. A paradigm shift in the way of offering services through connected health services and emphasizing that privacy and security concerns are of utmost importance when it comes to connected health. Responsibility and accountability after acquiring data are very important. The question is how to analyze the data and get actionable insight. Analytics and IoT should be considered together for actionable insight. The challenge of interoperability has turned up with an increase in the number of devices being used.

Trends and Opportunities of Medical IoT

IoT or Internet of Things is not new, but it has been gaining traction at a very high pace. Since the inception of the word IoT, there has been an ongoing conversation about how it might change healthcare, improve patient safety, affordability and accessibility for patients.

Healthcare in India has a huge potential in terms of IoMT or medical IoT solutions. There will always be challenges and opportunities in this sector. Connected health is contributing towards the growth in space of IoT, but is lagging behind many other connected sectors.

One of the key challenges in developing the algorithm for medical devices such as CT scans and X-rays. Application of artificial intelligence and machine learning in healthcare should be cautiously done because in case of a CT scan if we miss a module it has life risk and hence should be used carefully and should be a well-validated clinical algorithm.

Since the infant mortality rate in India is twice the rest of the world, and that is certainly alarming as the bottom of the pyramid is affected; there is a company which focuses on the mortality rate of low weight birth babies. They have come up with developing a bracelet which diagnoses hypothermia in low birth weight babies. This was a very simple and innovative device, but then they analyzed the intermissions they can work on and came up with baby cradle. The main challenges to develop and design such a product is to cope with the cost factor and the startups definitely need funds to develop such a technology.

The goal of connected health is not just early identification of health issues, but also effective patient care and safety. Today IoT platforms support integration of medical devices and wearables. The need for security is as important as when it comes to IoT and accessing healthcare data and strengthening advocacy for connected health.

Things change very rapidly and in very small time, and IoT is taking shape with it. But who will fund the cost of development/ Can government help the industry in making such policies?

Business Models of Successful IOMT in India and Challenges

The IoT healthcare business strategy is not yet robust because it involves a set of elements with new requirements such as new operational processes and policies, new infrastructure systems, distributed target customers and transformed organizational structures. Therefore, there is a need for a new business model. The IoT technology opens a new dimension of business opportunities for healthcare companies and the IoT platform becomes a key artifact in this transformation. Early movers who are taking a proactive approach to establishing their IoT healthcare ecosystem will tap into new business models. In this part of the business model, the panel discussed the basis of pricing and the way of charging for a product or service. Besides this, the panel also discussed the ways of revenue generation.

While there are many benefits of the Internet of things in healthcare, it isn’t without its challenges. As with any new technology in healthcare, hospital and IT executives are concerned about data security and IoT device management. What are the potential barriers to IoT adoption and how healthcare IT can overcome those obstacles?

AI and IoT change the way healthcare is delivered and we obviously are on the cusp of a revolution. This definitely poses a fair amount of concerns but also huge possibilities. The panel also discussed how Medicare is 100th the cost per person when compared to Obama care. So clearly, there must be more innovations coming from IoT and AI; they are going to help us reduce the cost.

In the past, how people tried to use the data for the benefit of both patients and providers, starting from the patient side faced huge failures, as nobody was willing to pay. And that’s where the thinking came from that; how do we really make this work? How do we really turn this data into a business model? And that’s where they pivoted the model, working with providers and using their data sets. But then the question comes up, “Why the providers would share their data?”. Thus, the first pitching that started was to use the provider’s data for their patient care. And it didn’t work well. The whole narrative was, “What’s in it for providers?”.Therefore, the business model turned out to be, as we kept on talking to people, we realized that the data is going to be useful for provider’s revenue success, and then the same datasets will help the patients. A solution that they projected is to help retain the provider with patients’ data, grow their revenues and help in patient care.

The MedTech certainly seems more complex. Where they are trying to come out with a dermatology solution and oral health solution for serious diseases where a cell phone image taken from an off the shelf mobile phone camera is sent to an AI backend and it gives a diagnosis and possible treatment options for a variety of skin diseases, particularly oral cancer. Such cases are very prevalent. What the panelist found is a landscape extremely complex in terms of the business model because when someone comes out with something like this, then figuring out who would it be paying is difficult. And suddenly the AI and IoT thing comes up and say that it can perform this diagnosis at par the level and in certain cases better than certain trained specialists. This does not support their case.

One of the panelists shared her thoughts on important factors to concentrate and realize why health care has not moved digitally as compared to other industries like banking, insurance and how a lot of digital interventions can happen in healthcare. There are a whole lot of opportunities.

The main thing to focus on is What is the problem? What is the solution? And who’s going to pay you? Because that’s where the panelists believe that lots of startups have a scope.

The customer is one, the doctor is another and hospital, the other spectrum. So how to manage this change and address the change management. If you give a thought on what to overcome, it gives you a kind of value that you try and achieve success and how do we overcome the quality assurance issues, change issues, challenges that one sees in terms of adoption. Let’s say for the doctors, it took a hundred years to the doctor to adopt stethoscope. Today, it’s widely accepted. IoMT is something that is obviously very innovative, very useful. But then not every doctor will accept it right away. How does one plan to overcome that barrier? So, they might just want one to focus on change management issues.

There are three components of the IT embedment in a hospital. One is the business side of it, which gets adopted immediately. There’s just no resistance to it. The second side is the paramedical side of it; it has pathology, radiology, and other such things. They take a little time but they come on board. The learning curve is much shorter over there. The third one is the clinical side, which is the most difficult, as in a hospital system there are doctors who are most resistant to changes and the reason being their upbringing and learning of clinical practices in a certain way.

The question arises “How does one change their practices?” Changed management is already happening at the college level. The medical students who are coming out now are more hands-on and are accepting the new technological changes. We will have to wait a little while, but they will accept it. When we talk about a change in the management, the problem that arises is not specific to India only. In the USA, George Bush had said that he wanted EMR to be adopted by everyone within the next ten years. Surprisingly, he didn’t even get 15% conversion in those ten years.

It is important to secure the data and look over the cost implications of data security issues in connected health work moving forward. There is a need for appropriate interventions at the transition level of doctors and patients, as well as the importance of advocacy and awareness‐raising at community level about connected health. There is also a need for financial support for encouraging the tech enthusiasts of the country to address health issues in India with connected health solutions. One needs to understand customer value as well. How do we speak the right language in terms of what would appeal to that particular user or customer or doctor or hospital for that matter only then we will see more IoMT adoption happening. Yes, there is a need to understand the regulatory framework. Startups needs to adopt a lean structure in collaboration with the medical partners and come up with innovative solutions. India has a fantastic opportunity, but clearly it does need elements to come together and work together.