The critical care environment has undergone significant alterations in the past several years. This has happened because our lifestyles in the fast-paced lives of modern India are ensuring that most people, in the age group of 30-50 years are falling prey to life-threatening cardiac diseases and strokes, in addition to diabetes, hypertension, cancers, liver, kidney and lung diseases – these diseases being called Non-Communicable Diseases or NCDs. They are now responsible for killing more than 65% of our population says Dr Arvind Lal, known for his diagnostic labs across the country.

Flagging concerns on such trends, these patients need high-cost intensive care, be it for complications of heart attacks, strokes, diabetes, hypertension, cancer or lung diseases. This is where the importance of Point-of-care testing (POCT) comes in. It helps in almost diagnosing the patient instantly and improves the physician’s ability to take immediate corrective action and decreases hospital stay. One such test is Troponin – that has revolutionized cardiac care by diagnosing heart attacks or myocardial infarction.

This article is based on the keynote address on the occasion of 2nd Annual International InnoHEALTH Conference 2017 – ‘Transforming Healthcare Through Innovation’ in New Delhi, said there are numerous promising diagnostic technologies. The key message is that in a country where 70% of the population lives in rural surroundings, ‘it is our duty to rapidly adopt disruptive innovative affordable technologies including telemedicine. Thus, our underserved population would be able to avail of the best treatment possible and bring in massive visible change’. He said the importance of bringing quality healthcare needs no reminder and the time has come for India to change the direction of healthcare for the masses.

Healthcare is a right – and access to good healthcare should not depend on where one lives and how much he or she earns. But sadly, that is exactly what plagues India’s healthcare today, he lamented. India faces a severe shortage of both hard infrastructure and talent. With about one doctor and one functional bed per 1000 population, healthcare is truly underserved in India. Add to this the regional imbalances and variations in healthcare delivery. The healthcare infrastructure is skewed towards urban over rural India.

Although rural India accounts for about 70% of the population, it has less than one-third of the nation’s hospitals, doctors and beds, resulting in large disparities in health outcomes across urban and rural India. British Medical Journal (BMJ) has observed that there is a remarkable saving of lives in India if good healthcare facilities consisting of operation theatres, surgeons, anaesthetists, blood banks are available within 50 kilometres of the patient providing quality medical services within the ‘golden hour’.

Though there has been a sea change in the last five decades, India now needs to reinvent the field of diagnostics as laboratory tests are responsible for 70% of all clinical or medical decisions.

In today’s life where internet rules the roost, the patients have become very knowledgeable, thanks to the globalisation of healthcare, and are demanding very high-quality healthcare for themselves. They are insisting on a very wholesome and satisfying experience rather than being told that the ‘treatment is over’.

Soon, a time will come when the tests shall be ordered by the patients based on clinical history and clinical findings that shall be answered by an Artificial Intelligence (AI) application. Artificial intelligence has already found several areas in healthcare from the design of treatment plans to assist in repetitive jobs to medication management and drug designing. The most obvious application of artificial intelligence in healthcare is data management. Collecting it, storing it, normalizing it, tracing its lineage – it may well be the first step in revolutionizing the existing healthcare systems.

Recently, the AI research branch of the search giant, Google, launched its Google Deepmind Health project, which is used to mine the data of medical records in order to provide better and faster health services. The project is in its initial phase, and at present, they are working with Moorfields Eye Hospital of NHS Foundation Trust, UK to improve eye treatment.

Just a few years ago the patient after giving the sample used to come back in the evening to the lab to collect a physical copy of the test report. This was replaced by making the report available on the internet that could be downloaded by the patient in the comfort of his home. These days this has been further replaced by making available an App on his mobile phone wherein he can book an appointment for the sample to be collected at home and the report being later available on the same mobile App.

‘IBM Watson, whose headquarters I had the privilege of visiting a few months back in the Silicon Valley, is an AI-based engine that has launched its special program for oncologists to provide clinicians evidence-based treatment options. The program has an advanced ability to analyze the meaning and context of structured and unstructured data in clinical notes and reports in its encyclopedic memory that may be critical to selecting a treatment pathway’. IBM launched another algorithm called Medical Sieve. It is an ambitious long-term exploratory project to build a next-generation ‘cognitive health assistant’ that is able to analyze radiology images to spot and detect abnormalities faster and more reliably. This shall help radiologists in the future to look at the most complicated cases where human supervision is essential.

The lab-on-a-chip (LOC) is another device that integrates one or several laboratory functions on a single integrated circuit (commonly called a “chip”) of only a few square centimetres to achieve automation and high throughput screening. Imagine that a patient comes to one of our 2,100 collection centres in the remote tier three or tier four towns in India with the high fever. We take a drop of blood from his finger and inform the clinician almost immediately that the patient is suffering from Chikungunya and not from Malaria or Typhoid, or Dengue fever or Japanese Encephalitis – all in a matter of minutes! The driving notion behind POCT is to bring the test conveniently and immediately to the patient. Needless to add, the patient’s data by POCT shall be made available to update the patient’s electronic health records (EHR).

Talking about POCT Instruments: Currently, two broad type of POCT instruments are available: Small benchtop analyzers (for example, blood gas and electrolyte systems) and handheld, single-use devices (such as urine albumin, blood glucose, and coagulation tests). Now let us talk about if POCT is Boon or Bane? The strong point of POCT is speed and the rapidity with which it shall save lives in emergencies. As India marches towards quality healthcare delivery, in course of time regulatory compliances shall have to be adhered to in the interest of the patient’s health.

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An innovative Pan-India health scheme will be unveiled as announced by the PM Narendra Modi from Ramparts of the Red Fort on Independence Day on 25th September, the birth anniversary of Pandit Deen Dayal Upadhyaya. Pradhanmantri Jan Arogya Abhiyan would also go operational– it is set to get common man free treatment for serious diseases. The Pradhanmantri Jan Arogya Abhiyan and Ayushman Bharat Yojana will cover 10 crore families with a provision of 5 lakh rupees per annum health assurance for each family. It will also open new avenues of employment in the health sector for youth especially from middle-class families. New hospitals will be built in the tier-2 and tier-3 cities. They will require medical staff in large numbers. Such a gigantic plan will bring forth radical changes.

Also read: Innovation is the New Buzz Word

We, at InnoHEALTH Magazine, are confident to play a major role in highlighting the scheme for the benefit of various stakeholders – may it be public hospitals, private entities or the patients. In view of bringing focus on a slew of issues, which are constantly in debate among the medical fraternity members, our magazine aims to focus on diagnostic tools in the field of treatment through this issue.

In the global business scenario, now a witness to major changes due to growing political reasons, Trade tariffs, and Tax structure is bound to be affected badly by such developments. So, we are trying to keep the close watch on medical diagnostic tools, medicines price tags and a torrent of new diseases caused by current lifestyles. We had a discussion with Dr. Arvind Lal whose internationally famed pathology labs provide deep insight into disciplines of pathological tests and precise examination of diseases.

Since time immemorial, India is known worldwide for its ancient traditional medicines, but it is for the first time that a new protocol on Ayurveda medicines has been scripted. The AYUSH Ministry is closely studying the same while exploring ways for its effective usage. The protocol has been prepared on the basis of AI (Artificial Intelligence). In the current edition, we are also publishing a detailed report on AI that is making remarkable forays in the field.

As the old age is a natural phenomenon and each one of us has to face this stark reality, we have tried to rivet our eyes to problems afflicting the old people both socially and medically. The world is observing International Day for Older Persons on 1st October, so the topic gains more relevance.

Interesting stories list is unending and some of these are: A Consequence of Modern Day Living – Burnout; Fairy tales of Nanoparticles from Iceland to Jamia Millia Islamia; AI Engraving Footprints on Healthcare Transcontinental Canvas; National center for ageing coming in New Delhi; Lonely people run the risk of dying early; Low back pain is the leading cause of disability worldwide; Religious people live four years longer than atheists; A study has unknotted long-term impact of stroke; etc. In addition to these, we are also publishing a host of latest researches which gives scientific explanations of many usual occurrences in human beings.

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