Healthcare Policy Archives - InnoHEALTH magazine

Transforming Healthcare: The Game-Changing Role of AI in Equity and Innovation

Khushi Khandelwal — Thu, 09 Jan 2025 10:30:00 +0000

Rohit Ghosh

In a recent conversation, Rohit Ghosh, a distinguished expert in healthcare AI and former executive at Cure.ai, shared his profound insights into the game-changing role of artificial intelligence in modern healthcare. His journey, from diverse fields like investment banking and logistics to the forefront of healthcare AI, highlights the powerful impact of innovative technology on improving medical practices and patient outcomes worldwide.

A Journey Towards Healthcare Transformation

Ghosh’s transition to healthcare AI was driven by a desire to make a lasting difference. After a brief stint in industries unrelated to healthcare, he recognized his passion for leveraging advanced technology to save lives. This realization led to the co-founding of Cure.ai, where Ghosh dedicated eight years to developing AI-driven solutions aimed at addressing some of the biggest challenges in healthcare.

The Integration of AI in Healthcare and Its Benefits

The integration of AI into healthcare systems has been particularly effective in the field of medical imaging. Ghosh explains that AI has three primary benefits in radiology:

Enhanced Efficiency: Traditionally, radiologists spend significant time analyzing medical images like CT scans and MRIs, which can take up to 30 minutes. With AI-powered pre-analysis, this time is drastically reduced, allowing radiologists to focus on the most critical areas.
Improved Accuracy: AI excels in detecting minute details that might be missed by the human eye. Whether it’s a tiny nodule in the lungs or a subtle brain bleed, AI improves the precision of diagnosis by complementing human expertise.
Early Detection: One of the most significant advantages of AI is its ability to catch incidental findings, such as detecting early-stage cancer in patients who are being scanned for unrelated issues. Early detection can lead to life-saving interventions.

Reducing Healthcare Inequities

One of the most profound impacts of AI, according to Ghosh, is its ability to reduce healthcare disparities, especially in underserved and rural areas. AI can democratize access to high-quality care by enabling timely diagnoses, even in remote locations:

Rural Hospitals: In areas where radiologists aren’t available around the clock, AI can provide immediate diagnostic support for urgent conditions like strokes.
Tuberculosis: AI-driven diagnostics can reduce the time needed for tuberculosis diagnosis from weeks to just one hour, a critical improvement in areas where the disease is prevalent.
Remote Care: AI bridges the gap between rural and urban healthcare, ensuring that patients in remote locations receive the same standard of care available in major cities.

Overcoming Challenges

While the potential of AI in healthcare is immense, there are several challenges that must be addressed to fully realize its benefits:

Awareness Gap: Many healthcare practitioners are still unaware of the full capabilities and limitations of AI in medical applications.
Evaluation Expertise: Hospitals and healthcare providers need clear guidelines on how to evaluate and adopt AI solutions effectively.
Policy and Regulation: Policymakers must keep pace with technological advancements, ensuring that regulations support innovation while safeguarding patient care.

Future Trends in AI and Healthcare

Looking ahead, Ghosh highlights several promising trends in healthcare AI:

Personalized Medicine: AI is enabling the discovery of new biomarkers, leading to more targeted and individualized treatments.
Preventive Healthcare: The shift from reactive care to proactive health monitoring will allow for earlier interventions and better health outcomes.
Drug Discovery: AI is accelerating the development of new drugs, as well as optimizing combinations of existing medications for improved efficacy.

Building a Sustainable AI Ecosystem

For AI to truly revolutionize healthcare, collaboration among key stakeholders is essential. Policymakers, technologists, and healthcare professionals must work together to build a sustainable ecosystem that promotes innovation while ensuring that AI-powered healthcare solutions are accessible to all. Proper implementation, equitable access, and forward-thinking policies are the cornerstones of a future where AI plays a central role in patient care.

The journey of integrating AI into healthcare is a long but rewarding one. Persistence and collaboration will turn today’s innovations into tomorrow’s standard practices. AI’s potential to enhance healthcare is not just about technology, but about transforming the way care is delivered, especially in regions that need it most. By continuing to push the boundaries of AI, the healthcare industry can achieve a more equitable and efficient system, providing high-quality care for all.

Authors Biography

Rohit Ghosh, an IIT-Bombay graduate and Founding Member of Qure.ai, specializes in business development and strategy. A Google Developer Expert in Machine Learning, he has 15+ publications, including in The Lancet. Rohit mentors data science students, collaborates with GreyAtom, and speaks at global conferences on AI and ML.

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Transforming Public Health: Addressing Challenges and Shaping the Future

Khushi Khandelwal — Thu, 02 Jan 2025 06:30:00 +0000

Prof.(Dr.) Sanjiv Kumar

In the ever-evolving field of public health, experts like Dr. Sanjiv Kumar is at the forefront for paving the way for change. In a recent episode of the InnoHEALTH Podcast, Dr. Kumar shared his valuable insights on the challenges, opportunities, and future directions of public health in India. As a seasoned public health expert, his perspectives offer a roadmap for navigating the complexities of healthcare in the 21st century.

Enhancing Healthcare Accessibility

One of the most pressing issues discussed was healthcare accessibility. Prof. Kumar noted that despite significant advancements, there remains a stark disparity in access to healthcare services, particularly in low- and middle-income countries. He argued that healthcare should be a universal right, not a privilege reserved for those in urban or economically advantaged areas.

To address these disparities, Prof. Kumar suggested several strategies. He advocated for the expansion of mobile health units that can reach remote and underserved communities, providing essential medical services and screenings. Additionally, he highlighted the potential of telemedicine to bridge the gap in areas where physical healthcare infrastructure is lacking. However, he cautioned that the success of these initiatives hinges on the availability of internet connectivity and digital literacy in these regions.

Prof. Kumar also stressed the need for governments and international organizations to invest in strengthening healthcare systems in these countries. This includes not only building physical infrastructure but also training local healthcare workers and ensuring that they have the necessary resources to deliver quality care.

The Shift Toward Preventive Healthcare

Prof. Kumar devoted a significant portion of the discussion to the concept of preventive healthcare. He argued that healthcare systems worldwide are overly focused on treating diseases rather than preventing them. This reactive approach, he suggested, is unsustainable in the long term, particularly as populations age and the prevalence of chronic diseases increases.

Preventive healthcare, according to Prof. Kumar, should be a priority for both policymakers and healthcare providers. He advocated for increased public health education, encouraging people to adopt healthier lifestyles that reduce the risk of diseases such as diabetes, heart disease, and cancer. Prof. Kumar also pointed to the importance of regular screenings and early detection programs, which can significantly improve outcomes by catching diseases at an earlier, more treatable stage.

He called for more investment in community-based programs that empower individuals to take charge of their health. These programs, he argued, should be tailored to the specific needs of different populations, taking into account cultural, social, and economic factors that influence health behaviors.

Addressing the Healthcare Workforce Crisis

The conversation also covered the challenges faced by the healthcare workforce, particularly in light of the COVID-19 pandemic. Prof. Kumar acknowledged the extraordinary efforts of healthcare workers during the pandemic, but he also highlighted the significant strain that the crisis has placed on them.

He noted that many healthcare systems are grappling with a shortage of trained professionals, which has been exacerbated by the pandemic. This shortage not only affects patient care but also contributes to burnout and mental health issues among healthcare workers.

To address this crisis, Prof. Kumar proposed a multi-faceted approach. He called for better support systems for healthcare workers, including mental health resources and professional development opportunities. Additionally, he emphasized the need for policies that promote the recruitment and retention of healthcare professionals, particularly in underserved areas.

Prof. Kumar also discussed the importance of creating a more resilient healthcare workforce, capable of adapting to future challenges. This includes investing in continuous education and training programs that keep healthcare workers up to date with the latest medical advancements and technologies.

Digital Transformation in Healthcare

Digital transformation was another key theme in the discussion. Prof. Kumar highlighted how the healthcare industry is increasingly leveraging digital technologies to improve care delivery, enhance patient outcomes, and reduce costs. From electronic health records to AI-driven diagnostic tools, technology is revolutionizing the way healthcare is provided.

However, Prof. Kumar cautioned that the digital divide poses a significant challenge to the widespread adoption of these technologies. He stressed that efforts to digitalize healthcare must be accompanied by initiatives to ensure that all populations have access to the necessary tools and training. This is particularly important in rural and remote areas, where digital infrastructure may be lacking.

Moreover, Prof. Kumar emphasized the importance of data security and privacy in the digital age. As healthcare systems become more reliant on digital tools, safeguarding patient information from cyber threats becomes paramount. He called for robust cybersecurity measures to protect sensitive health data and maintain trust in digital healthcare systems.

Policy and Regulation: Shaping the Future of Healthcare

Finally, Prof. Kumar touched upon the role of policy and regulation in shaping the future of healthcare. He argued that effective healthcare policies must be grounded in evidence and informed by the realities on the ground. Policymakers, he suggested, should engage with healthcare providers, patients, and communities to develop regulations that are both practical and equitable.

Prof. Kumar also discussed the need for international collaboration in addressing global health challenges. He pointed out that many of the issues facing the healthcare industry, such as pandemics, antibiotic resistance, and climate change, transcend national borders. As such, global cooperation is essential in developing solutions that benefit all of humanity.

In conclusion, Prof. Sanjiv Kumar’s discussion provided a comprehensive overview of the current challenges and opportunities in the healthcare sector. His insights offer valuable guidance for professionals, policymakers, and communities striving to create a more accessible, sustainable, and equitable healthcare system. As the healthcare industry continues to evolve, the themes highlighted by Prof. Kumar—communication, accessibility, preventive care, workforce support, digital transformation, and effective policy-making—will undoubtedly play a crucial role in shaping its future.

Authors biography

Dr. Sanjiv Kumar has vast experience of 47 year in the national and International arena and plays a significant role in many healthcare policies. He received several national and international accolades and awards.

The post Transforming Public Health: Addressing Challenges and Shaping the Future appeared first on InnoHEALTH magazine.

Book Review – Dissenting Diagnosis

Khushi Khandelwal — Tue, 31 Dec 2024 10:30:00 +0000

Reviewed by Dr. Debleena Bhattachaarya

In Dissenting Diagnosis, Dr. Arun Gadre and Dr. Abhay Shukla provides an insightful well-researched analysis of the troubling state of medicine in contemporary India. The book draws on the candid testimonies of seventy-eight physicians working in both the private and public sectors and sheds light on health care abuse and ethical violations.

The book addresses the growing dissatisfaction with medical care in India, highlighting issues such as unnecessary tests, botched operations, and the use of expensive, and sometimes harmful, medications. With a burgeoning medical sector, especially in urban centers where multi-specialty hospitals and advanced technologies proliferate, the principles of rational and ethical medical care appear to be under siege. The book also gives a glimpse of the manipulative theory used by the practitioners in luring the patients for spending a humongous amount of money. The various malpractices in the most noble profession has not only made a deep dent which is irreplaceable but also hampered the faith one has on the doctors. The place of almighty adjourned to the doctors was maligned with greed..

Through their research, Gadre and Shukla reveal how the very systems meant to safeguard patients often fall short, contributing to widespread malpractice and corruption.Medical ethics principles seem to have underpinned the growth of medicine, especially in urban areas where more specialty hospitals and advanced technology are expanding and their research found that the medical fraternity intended to protect patients often fail, leading to widespread misconduct and corruption.

Gadre and Shukla provide an important lens on the current state of Indian health by weaving first-hand accounts from physicians frustrated by the systemic issues in their field. The strength of the book is its detailed description of how vulnerable patients are often exploited by a system that prioritizes profit over patient well-being. The authors’ insights provide a better understanding of the mechanisms by which professional organizations and the medical profession contribute to this problem and the challenges it faces. One notable feature of the book is its balance between exploration and creative solutions. While the authors effectively demonstrate policy deficiencies, they also propose implementable reforms aimed at fostering more morale and patience.
This book is highly recommended for anyone interested in healthcare reform, medical ethics, or the state of medical practice in India. It is particularly valuable for medical professionals, healthcare policymakers, and advocates for patient rights. Dissenting Diagnosis offers a critical perspective that is both enlightening and actionable, making it a significant contribution to the discourse on healthcare quality and ethics.

The post Book Review – Dissenting Diagnosis appeared first on InnoHEALTH magazine.

Healthcare Reform is Trickier Than You Think

InnoHEALTH Magazine — Wed, 29 Mar 2017 06:50:30 +0000

Healthcare is a troubled industry. There is no known health service system that would work to the satisfaction of all major stakeholders, patients, providers, and payers. No matter the amounts spent, nothing is ever enough.

The resource problem looks different in the rich and in the developing world. In affluent countries demand is relentlessly driven by new technologies and cures, ageing populations, life-style –related problems and the medicalization of trivial ailments. Islands of undercare dot a sea of overcare. In the developing world the situation is the reverse.

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All responsible governments have noticed that the situation is unsustainable. In Finland gross health service expenses have doubled since the year 2000 outpacing economic growth by several percentage points. Health and welfare has become the cuckold that kicks other public tasks, such as infrastructure, education and defense out of the nest.

The obvious counter-measure is to increase productivity. According to a recent study by Aalto University, there is ample room for that. If all districts in the country, after adjusting for local variations in population and morbidity, would perform at the level of the national average, one billion euro could be saved out of a total expenditure of eighteen billion. If all would perform at the level of the best, no innovations required, the savings could be three billions.

Bringing the Concept of Patient Experience & Standards to India

Such regional variation is puzzling in a health system that is to ninety percent tax financed and centrally regulated. Neither the government, nor the professions have been able to implement standardized best practices. There is a strong case for Lean healthcare.

Raw improvement of everything, however, may be a dull weapon. There are several interesting patterns that are not visible to the naked eye. A data –driven helicopter perspective is needed. There are areas where improvement would be especially welcome, and not only in the shape of smooth processes but better structures and allocations.

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Curiously, there can be simultaneous overspending and undercare. A common observation is that healthcare expenditure follows the Pareto distribution or the 20/80 rule: one fifth of the population spends four fifths of the resources. In a recent study, The Nordic Healthcare Group (NHG), a consultancy, studied the health expenses in a medium-sized city. The distribution was sharper than the traditional Pareto. Ten percent consumed seventy percent. There was a hard core of high spenders, a few hundred individuals that consumed more than half of the total municipal health and welfare budget. They could be divided into three categories: expensive somatic cases such as premature and massive trauma; elderly multi-morbidity patients in around-the-clock care; and the sad combination of substance abuse and mental disorder. With the possible exception of the first group, these people did not get value for the money. Their quality of life was overall bad.

This happens in a welfare society that has for decades mobilized the full force of the state and committed massive resources to universal access and equality of care. Still there some people are simultaneously overserved and undercared.

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Growth has been fastest in the extremes of the care spectrum. The most technically advanced specialist care spends like there were no tomorrow. The low end of home and community care is not that expensive per unit, but the number of cases increases dramatically. In Finland between the years 2000 and 2014 expenditure for specialist care doubled, long-term care for the elderly and handicapped grew 160%, while primary care have had to do with a paltry 60% increase. The trouble is in the middle.

Since WHO’s Alma Ata declaration in 1978 every policymaker has paid lip service to the strengthening of primary care. Therapies should be administered at the lowest sufficient level to save the specialized resources to those that truly need them. It is better to treat diseases early than to allow time to turn them into complications. Despite the best of intentions, quite the opposite is happening. A relatively weakened primary care feeds growing numbers of increasingly sick people to hospitals.

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It is common knowledge that free markets do not work in healthcare. The relative weights of primary and secondary care, however are powerfully market driven. Consider two hypothetical doctors. A is an accomplished neurosurgeon, who successfully saves lives by removing brain tumors. B is a general practitioner, whose working day is an endless stream of small infections, minor trauma, and unspecified pain. As a patient, taxpayer, or regulator, how much would you be willing to pay for a day’s work to A and to B?

The answer is obvious. Medical students, investors and decision makers have long since decided to follow the money. In the Nordic countries center-left governments have traditionally been suspicious, if not openly hostile to markets in healthcare. Still, and despite all the Alma Ata –rhetoric, they have been incapable of stemming this particular market mechanism.

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This points to a broader problem. It appears that even in publicly financed and administered systems, public sector provision is not under public sector control. The government did not call for rampant cost-inflation. No politician has demanded queues and increasing socio-economic health inequality. Still it happens.

The Norwegian political scientist Stein Ringen has eloquently described this phenomenon in his book A Nation of Devils. Politicians may think they are in charge. As a matter of fact they don’t do things, they just issue statements, make decisions and allocate money. Before anything real happens on the ground, the issue has to travel through a lengthy chain of civil servants and administrators, who have every opportunity to turn gold into lead.

It is well known that a core issue in health policy is the information asymmetry between patients and doctors. A similar, perhaps even more devastating asymmetry is between politicians and professionals. For this reason planned economies have never worked as planned.

If markets don’t work and command-and-control is hopeless, something else needs to be done. The answer is to be sought from the design of quasi-markets. While greed is and has always been pervasive, nothing controls the greed of a seller as efficiently as the greed of a buyer.

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The current center-right Finnish Government has realized the problem and initiated a sweeping reform. While the initiative sill has to run the gauntlet of entrenched interest groups and parliamentary opposition the basic principles are clear.

For a nation to contain health expenditures at a sustainable level without endangering public health, some or all of the following mechanisms must be put at work:

– Care should be initiated at the right time; not too early, not too late.

– Care should be administered at the lowest sufficient level; primary and secondary care must take joint responsibility of care pathways.

– The care of very expensive multi-morbidity cases must be integrated to include somatic, psychiatric and social care.

– The overall productivity and quality of care processes and administration must be improved following the principles of Lean healthcare.

– Care should, when possible, be evidence –based not to do useless interventions.

– Increasing health literacy and the awareness of life-style related diseases should reduce demand.

The core issue is how to design a system that can put to work all or some of these mechanisms. There are no simple solutions. Policy makers have two levers at their disposal, information and money.

The information should be about value. As Michael Porter and other proponents of the Value –based Healthcare movement have suggested, value is the relation between health outcomes and the money spent, measured at the patient level over a full cycle of care. To develop accurate and comparable measures of health outcomes is a formidable task that is currently undertaken by several research and development initiatives around the world.

Addressing Unmet Needs in India’s Health System

If such information were available, policy makers could design health finance systems that could align the interests of patients, payers and providers.

In Finland some of the central policy proposals are, first, a single-payer system. The state collects all money and distributes them to regional authorities.

Second, all caregivers should be organized as limited liability companies with standardized accounting and reporting. While most of the money will still flow from the taxpayers, every caregiver would get its income following the same rules and be subject to the same outcome measures. The current public providers who would loose their privileges and be forced to compete, obviously, will furiously resist.

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Third, to allow patient choice and strengthen primary care, a finance system based on capitation is proposed. Each citizen should register with a health- and welfare center, which would then receive a fixed annual per capita remuneration from the government.

The amount of the capitation money, and the corresponding variety of services that it should cover, are hotly debated. At the low end, the amount could be calculated based on the average annual spend of the healthy adult population, which currently is in the range of 250 €. At the high end it could include just everything and be about 3 500 €, which is the total per capita expenditure. In the latter case the primary care centers would get full control of all financial flows. On the behalf of patients they would purchase clinical interventions from specialist hospitals as needed, essentially taking the role of an insurer. There would be several problems with such drastic measures, so there will probably be a compromise allowing some part of the specialist care to be financed on a fee-for-service –basis by the regions.

Ten recommendations for Digital Health Interventions

While capitation –based finance provides strong incentives to primary care; there are some known pitfalls. Since the income comes by registered citizen and the costs come from the resources needed to provide service, there is a temptation to engage in skimming, i.e. lure healthy individuals to register while denying service from those with pre-existing conditions. This can be tackled by legislation that prohibits denying anybody from registering as well as kicking anybody off the list. There would still be the risk of undercare and cost-shifting, i.e. costly patients are referred to specialist care, and to be paid directly by the government.

The design of a quasi-market with regulated competition and patient choice requires accurate and publicly available information on value: the relation between outcomes and euros spent at each care organization. Therefore the key task for researchers and policy makers is to develop and experiment with information systems that could do this.

WHO’s First Guideline to Digital Health Interventions

For health policy makers in India and other rapidly developing countries this may sound like a rich-man’s problem. Indeed it is. The message, however, should be that money will not solve a nations health problems. The pit has no bottom. Health systems emerge slowly and are difficult to change. Latecomers can always have the privilege to learn from other’s mistakes and make a mighty leap to the front.

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About the author

Paul Lillrank has been Professor of Quality and Service Management at Aalto University since 1994. He has served as the Head of the Department of Industrial Engineering and Management and been Academic Dean of the school’s MBA program. He received a Ph.D. in Social and Political Sciences at Helsinki University in 1988 after spending six years as a post-graduate student in Japan where he researched quality management in Japanese industry. He is a pioneer in introducing industrial management methods to the study of healthcare service production. He has been visiting professor at the University of Tokyo, and teaches regularly at the Indian Institute of Technology, Kharagpur.

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