View from India: Connect the unconnected in healthcare

Looking back, astronomy gave scope for the growth of computational science. And computational science has opened out the applications of deep learning. That’s one side of the story. On the other side, biology has benefitted from computational science. “Complex biology operations are possible using computational science as the base. Pursuing this, biological computing is expected to emerge from this,” said Professor Vijay Chandru, Centre for Bio-Systems Science and Engineering, the Indian Institute of Science, speaking at the Digital Technologies and Precision Health Webinar organised by Carnegie India in partnership with Plaksha University (Mohali).

The next stage can happen when scientists-researchers work out strategies to engineer biology. Data encoding in biology can become a reality and can be described as a move towards scientific progress. It would be nice if some sort of diagnostic services can emerge from solutions based on computational science and bio-informatics solutions; it would be even better if it can be packaged for intensive care units, as not everyone can have access to highest level of healthcare. This can happen if the solutions can be scaled to expand footprint nationally and are affordable.

Several segments of healthcare have gone digital. For instance, pathology processes are being automated sp that hundreds of samples can be done in a day.

A pandemic-led outcome is genome sequencing, as viral genome variations need to be tracked to gauge the spread of the pandemic. There’s a widespread deployment of sequencing technology; how this could become a preferred choice for clinical use would make it interesting. “There’s a push to build capacity to pursue genome projects. India has sequencing platforms like the Institute of Genomics and Integrative Biology in Delhi, the Centre for Cellular & Molecular Biology in Hyderabad, Council of Scientific & Industrial Research Institutions, the Indian Institute of Science in Bangalore and All India Institute of Medical Science in Delhi,” said Chandru.

Artificial intelligence (AI) and machine learning (ML) can be leveraged to understand the human genomic makeup. AI applications are being tapped for insights into complicated healthcare. “AI-ML can help diagnose imaging in radiology. It can also streamline diagnostic time and help patients who can’t get access to healthcare. AI applications are diverse,” added Genya V Dana, head of Healthcare at the World Economic Forum. Perhaps the technology can facilitate chest X-rays, especially in cases when pollution causes lung congestion. 

The next step is to figure out possibilities of AI-ML solutions for doctor-patient interactions. The convergence of AI-ML can be used for predictive analytics, genetic screening, testing, and sequencing. And if it can be scaled globally, then perhaps there’s nothing like it. It may lead to precision medicine. “Nevertheless, there’s a downside to this. Genomic data of patients requires protection, as the information is sensitive and private. The ability to diagnose and derive information raises ethical issues of privacy,” cautioned Dana.

Along with healthcare, the records too have been digitised. Digital health records have potential to change the healthcare system in India. “E-health records and digital lockers are essential for national healthcare programmes. A framework along with governance issues has to be built for the health data of individuals. It will come under Ayushman Bharat, whose aim is to achieve universal health coverage,” explained Chandru. When we look at the health identity of individuals, one is reminded of the manner in which land records have been digitised. This example may be worth following.  

Other examples are Pan India initiatives such as the unique identification number of individuals, which we know as Aadhaar. The other national endeavour is the Covid-19 vaccine. Both projects have achieved scale, as they have given 1.3 billion citizens a certified identity. Given their success, it would be nice if a similar exercise is carried out nationally in the healthcare segment. It could turn out to be leap frog opportunity, but it has to be built from scratch.

In summary, technology can help elevate healthcare pan India. Encouragement can come from communications verticals like mobile technology. Seen from the digital point of view, this makes sense, but what remains to be seen is how healthcare can be promoted and become accessible to the masses. Primary Health Centres (PHCs) can probably bridge the gap, but infrastructure such as uninterrupted power supply and consumables including syringes and oxygen need to be in place for proper functioning of PHCs. Along with that, if there’s a shortage of PHC healthcare workers, nurses and assistants, this needs to be addressed to improve the doctor-to-patient ratio, and the healthcare workers require training. They need to be skilled to use point-of-care devices for diagnosis so that they can be the mediator between the physician and patient.