Over the next few years it is likely to fundamentally change how healthcare is delivered and how the outcomes are measured.
That revolution is called Health 4.0.
However, before we turn to Health 4.0 and understand its various aspects, components and possible impact, to set the context, perhaps it might be better to take a couple of steps back and understand how the industry has evolved and where it stands, especially in India.
The decade from 2005 onwards saw the development of genomic information, emergence of wearables and implantables. The integration of all this data along with networked EHR systems saw the emergence of Health 3.0.
What we are seeing today is the emergence of Health 4.0. It is the coming together of all these technologies coupled with real-time data collection, increased use of AI and an overlay of invisible user interfaces. The focus on collaboration, coherence, and convergence will make healthcare more predictive and personalised.
It is not just the enhanced amount of data that is available to doctors, but the real critical factors here are the ability to extract insights from the data being captured and the portability of this data.
Data portability allows patients and their physicians to access it anytime anywhere and enhanced analytics allows for differential diagnosis and medical responses that can be predictive, timely and innovative. Health 4.0 allows the value of data more consistently and effectively. It can pinpoint areas of improvement and enable more informed decisions.
What it also does is help move the entire healthcare industry from a system that is reactive and focused on fee-for-service to a system that is value-based, which measures outcomes and ensures proactive prevention. This has already started in the US, where the Department of Health has announced that 90% of Medicare would move to a value-based system by next year.
The Indian healthcare industry is growing at a rapid pace and is expected to be at USD280 billion by 2020. Yet it is also fragmented. Some of the larger super-specialty chains are moving towards Health 4.0, but the bulk of the healthcare industry is stuck in legacy systems.
There are, however, several key factors that are driving change that could soon snowball into a revolution.
First is the government. In its National Health Policy 2017, unveiled a few months ago, the central government has talked about building a national IT backbone that will help in integrating EHRs and making them portable. For the government, initiatives like this are the key to meeting its societal objectives of enhanced access to healthcare and achieving the Sustainable Development Goal of Health for All.
The second factor driving change is enhanced penetration of health insurance. The insurance companies, in a bid to weed out spurious claims, are increasingly demanding a level of data collection and analytics that is forcing healthcare providers to change.
The third factor is the rise of an aspirational middle-class that is more informed and hence demands better service from its healthcare providers. The healthcare providers themselves – diagnosticians, physicians, surgeons and hospitals as a whole – are also realising that with the increased use of Health 4.0-enabled tools, their efficiency is enhanced and outcomes are becoming more effective.
The fourth factor is the emergence of Patient-Centered care. But the fact is that true patient-centered care requires a radical shift in old healthcare delivery models. Today, healthcare delivery is episodic. If a patient feels unwell, he/she approaches a doctor. Next step will be moving from patient centered to person centered care which primarily shifts the focus from disease and treatment to wellness and prevention. Truly person-centered care will take into consideration not just the individual but also factors like medical history of the individual’s family, as well as his/her lifestyle, demographics and ability to access healthcare. Healthcare plans developed taking such factors into account focus on providing care that is personalised, enabling, and co-ordinated and that treats people with compassion and respect.
The final factor that is driving this change is the data revolution that is currently taking place in the country. Access of affordable, high-speed data connectivity – both as a result of government’s Digital India initiatives and private sector competition – makes it possible for both doctors and patients from smaller towns to access some of the benefits of Health 4.0. To sum up, the focus is shifting to Integration of capabilities, patient-centered care and ownership of clinical outcomes.
One key issue that requires tackling is the need for a physical presence that is felt by patients and even doctors. What is needed then, is a hybrid model that combines hi-tech with hi-touch. We need to build a platform that connects the entire eco-system (integrated and connected devices) that extracts valuable patient information and mines the derived intelligence to innovate for predictive and personalised medicine and delivers blended (hi-tech and hi-touch) services across the entire spectrum of wellness, prevention, cure and care.
That is the big opportunity for enhanced patient care and healthcare outcomes, as well as creating value for stakeholders.