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Automation – The future of healthcare

The ongoing pandemic has brought the healthcare industry to its knees not just in India but globally. In India particularly, there has always been an imbalance between the healthcare infrastructure and number of patients. With the additional stress of the pandemic, this gap has only widened, leading to the obvious inadequacy of the facilities and manpower. According to the information released by the Economic Survey 2019-20 regarding the medical infrastructure, the doctor-population ratio in India is 1:1456, much lesser than the WHO recommendation of 1:1000. There is an increasing need for more medical graduates every year but the actual numbers are decreasing. Apart from this, the healthcare costs to the patients are alarming, the hospital costs are increasing, and a significant portion of the medical bills is paid by loans or sale of assets, pushing the people into severe financial stress, especially in emergency situations. All of this is worsened by increased incidence of diseases in younger population e.g., metabolic disorders, and cancer. Overall, there is a foreseeable inadequacy of healthcare access to the general population.

In September 2018, the Government of India launched the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana as part of the Indian Government’s National Health Policy aiming to provide free access to healthcare for 50 crore people in the country. Private hospitals which cater to a majority of patients in the country are obligated to support Ayushman Bharat patients by charging them at much lower rates than the current rates, the private hospitals need to become much more productive to maintain the current standards, leading to additional pressure on the healthcare system.

To put things in perspective, I would like to give an example of my own laboratory, where before the pandemic we did only advanced next generation sequencing (NGS) assays. The RT-PCR was merely a step in the NGS workflow. About an year back when the COVID-19 pandemic struck the country, we decided to use our setup for testing for COVID-19, since we had the best in class equipment and highly skilled manpower. A typical RT-PCR test for COVID-19, requires multiple steps. Sample collection, sample registration form ID generation (via the government’s RT-PCR app), registration in the lab’s information system, RNA extraction from the sample, preparation of PCR reagent mix, loading, the actual PCR reaction, taking the data from the machine and generating reports, uploading of the results on the government portal and releasing the results to the patients. This whole life cycle of the sample may take somewhere between 6 hours to more than 24 hours. To start with, we could process no more than 100 samples a day, as we had a small team and everything was done manually. Few weeks into the testing we realized that to cater to the increasing workloads and to be able to meet the committed timelines, the only solution is either increase manpower or relieve our existing manpower of some of the workload which a machine can do. We brought in automation at every step of the process, such as using automated extraction equipment, bulk registrations, bulk upload of results, bots, etc. and can now process almost 3,000 samples per day with a turn-around time of less than 24 hours.

I believe that automation is the way to go forward to prepare to increase the efficiency of our healthcare infrastructure.

Automation and Artificial Intelligence will play a definite role in changing the face of Indian healthcare in the next few years by improved and efficient use of the existing doctors and paramedics, improving operational efficiency, logistical workflows, patient experience, personalized attention to each patient and making healthcare easily accessible to the general population. It would be wise and the right time for healthcare institutions to invest in automation to prepare for the increased patient workloads and to deal with the unfavorable doctor to population ratios.