Imaging & AI to take center stage in combat against COVID-19

Indian medical devices companies continue to face disruptions in the supply chain ecosystem as India is heavily dependent on imports for total imaging equipment. With the lockdown likely to be eased and the gradual resumption of elective procedures, there will be an increase in demand for equipment and procedures.

Globally, CT (computerized tomography), X-ray (digital and portable), and ultrasound (point-of-care) modalities were at the combat forefront for effective and early diagnosis of COVID-19. In India, this was not the case at the outset as the country was heavily dependent on PCR (polymerase chain reaction) and swab tests. Eventually, the worsening situation meant that the Indian government began to embrace the utilization of point-of-care imaging modalities (digital and portable X-ray and ultrasound).

Aggressive technology partnerships with artificial intelligence (AI) vendors in X-ray specificities highlight India’s willingness to embrace AI-led chest X-ray scanning for effective diagnosis and triaging of COVID-19 cases. The current crisis has given rise to several partnerships in India, including Behold.ai’s partnership with Apollo Hospitals to implement AI-based chest X-ray technology, and the joint initiative by NTT Data Corporation and DeepTekInc to use AI technology to analyze patient’s images from X-ray and CT and enhance the efficacy of triaging.

Though the AI-led technology partnerships with hospitals continue to rise, the National Informatics Centre (NIC) of India is still awaiting a diverse pool of sampling of chest X-rays to use the data to create a prototype for COVID-19 detection throughout the country. According to media reports, Dr VP Joy, Secretary (Coordination), Cabinet Secretariat, sought the intervention of the Indian Council of Medical Research (ICMR) in arranging the X-rays from various states on a priority basis so that NIC can train and release the AI model as a prototype.

Considering the current COVID-19 scenario in India, the Ministry of Healthcare will look to devise structural strategies for technology partnerships. But there will be a cautious approach when it comes to embracing AI in X-ray, even though it will curb the ongoing operational changes when handled effectively. Further, there will be an uptick in the adoption of cloud implementation, picture archiving and communication systems (PACS), and vendor-neutral archive (VNA) channels among healthcare providers as healthcare companies facilitate a seamless adoption of the technology-enabled models to engage patients, and for remote engagement strategies.

Across various segments of medical imaging, equipment relying primarily on imports are affected more by COVID-19 (imports account for more than 85 percent of CT and MRIs, whereas only about 40–50 percent of X-rays). As there are supply chain disruptions globally due to COVID-19, the workflow needs to be managed with the current capacity. The supply from domestic players will be crucial as the existing stock is likely to suffice only for immediate requirements.

According to Frost & Sullivan, due to the delay in procurements (in 1Q and 2Q of 2020), the market was down by 30–40 percent for X-ray modalities. If the lockdown is extended in certain states, then the financial year (FY) business propositions on the X-ray unit shipments may be hampered by more than 25 percent.

With the government keen on utilizing X-ray (digital and portable solutions) at the forefront in combating COVID-19, a surge in procurements of computed radiography (CR) and mobile digital radiography (DR) is likely along with the adoption of AI technologies. The market will grow, but only within certain sub-segments of X-ray. There is also an opportunity for domestic manufacturers to fill certain requirements in the X-ray market, like portable DR and CR solutions.

The effective allocations of the healthcare stimulus package and the PM CARES Fund will determine whether the hard-hit imaging modality business can emerge from the ongoing pandemic, with its head above water.