Next step is to expand healthcare system in India

COVID-19 has in many ways revealed the deep-rooted challenges of ensuring healthcare access and equity for all. It has sown the seed that public and private stakeholders need to rethink how we are going to address the basic systemic issues in India. We need to urgently look at investing in and rebuilding healthcare infrastructure. The plan for the next five years needs to be rooted in India’s ground reality, not forced by domestic politics, international pressure, or new studies on pandemic scenarios and virus mutations. This requires a well-calibrated investment strategy and participation from both public and private sectors to secure our nation’s future through a universal reliable system that has affordable excellence goals at its core.

Today, stakeholders within the healthcare ecosystem have the reach and convening power to harness their expertise across the ecosystem into powerful solutions benefiting people and galvanizing tangible action. We have to collaborate and propel investments in three critical areas that will transform the health system.

• Leverage India’s technology, clinical, and services prowess to catapult India into a global hub for digital health, innovation, and medical value tourism.
• Unlock health financing and expand hospital capacity, especially in areas where healthcare is underpenetrated.
• Make home and local community, the nerve center for wellness, preventive, rehabilitative, and geriatric health.

If we assess the priority areas – cost effectiveness, safety and quality of clinicians sets India apart in medical tourism. India offers high-quality medical treatment services at far cheaper costs than developed nations.

Globally, AI assistance and remote patient-monitoring tools have immense potential to help physicians focus on critical services and manage chronic disease more efficiently. According to surveyed global physicians, a significant portion of non-emergency services currently offered in hospitals can be provided through alternate delivery points, powered by AI, machine learning, digital health, and customized home-care services. It is, therefore, recommended that the government sets clear regulatory standards and norms, increases investment in building human resource and data intelligence capacities for adopting digital health, and creates an industry startup interface for rapid test, prototype, and scaling up of market-ready innovations.

A second priority area is expanding hospital capacity in tier-II and tier-III settings through new infrastructure models, which focus on generating viable revenue and high asset utilization. So far, hospital investment in India has been limited owing to multiple challenges of pricing, demand uncertainties, talent shortage, and cost recovery. For this, we need to invite private sector participation through incentivization, prepare clear public-private partnership guidelines and benchmark standards to build new healthcare infrastructure, and address investment risks with a goal to achieve efficient care, optimized capital investments and capital recycling, demand channelization, and insurance uptick to ensure new asset utilization (long-term purchase mechanisms).

The third key area is shifting the care continuum outside of hospitals by making home and the local community nerve centers for wellness, preventive, rehabilitative, chronic, and geriatric health by leveraging technology. The base components for this will be integrated governance, financing of chronic care, and private sector stewardship. The growth enablers in this sector would be creation of a special cadre of specialists, tax reforms, defining areas for PPP, and fostering innovation. A three-tiered approach has to be followed to strengthen the home and community support network and creating a social safety net for citizens.

Finally, the current primary healthcare model (PHC-CHC) has to be completely revamped to make it efficient, comprehensive, and accessible through multi-sectoral collaboration. The three core functions of governance, system management and performance monitoring are separated and need to be managed by the government, PPP, and a third party to increase accountability for improved access and health outcomes. Greater community engagement, increasing service delivery by including a broader range of care, and screening and diagnostics with NCD management is the way forward to advance primary care, the very foundation of the healthcare service delivery for any nation.

Our population numbers place great pressure on our limited resources and healthcare infrastructure. With the government increasing healthcare outlay this year, and digital health bolstering service delivery, healthcare partners across the spectrum need to come together to move from a tactical approach to a longer-term strategy to redefine healthcare for India.