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The changing face of diagnostics amidst accelerated technology adoption during COVID-19

Who would have imagined a year back that every household would be familiar with what a CT value stands for, and that instead of a handful of large labs doing the RT-PCR test we would have more than 2500 labs with molecular testing capability available in India. This is just one of the paradigm shifts that COVID-19 has unravelled.

During the COVID-19 pandemic, digital and telehealth usage surged as patients and providers sought ways to safely access and deliver healthcare. This step-change, borne out of necessity, was enabled by increased consumer and provider willingness to use telehealth and an enabling regulatory environment.

Digital lab reports of inflammatory biomarkers coupled with pulse oximeter and thermometer readings were used for home monitoring, triage, and assessment of COVID patients and treatment through teleconsultation. During the tragedy of the pandemic, this offered a bridge to care, and now offers a chance to reinvent virtual and hybrid virtual/in-person care models, with a goal of improved healthcare access, outcomes, and affordability.

This pandemic exploded the need for testing with a scale up required at a pace not seen before. It underscored the importance of diagnostics for not only screening and surveillance but also for treatment, monitoring, and predicting outcomes.

It is not surprising then that major innovations and disruptive technologies have diagnostics as their epicenter amidst a healthcare milieu with higher digital adoption as a new normal. This now sets the stage for the diagnostics industry to use Digital Technology and Analytics in changing health management from treating sickness to promoting wellness. Health systems will need to place a greater focus on shifting from reactive to proactive care.

The creation of a wellness health model, using predictive health algorithms based on past trend of patient data, can allow patients to view their own lab results, monitor vital signs, and apply artificial intelligence (AI) algorithms to assess current health status, suggest behavior changes, and notify patients when medical care is needed.

The rise of participatory healthcare using connected devices is already a reality in diabetes care, where combining continuous glucose monitoring and insulin delivery allows diabetics and their physicians to fine-tune the control of patient’s blood sugar in response to the body’s needs.

COVID-19 forced everyone to do more with limited time and resources. Amid lockdown and resource constraints, Dr Lal PathLabs leveraged its early adoption of digital histopathology to service hospitals and patients for histopathology reporting.

As the largest histopathology processing center in India, with close to 1200 biopsy samples a day, it was natural that we lead the way to digital histopathology. We were the first lab in India to install the high-throughput Philips Whole Slide Image (WSI) digital scanner.

During the pandemic, this platform helped pathologists access digital images from different sites, creating a platform for better multidisciplinary teams and specialty segment reporting. We were able to unchain our pathologists’ expertise from their (physical) labs, allowing them to now practice anatomic pathology anywhere, independent of the physical location of the biopsy, the glass slide and the patient with easy review and second opinion/ expert consults between the pathologists.

The adoption of digitization has made it possible for us to use AI and computational algorithms for the quantification of breast cancer panel immunohistochemistry, making reporting more accurate and more reproducible. It has helped us integrate our reporting with genomic profiling in oncopathology.

The use of AI-driven clinical decision support tools to analyze images, detect and grade cancer in biopsies, and distinguish other clinically relevant factors, help pathologists reduce error rates and deliver more efficient, metric-driven, objective, and accurate reports.

Today, they are a complementary tool to the onco-pathologist and are expected to impact critical areas affecting both cost and efficiencies in healthcare diagnostics by reducing diagnostic errors, accelerating access to AI-based second opinions, improving patient care and increasing the body of knowledge in healthcare.

The pandemic has also made a significant positive impact on public and private partnership for delivery of healthcare. Flow of data from government portals to private labs and vice versa was quickly established and this has set the environment for shared data for patient health outcomes.

The urgent need for timely, and real-time data entry into ICMR/government portals catapulted the adoption of digital initiatives and workflow designs using automated robotic entries via bots. As a response to the pandemic, we worked smarter and faster.

This phenomenon of digitization will only accelerate into the future, given the expectations from the government, patients, and society at large. Along with this digital ecosystem will come the challenge of patient data privacy management.

I believe the adoption and use of blockchain in healthcare data will become an imperative to allow for secure patient data exchange between healthcare providers, diagnostics, and the state to predict and prevent infections and improve patient outcomes.

Technology and its adoption is key to providing cost-effective health care that is personalized and scalable across broad geographic areas. Technology is the answer to how we provide better disease surveillance, better patient-consumer engagement, and better care delivery. I think technology and our experiences during this public health crisis will lead our industry to do more, intelligently.

In a dramatic fashion, this pandemic will change the delivery of care forever….

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