Disruption in Healthcare - India

Health care is currently experiencing a wave of disruption. Patients are becoming active consumers. Medical device makers, drug companies and digital technology companies are now collaborating.

Patients as consumers expect to get more services around their products and are increasingly willing to contribute data to get better outcomes.

Health costs soar in part due to the dominance of the “fee-for-service” model. This model gives medical professionals incentives to provide as many procedures, drugs and devices as possible – and in the most expensive scenarios. Health care providers receive no incentives for prevention. This fuels a defective system that pays professionals to wait until patients are ill before taking action.

Preventing disease doesn’t earn profits, and the health care system can’t measure the effectiveness of the costly procedures that clinicians order after a patient becomes ill.

Health care is becoming a real market – we pay when we receive something of value, and we are willing to pay when the value is greater.

This flawed approach shows signs of changing. Reforms such as quality reports about physicians shift public focus toward a “value basis” that rewards providers for good outcomes, not just inputs

Health care system to move from fee-for-service offerings to a more value-driven model.

In India, we are at the first stage of value curve where clinicians & healthcare provider perform procedure / surgery, provide a drug or device to treat a specific condition.

We will need to progress to stage 2 of the value curve where healthcare service provider add technology such as apps and web content that provide additional information for patients.

The developed world right now at stage 3 & 4 of value curve where healthcare service provider implement a variety of services, such as remote sensors and wearable devices to boost patient health by offering an array of services. This business model collects revenue for these services. Patient outcomes partially determine payment.

“The sicker the patients, the more chronic the disease, and the greater the cost burden the disease places on the health system, the higher the likelihood that a value-based economic model can be successfully defined.” *1

Clinicians can’t achieve results without compliant patients. That’s a challenge for companies that sell a device or drug. Pacemakers can help keep patients out of the hospital only if those patients watch their diets and take their diuretics. A diabetes drug is no cure for people who refuse to lose weight, exercise or adjust their diet. Patient behaviour makes diabetes especially difficult to treat. As many as 40% of diagnosed diabetics never follow up for treatment. Among the group that starts therapy, some 40% stop taking diabetes drugs within eight months. Selling a prescription drug is only a small part of the broader financial and social issues affecting diabetes patients.

Companies that are Around-the-Patient Innovations seek to move from selling a basic product to addressing patients’ lifestyle challenges. In Accenture surveys, patients expressed a willingness to manage their health and an openness to using services that help them. Two-thirds of patients report that face-to-face meetings with doctors are the most important way they receive health information. However, 57% say digital information sources are important.

For years, the healthcare industry divided health care delivery into three segments: “specialty therapeutics” (cardiovascular diseases or neurological disorders); “geographic regions” (the service area of a hospital); and health care “settings” (a hospital, nursing home or home health care environment). This old paradigm is making a transition to a new model emphasizing health over disease and value over volume.

How the Healthcare delivery Model will change:

1.     Location doesn’t matter: Care no longer will happen primarily at doctors’ offices and hospitals. Instead, health care will increasingly become untethered from traditional locations thanks to Tele Medicine, wearable sensors, mobile devices.

2.     Patient to Play bigger role: Patient is customer and will take health is in hand with empowerment.

3.     Redefining Medicine: Healthcare providers will use drugs in beneficial, cost-effective ways and not just a chemical.

4.     Redefining Care: Curative to preventive healthcare.

5.     Redefining Payment Method: Paying for results and not for service.

6.     Innovations: R&D no longer stop with FDA / CE approval. Advances in genomics, genetics and immunology are fundamentally redefining medical breakthroughs.

7.     Era of Personalisation: Precision medicine will allow doctors to tailor treatments to individual patients. Portable digital medical information will speed up diagnoses.

8.     New Business Model: Value based care. Govt & Health insurers will become providers and analytics specialists. Like hire an Uber driver for a ride, we might hire a health coach for advice and feedback.

Disruption in healthcare is coming with force and my problem is we, in India are not prepared for it. Healthcare delivery model is changing fast. Whats our vision for healthcare in India after 25 years? When our “demographic dividend” young population will age? What are we doing about NCDs? We cant meet healthcare requirement or provide delivery by Curative Health method but then what are we doing about preventive health?

We need more visionary Leaders in healthcare but I am very optimistic about our country, the reason being, we have world’s best clinicians amongst us. We have world’s best brains in innovation. We will surely prevail.