Medical Technology: India’s chance to fix a broken health System

Health Systems have suffered through the chronic ailments of staff shortage, lack of access and ineffective coordination between the primary, secondary, tertiary and referral care. An exponentially growing pharmaceutical sector, a dynamic medical education eco-system producing over 1 lakh doctors every year, and large chains of diagnostic care in a free-market place have added strengths, but have also made healthcare, as a system, skewed and vulnerable. Its vulnerability comes from the fact that it is more accessible for those who can pay, more approachable if consumed more as in the case of luxury health, and more expensive as a portion of the per capita, for those who are at the bottom of the earning pyramid. Despite many efforts, these situations have not changed, until the new wave of health, the Medical Technology (Med Tech) arrived on the scene. India never looked towards Med Tech as a health system solution but saw it only as a bundle of products, largely due to looming import dependency of over 90 per cent till about 5 years ago. With creation of Andhra Pradesh Medical Technology Zone (AMTZ)- now the world's largest medical technology eco-system, with Production Linked Incentive (PLI) and Research Linked Incentive (RLI) schemes driving growth and the wave of tech and Artificial Intelligence ( AI) platforms, Med Tech can be India's golden change to correct health system challenges - that can bring disruption, growth, and health. Here are six drivers that can make it happen:

Health ATMs: just like the sanitary napkins became a disruptor for women's health, automated Health ATMs, now being produced at scale, can bring Health assessment and diagnostics with tele-care, at the fingertips of citizens. From colleges to factories, Health ATMs can be a true dispenser of care at costs at very low costs. All it would take is adoption at scale by public and private corporations, and a bit of motivation by thought leaders.

Allowing Self -Testing:  Surprisingly, except for a self-test kit for Pregnancy, no other diagnostic test can be sold in a pharmacy shop. Citizens can buy a thermometer, glucometer, or a wheelchair without a prescription, but cannot buy under current laws, any diagnostic kit for Tuberculosis, Malaria, Dengue or any other infectious /chronic care device/kits from open market. With Diagnostics being the gateway to treatment, all it would take it to keep a bunch of testing kits, in Schedule-K or Over the counter allowed list of items, enabling pharmacy shops to store and sell them without a prescription.

Tele-surgery: Tele-surgery is where telemedicine was 25 years ago. With Robotic surgery systems with Tele/Remote surgery capability now in market, a large gap in availability of specialised surgeons can be filled in, not by substituting them, but my complimenting their skills with Tele-Surgery systems. Tele Surgery capable Robotic Systems can help general surgeons at remote locations, perform Gastro, Ortho and even Cardiac surgeries with ease, controlled by Specialist Surgeons at Hubs without any risk to patients.

Accessibility products: A large segment of society, particularly the elderly and divyanjans experience lack of care due to a lack of basic health care products like wheelchairs, hearing aids, making them vulnerable and adding more challenges to the healthcare system. A co-payment-based system that allows Divyanjans and the elderly to receive these important 'care-goods' periodically would bridge a vital gap and keep their health stable.  Enabling Home and Mobile Care: Burden of Renal Care /Dialysis, Dental Care and several other services will keep getting added due to rising NCDs. No amount of expansion of hospital sites can truly fulfil the growing need. A deregulation of medical services enabling critical care like Dialysis, Pain Management for Palliative Care, Dental care using mobile units, or home care delivery solutions will allow private sector to spread its services into the urban locations.

Ethical pricing norms: 2015 saw the price regulation on cardiac stents, leading to cardiac care becoming substantially more affordable and also growing the domestic cardiac stents manufacturing industry. The same exercise on knee implants led to similar outcomes. With 1.4 billion people's needs as potential market, an organised price rationalisation exercise is suggested. This needs to be done in consultation with healthcare providers and the domestic medical devices manufacturing industry. These six strategies can open up healthcare systems and healthcare markets with access, growth and transparency. Demand generation could be used as an engine for growth, converting India’s 15 billion USD Med Tech Industry to reach about 50 billion USD by 2047. India's traditional import dependency in Med-Tech can be reduced to as low as 20 per cent, making India a net exporter of medical technology - from India to the World.

Dr Sharma is Managing Director and Founder CEO of AMTZ, Vizag and Trustee of India Brand Equity Foundation; views are personal