Raghava Rao, Director & Co-Founder, Camomile Healthcare Ventures Pvt Ltd, has over 17 years of experience and has held senior management / Board positions with Indian and Multinational healthcare companies. He is widely travelled and has worked on multiple projects and initiatives in the Indian and the international healthcare sector. Rao has co founded Camomile Healthcare Ventures, a boutique Healthcare Transformation and Investment firm with focus on advising Healthcare CEO’s and Board of Directors on transformation and value creation. The second vertical of Camomile is focused on Healthcare skilling and Capacity Building. As part of Healthcare skilling vertical, the company intends to establish a network of simulation based training centers for skilling healthcare professionals. Rao in email interaction with Ekta Srivastava, Health Technology share his views on future of technology driven healthcare system in India
In your opinion, what role do emerging technologies like Big data play in the current technology adoption for healthcare vertical?
Healthcare has been a laggard in the adoption of Technology and this comes at a huge cost including lost lives and inefficient treatment techniques. Hospitals are still grappling with hundreds of forms, filled up manually for each patient’s admission and stored for 7 years in their medical records department. In the US alone, healthcare generated 150 exabytes of data during 2013 and this is doubling every year.
If we look at the time spent, the resources involved and the money spent in undertaking this exercise is a colossal waste and can be easily replaced with significantly better efficiencies with the technology available today.
Big data is apt for Healthcare. It could help save billions of dollars in healthcare spending, save costly medical errors, reduce costs and improve care. As per estimate of McKinsey, Big Data can help save over US$300 Billion. However, the greatest challenge facing the industry is learning how to realize the value of big data, use it to bend the cost curve, share it and secure it.
The public sector is still lagging in terms of technology adoption in India, more so for an essential sector like healthcare and pharma. What do you think should be done to encourage the use of technology in providing better services to low cost healthcare needs?
Government spends less than 1% of the GDP on healthcare. This is probably amongst the lowest in the world. Most of the available funds are spent on salaries and on-going maintenance. Very little is available for capital expenditure and new projects including technology.
The Government should make it mandatory to implement certain e-health initiatives to improve and make quality care accessible. A national policy on technology use and e-health initiatives should be instituted. Telemedicine should be encouraged by the government and investments should be made into Telemedicine and digitization of Health Records.
While Big data is on the forefront of enterprise, do you think the Pharma sector can also benefit from it? What is public policy doing to leverage this technology?
Big Data is most valuable in situations, which are seeing explosion in types and volume of data. Pharmaceutical industry generates data from several sources viz., patients, retailers, caregivers and R&D itself. The data growth in pharma industry is explosive. Effectively utilizing these data will help pharmaceutical companies better identify new potential drugs and develop them into effective, approved and reimbursed medicines more quickly.
It is one thing to have objectives on a manifesto, another to actually convert them into goals and work towards it. Do you think the government is doing enough to provide better healthcare services to the average Indian?
Our government is playing the role of enabling healthcare through the private sector as well as the role of a provider. Only 20% of the spending on healthcare is by the government and the rest is from the private sector. Insurance covers less than 10% of our country’s population.
India has a dichotomy in healthcare delivery, some of our cities have access to the best healthcare services that the world can provide and on the other hand, we have rural population dying from conditions that could be easily prevented. Our Government should bridge the urban and rural gap to ensure that a minimum standard of healthcare is available to the population.
It would be effective if the government focuses on primary care and communicable diseases and encourage the private sector to build capabilities to tackle the non-communicable diseases and tertiary care needs. Only 5-7% of the total beds are tertiary care beds as against 25-30% in middle-income and high-income countries. India needs huge number of tertiary care beds and this investment can come only from the private sector.
The government should also enable a more conducive environment to the private sector. Incentives for skilled individuals to practice in semi urban and rural areas should be provided.
Make in India is the new rage. How can healthcare and pharma sector benefit from it?
Hospital is one of the few sectors that allow 100% FDI. A few international chains have already established operations like the Parkway Group, Tshusho Toyota, Joslin, DaVita, Bourn Hall, UK, Medicover and others and many of them have also drawn aggressive expansion plans.
India needs over 1,00,000 beds to be added every year and this requires massive investments. Foreign healthcare chains can bridge the need gap for high quality healthcare and bring the required capital to improve the healthcare status of our country.
How can a PPP be a better alternative to fully owned governmental healthcare schemes? Do you see the PPP initiatives as more efficient at delivery of services?
Our Public Healthcare Infrastructure is large in both rural and urban India. In rural areas, the public infrastructure comprises of a vast base of primary health centres, community health centres and sub-centres. The public infrastructure in urban India consists of tertiary medical colleges, district and taluk hospitals and urban health-posts. However, multiple surveys have showed that patients prefer private providers for most of their needs, as doctors and medicines are more easily available there and patients perceive a better quality of care.
The PPP model can be effectively put into use with the right framework that ensures a win win situation for both the private sector and the public sector. The Government can leverage on the infrastructure and the real estate it holds and the private sector can leverage its human resource talent and the systems. Real estate constitutes over 60% of the capital expenses of a hospital and the government can provide infrastructure at their existing facilities. This will ease the capital burden of the private sector and enable the growth of the healthcare sector. Patients will be able to access high quality healthcare services at a lower cost and thereby decreasing the disease burden in the society.
I believe that a successful PPP model in healthcare can bring multiple benefits including the following,
- Improved access and reach
- Better efficiencies
- Improved equity in distribution of healthcare
- Improved quality
- Improved accountability
PPP has grown in popularity and many states have embraced the PPP model. Successful examples include the laboratory outsourcing by Himachal Government and Telangana, contracting of radiology and imaging services and others.
Telemedicine and wearable devices are the way forward, globally. How do you think India fares there, and what do you think should be done to meet global standards of adaptation?
Telemedicine is experiencing rapid growth and deployment, across a variety of healthcare applications, and is becoming a key component in the healthcare industry’s shift to value-based care and enhanced patient satisfaction.
The growth of Telemedicine is being supported by the growing needs of the patient for an equitable access to healthcare. These forces are pushing health care providers to include telemedicine as an integral part of their service offerings.
With a large proportion of population (over 70%) residing in the rural areas and not having access to specialist healthcare, telemedicine is a boon for the Indian population. Even in cities, hectic lifestyles and longer commutes make it difficult to visit the doctor. With over a billion mobile phone connections and over 200 million internet users, Telemedicine can be effectively used to decentralize India’s healthcare industry. It has the potential to enable rural India access specialists without having to travel hundreds of miles and spending a fortune on transportation.
As per estimates, the global telemedicine market is pegged at US$14.3 Billion during 2014 and is expected to grow to US$ 36.2 Billion, a CAGR of 14.3%. The key drivers for the growth being convenience, innovation, and a personalized health care experience. In India, the Telemedicine market is growing at over 20% CAGR.
However, key to the growth and sustainability of of the telemedicine network in India is the introduction of legal frameworks, development of national e-health policies, trained human resource and regular funding. It is also important to make efforts to create an overarching framework covering three levels namely – primary healthcare centres (PHC) to district, district to referral/super specialty hospitals. Making broadband available at the rural areas will be an important determinant for the growth of the Telemedicine.