Over the last 18 months, we have gone from a nation where most people didn’t attempt to decipher doctor’s prescriptions or fully understand their diagnosis, to using pulse oximeters and reading reams of information on dealing with the Covid-19 outbreak.
The reluctance to read prescriptions wasn’t necessarily due to laziness or the inability to decrypt illegible handwritings that doctors are notoriously known for, but it was symbolic of our absolute reliance on the traditional healthcare system — the inefficiency, disorganization and obsolescence all which have been revealed to us during the course of the pandemic.
Covid-19 has changed our view, but more importantly it has forced us to relook at the way we look at the healthcare sector. One might question why innovators in the healthcare technology space did not rise up to solve the problems of oxygen supply, hospitalization management or vaccine distribution?
To many of us, the contribution of heath tech may seem insignificant or dulled in comparison to that of Fintech, Edtech, or e-commerce during Covid-19, considering that this essentially is a health crisis. While the instinct tempts us to blame the lack of innovation among healthcare startups, the truth is that the double-bricked walls of healthcare are impossible to penetrate. While the opacity and ambiguity of healthcare system is by design, the public too were less receptive to avail digital healthcare services until the pandemic forced a shift of mindset.
For example, Practo a health tech startup which launched in 2008, developed a suite of services that included telemedicine, hospital management, drug delivery, and medical insurance way before the pandemic, but couldn’t gain any real ground and was reduced to an appointment booking platform. Only when India started to reel under the effects of Covid-19 in April 2020, the telemedicine function of Practo recorded a 100 % growth on a weekly basis.
The few health tech startups like Practo that existed pre Covid and those that were birthed during the pandemic, struggled to keep up with the rapidly growing user needs and demands and that pattern continues even as we write this.
This could be a sign of embracing technological innovation in the healthcare sector much like how the Fintech boom occurred after the 2008 financial crisis. Another strong indicator is the foray of India’s large corporate houses in digital businesses and them snapping up health tech startups with Tata Digital and Reliance Industries acquiring e-pharmacies 1 mg and Netmeds respectively.
Pandemic actions by India’s Health Tech
With access to medical and health care infra cut off during the pandemic, Indians were looking for alternative methods to reach healthcare professionals. There are over 3225 health tech startups across India whose market value currently stands at $2 billion, less than one per cent of the overall healthcare industry. There is a huge opportunity for growth for health-tech owing to its current meagre market share within the healthcare sector. The most crucial factors driving the growth currently are Covid-induced restrictions and safety protocols, and the acceptance of technology within the industry. This could become a sunshine sector which attracts investors owing to its exponential growth potential.
Let’s take a look at how health tech served the nation’s citizens during the pandemic.
Most startups such as Practo who were offering telemedicine services operated under no clear policy on how their business practice would be recognized and could be further developed. Thankfully with the government releasing its new telemedicine guidelines which cleared the ambiguity around remote healthcare services delivered via video, audio and text.
With one doctor for every 1445 people in the country, telemedicine is a more accessible and affordable alternative to in-person consultation. By 2025, the telemedicine market is estimated to hit $5.4 billion with a 31% CAGR. Telemedicine also has the huge potential to bridge the massive healthcare gap between rural and urban India.
Bengaluru-based telemedicine startup MFine has been providing 12000 consultations per day with over 4000 doctors on their platform, as their numbers increased 10X during 2020.
Most startups are scaling up and adding more services to their platforms owing to demand. Having partnered with over 600 hospitals and 400 labs, MFine has launched a slew of services including home RT-PCR tests, Covid Inflammation tests, high resolution CT scans, Covid homecare plans and an application to measure SpO2 levels.
Remote health monitoring was another digital health service that gained rapid momentum as Covid surged. The startups operating in this domain are Dozee, BlueSemi, HealthCube and Qure.ai among many others.
Created with an intent to reduce the burden on hospitals, Dozee partnered with 150 hospitals to monitor and track vital stats of patients remotely using sensors placed under beds which alerts hospital staff. Like MFine, Dozee also has a homecare plan that includes a contactless sensor to monitor heart rate, respiration, stress as well as sleep quality through a smart phone app. Their product has already garnered significant interest from the market during these uncertain times.
BlueSemi uses its AIoT-powered (Artificial Intelligence of Things) thermal scanners to record temperatures of essential workers that operate from their workplaces to provide them with constant monitoring of their health stats.
HealthCube works with a similar objective of regular screening of government servants and healthcare providers with COVIDSAFE — their risk management solution for Covid. It’s built to prevent transmission by detecting infection and its severity, and prioritizing tests and hospitalization accordingly.
AI-powered Mumbai-based startup Qure.ai has developed a monitoring tool to detect the progress and rate of Covid infection in the chest from X-rays. This allows healthcare professionals to monitor infection stages and decide on treatment plans.
Tracking and Contact Tracing
At the beginning of the pandemic, many Blockchain startups developed several solutions for tracking patients and tracing their contacts. Some of them are QuilllHill technologies, Aiisma, Accubits Technologies, TagBox, Hipla etc.
Founders of existing startups also worked in collaboration to meet the need of the hour. For example, founders of Vokal, Bounce and Urban Company developed a Quarantine app called the Q-app.
This picture below gives a list of startups that have been involved in Covid tracing activities.
As the number of cases rose steeply during the first half of 2020, contact tracing and tracking became essential to ‘break the chain’. Many startups devised tracing solutions in collaboration with state governments to map tracking data for better accuracy & provided authorities with necessary information to plan measures to control the spread of infections.
Could startups have done better?
Not really, with digital infrastructure almost non-existent in healthcare, innovation efforts taken by startups have been too narrow and they have been hindered with multiple roadblocks.
Innovation in the healthcare sector has been low primarily due to confidentiality and implementation of security policies to prevent people’s personal health data from being accessible to private technology businesses. The other reason was unwillingness among people to explore and embrace digital healthcare platforms.
What were the challenges health tech startups faced during Covid-19, and why couldn’t they be more agile in India’s time of need?
Lack of data
Lack of digital data is arguably the most important challenge in leveraging technology for Covid management across the country. This has initiated discussions around maintaining databases that have accurate and up to date electronic records of patient details, medical history etc that could be accessed by licensed medical professionals to gain knowledge and administer the right treatment to patients.
As a result, digitization across health care has ramped up, followed by processes and protocols for generation, recording, storage and usage of data such as medical and hospital records of patients.
For example, OkCredit – a startup that works on digitizing Indian SMB’s has launched a hyperlocal search tool for providing data on availability of medicines and critical Covid-19 treatment equipment. The data for medicines has been provided by over 2 lakh pharmacies while the data for equipment such as oxygen cylinders and hospital beds have been crowdsourced.
Talent & Scale
Most startups in India’s health tech sector have been stretched thin trying to manage the surge in demand for digital services. Scaling up operations was one of the biggest challenges they faced during this world-wide health crisis. Hiring, which was paramount to help meet these growing needs, couldn’t be prioritized and implemented efficiently and this just added to their woes.
Geographical and infrastructural diversity
The wide gap between rural and urban India in terms of infrastructural diversity is a challenge for the process of digitization in healthcare. Just like any other sector, change will take effect in incremental stages and eventually spread across the country. However, unlike other sectors, a health crisis caused by a virus as contagious as this cannot be handled by isolating cities from rural parts of the country.
Infrastructure in healthcare is still in its infancy and while Covid did accelerate development of the digital healthcare infrastructure, the task is a long and arduous one that warrants participation from multiple stakeholders. Here are some of the infrastructural issues healthcare faced by India.
· Supply Chain
Inefficiencies in the supply chain infrastructure within the country make it difficult to supply essentials including oxygen cylinders and vaccinations where they are needed the most. However, in the time of crisis a Hyderabad-based startup StratMed which is an aggregator platform that uses data and technology tried to fix this problem. It brought large-scale suppliers and buyers on the platform and expanded its network across 12 states in India which includes 50 hospitals and 300 pharma and medical device companies.
· Talent and experience
Like we read above, the ratio of doctors & primary healthcare providers to our population is a point of concern. We need more people actively taking up roles in this space to meet the needs of the country not only during the pandemic but beyond that as well. Edtech firms engaged in skilling need to step up and train healthcare workers remotely which would help in dealing with such situations in the future.
· Digital infrastructure
Hospital management, medical devices data, patient data, doctor records are some components of a digital health ecosystem that are necessary to build a strong foundation. Setting up procedures and policies to start aggregation of data at each of these levels should be a priority for the government which could potentially open up new pathways for innovation.
Covid-19 has shocked us into paying attention to our health and has brought the entire healthcare sector under the lens. We’ve gone from being passive observers to actively looking at how and where will this sector change, much like what happened with financial sector during ‘The Great Recession’.
Could this be the beginning where tech revolutionizes healthcare in India and that startups who innovate around AI, robotics, genomics and biotech could be the ones who become dominant players in this sector?
The utility of consumer and enterprise technology is no longer debated around costs and benefits in healthcare. Increasing number of people are gaining confidence to share their health data with technology startups whether it’s through fitness apps, health monitoring devices, testing kits or telemedicine platforms. Covid-19 has made it absolutely clear that technology can only prepare us for facing the next pandemic.
Today, health tech is looking at a future where users are willing to share their health data prioritizing safety over data security concerns. The security concerns that led to heavy regulations in healthcare still exist, and there will always be bad players in every ecosystem finding ways to exploit weaknesses. However, what has changed this time is that people are ready to make that trade-off.
However, we can’t afford to become lackadaisical with data privacy & security measures. Enforcing much needed policies which give startups the freedom to operate with fresh ideas in this space along with building accountability for actions deemed as innovations is required. We are at a proverbial crossroad where consumers are willing, startups are rearing and the government is watching, for how this crisis could turn into an opportunity for making India healthier and in the bargain one that would create wealth for the nation.