There is a WhatsApp joke making the rounds – who led the digital transformation of your company – CEO, CTO, agile squads or Covid-19. This aptly underlines the importance of digitisation in meeting the challenges posed by the Covid-19 pandemic.
During the past few weeks, several focused and timely initiatives were taken, including the adoption of frameworks to identify Startups and promote innovative technologies; guidelines to facilitate “Work From Home”; Tele-medicine; eCommerce for essential services like grocery, medicines and health services; and a digital intervention to enable Track and Trace of Covid-19 cases through a mobile App. These measures were made possible by a close collaboration not only amongst the various Government instrumentalities but also strong federal cooperation, and even more so, the partnerships with industry and academia. This indeed presents the silver lining to the dark clouds of a global pandemic that does not appear to discriminate between nations, religions, races or classes.
Let’s take the case of Tele-medicine and perhaps the broader scope of Digital Health in general. Telemedicine enables home delivery of healthcare services remotely using IT infrastructure, accompanied by the delivery of healthcare products and services through eCommerce. For a country like India that has significant gaps in health infrastructure and services, this technology appears the logical solution even for normal times. However, as recently as 2018, two doctors were charged by the Bombay High Court with criminal negligence for prescribing treatment over the telephone. The ‘Telemedicine Practice Guidelines’ recently issued by Government is a welcome step that provides legitimacy to telemedicine practice. To what extent people are able to benefit would depend on the country’s capacity and resolve in deploying telehealth solutions over the next few months.
Like any new technology, telemedicine is expected to follow an ‘S-curve’ of adoption with a slow market penetration initially as the solutions explore ways of becoming market-ready. This is where the solutions get refined, costs get stabilised and the various stakeholders (startups, patients and healthcare professionals) learn about them, understand how to use them, insurance markets mature and medico-legal aspects around telemedicine evolve. In comparison, telemedicine solutions are readily available in countries like China, Singapore, USA and the EU. Singapore released National Telemedicine Guidelines in 2015, the EU has an eHealth Action Plan since 2004 and, in the USA, California Telemedicine Development Act provided legitimacy to the practice way back in 1996. Over the years, the market in these countries has also matured. According to the American Hospital Association, as of 2017, 76% of hospitals have systems to remotely connect patients with practitioners as against 35% in 2010.
China, on the other hand, managed to keep strong its healthcare delivery architecture which includes its digital healthcare services, led by tele-medicine that had evolved stabilized solutions over years of active deployment. The first “Internet hospital” was launched in Guandong in 2012, and over the years the model has stabilized with 33,000 patient visits per day. This has been further flourished by key private startups such as PingAn Good Doctor and WeDoctor. Both these companies are today highly valuable companies, helping more than 2 million patients consult doctors online everyday. Though India is comparatively a late entrant, it has the advantage of learning from international experience and thereby leap frogging at a rapid pace. If this could happen in mobile telephony, it can also happen in telemedicine.
While the Indian telemedicine guidelines include prescription via tele-consultation, the regulatory framework for the ePharmacy sector needs to be adequately addressed. Despite proactive steps taken by the Government to streamline the regulatory regime for the ePharmacy sector, considerable uncertainty has persisted with several conflicting judicial pronouncements and inadequate executive orders. As a result, the sector is starved of capital at a time when start-ups in other sectors like mobility, fintech, etc have been able to attract billions in FDI. While regulation of this sector is crucial, given the concerns of misuse and illegal drug trafficking by rogue players, an enabling policy and regulatory framework is necessary for the requisite growth of ePharmacy. With the country-wide lockdown and an uncertain future, online pharmacy players could provide an essential service in support of the war against Covid-19.
Another technology that several countries, including China and Korea, have leveraged extensively in this crisis is the deployment of drones for delivery of medical supplies to healthcare facilities and people quarantined at home, besides monitoring adherence to lockdown. However, the use of drones in India faces several challenges starting from manufacturing to procurement and operation, primarily due to an inadequate regulatory regime. The global drone industry is growing between 16 and 17% CAGR. Though the market for Indian drone industry was projected at $881 mn by 2021, only 5 companies have received a total investment of $26 mn since 2013. This is in contrast to $770 mn in China and $450 mn in the US.
We are in the midst of the Fourth Industrial Revolution where the pace of change far exceeds the previous phases. Compared to 50, 22, 14, 12, 7 and 4 years which took telephones, television, computers, mobile phones, internet and Facebook, respectively to hit 50 million users, a mere 19 days was taken by a gaming app to meet this target. According to a report, digitising sectors could create an incremental economic value of $150 billion by 2025 and create 60-65 million jobs. For India that faces substantial access and resource barriers in providing basic facilities of healthcare and education to its populace, emerging technologies offer immense potential. At the same time it needs to be recognised that these technologies have immense disruption capabilities, besides new concerns on privacy and security, which will need to be addressed simultaneously.
A credible policy and regulatory framework has thus become important for not only putting in place necessary safeguards but also for creating an enabling environment for new market opportunities and innovations. An agile governance structure that is sensitised to the needs of the community and the changing technology, and willing to work in collaboration with the ecosystem, can help India leverage the benefits that frontier technology has to offer. The experience of the past few weeks has demonstrated the capacity and willingness of the Government to act on these lines. Going forward, this needs to be institutionalised through appropriate mechanisms that allow for closer interaction and constant feedback mechanisms with the stakeholder communities, be it the academia, industry, startups, incubation centers and R&D hubs, to facilitate rapid growth for meeting the present and future challenges.
DISCLAIMER : Views expressed above are the author’s own.