Focus on capacity and low bandwidth solutions is a priority of government, says top official

As part of India’s G20 presidency, a key agenda item involves promoting and aiding digital health innovations to enhance healthcare delivery and achieve universal health coverage. In an interview, Lav Agarwal, Additional Secretary, Ministry of Health & Family Welfare, discussed India’s data-driven approach to crisis management, the necessity of technology integration in healthcare, challenges in digital health programmes, and India’s digital health agenda going forward. Edited excerpts:

BT: What impact do you think technology has on enhancing healthcare delivery during crises like Covid-19? 

LA: Since the outbreak of the pandemic, India has adopted a data-first approach to manage the Covid-19 crisis. This approach hinges principally on the Indian Covid-19 portal, an in-house and extensively used tool for collating data from every district on a daily basis. The portal has been essential since it was launched in February 2020.

This streamlined data agglomeration was supported by a host of other initiatives. For instance, ROTC-supported contact tracing allowed for 220 million downloads, becoming an essential platform for people to access health services and information remotely. With over 150 million calls made just yesterday, this tool has been vital in fighting the pandemic.

Furthermore, the public interface enabled close monitoring of 2.2 billion digital imprints across the country. Each dose administered was digitally recorded, yielding crucial data. Integrated tools such as the RT PCR and ICMR portals helped manage the 913 million tests conducted in the country. This data helped track case trajectories and inform the deployment of measures based on case positivity. Other digital tools used for pandemic management included the oxygen demand tracker, which managed oxygen cylinder distribution during the most severe wave of cases. Genomic surveillance was also facilitated through an IT platform.

BT: Could you elaborate on the central government’s strategy of incorporating technology into healthcare? 

LA: In essence, technology played a pivotal role in understanding the trajectory of the crisis and formulating effective interventions. Preparing for future health emergencies is not a question of if, but when. And it is here that digital tools and technologies, proven in the fight against Covid-19, will have a crucial role.

India has employed an array of these tools effectively in the ongoing battle against Covid-19. The potential of these technologies will be further harnessed to strengthen India's ability to manage any future health emergencies better. Investing in such technologies is not an option but a necessary preparation for inevitable future public health emergencies.

BT: What obstacles have you encountered when implementing technology-driven healthcare solutions, and what strategies can be employed to overcome them? 

LA: Historically, the Ministry of Health, on both a national and state level, has initiated numerous digital health programmes. Over time, it has become apparent that while India has made significant strides in applying technology to health, these programmes have faced challenges with communication and compatibility. This digital disconnect mirrors the physical space, where a lack of communication among humans is a prevalent issue.

To address such challenges, the government recognised the necessity of an overarching ecosystem approach. This ideology led to the creation of the National Digital Health blueprint around five years ago. This blueprint served as the foundation for the launch of the Ayushman Bharat digital mission. Drawing data and conducting longitudinal studies yield insights that help avoid unnecessary diagnostics and foster precision medicine. With technological advancements like artificial intelligence and generative AI, the process of drug discovery can be expedited, facilitating faster and efficient results.

BT: India is prominently advancing the digital health agenda both domestically and globally. Can you provide insights into the current initiatives in this direction? 

LA: On an international scale, countries have expressed interest in India's technological solutions. Despite challenges such as managing large scale clinical studies and digital projects in rural India with limited network connectivity, India continues to gain ground in the digital health sector. Technological advancements bring forth new challenges. Meeting these challenges has required a continuous engagement process and the development of new strategies. Measures have been taken to control the cycle of epidemics and prioritise sustainable technological tools and innovations.

The government also launched the concept of digital public goods, where the emphasis is on the utilisation and scaling of solutions on a national level. For instance, in telemedicine, Genie, an AI-powered tool, aids in medical surveillance and monitoring across multiple languages. To ensure ongoing progress, a focus on capacity and low-bandwidth solutions remains paramount. Moreover, the agility to adapt and integrate new technologies into the health system is critical. Despite the myriad challenges at hand, these pushes in digital health are hailed as a game-changer for the country and its future healthcare system.