Vikram Kapur and Satyam Mehra, partners with Bain & Company’s Global Healthcare practice, explain why India’s adoption of digital healthcare could prove to be the elixir of life for which Indian healthcare has been yearning
India has been doing its best to take long strides in digital healthcare ever since the Union government’s Ministry of Health and Family Welfare launched its e-health initiatives across all states over a decade ago.
Adoption of digital technologies in the country, however, has been relatively low. Even e-pharmacy players, which comprise the most scaled up segment of the digital
health space, comprise only 3-4% of the overall retail pharmacy market. India has a large number of digital health start-ups, but few have managed to scale up and even fewer have created a path to profitable economics.
The issue has been limited adoption by physicians and patients, and an even lower propensity to pay and to be loyal to a platform.
Covid-19 has helped spur India’s adoption of digital healthcare. In the Indian context, this acceleration is far more significant than it might be elsewhere. India has eight doctors per 10,000 patients, in addition to wide regional and urban-rural disparities in healthcare. While Covid-19 has wreaked an immeasurable toll, the acceleration of digital uptake could well be the silver lining for which the industry has been waiting.
Considering the paucity of healthcare infrastructure, including doctors, hospitals and testing labs, India is a country tailor-made for digital disruption.
Indeed, the Covid-19 pandemic has brought to the fore the critical need for cutting-edge technological tools and innovation in the areas of public health, medicine and wellness. It has expanded the scope of digital health in the policy and public discourse.
Consumers too are becoming increasingly aware of the wide array of wearable gadgets, mobile health apps and artificial intelligence (AI) tools.
Readiness for change among physicians and patients
While the pandemic has accelerated the trend toward digital, the winds of change have been blowing for a while. On the physician front, there is increased complexity as doctors feel that they need to be aware of a broad range of diseases and treatment protocols, while managing the care of their chronic patients and handling the heightened expectations of an increasingly informed and demanding public.
According to a recent pre-Covid-19 physician survey conducted by Bain & Company, a majority of physicians expect to adopt telemedicine, remote patient monitoring and digital technology in patient diagnosis and profiling.
Such openness to adopt is likely to translate into action and potentially lasting behaviour change with the curtailment of physical visits during Covid-19.
The importance of in-person visits from a medical representative (MRs) is fast-diminishing as more doctors turn to digital sources. Used by 83% of doctors, digital channels are now their primary source of information.
Furthermore, about 90% of doctors expect to increase their adoption of digital sources in the next three to five years. Even typically physical means of engagement, such as MR-to-physician and physician peer-to-peer learning/CME, are being brought online through digital platforms and webinars.
Pharma companies are not alone on this journey. They are supported by a host of B2B health start-ups that provide a range of services, from doctor-MR engagement platforms, to real-world data specific to local markets, to EMR-plus services.
One such company is THB, which is partnering with pharmaceutical companies to help them engage more meaningfully with physicians. THB leverages anonymised data from diagnostic labs, enables digital delivery of content and provides digital modes of doctor engagement for a range of use cases, from new drug launches and brand detailing to doctor upskilling. Differentiation and being able to break through the clutter will distinguish the winners from the losers as doctors get increasingly inundated with digital reach outs.
Meanwhile, we are seeing the evolution of a new type of patient-consumer: one who is curious and well-informed, who seeks to take control of his or her own health and demands the convenience of on-demand digital delivery.
The emerging digital ecosystem can help solve several of patients’ key pain points – from long wait times in hospitals and clinics, to high costs associated with current models of care, to inadequate information on healthcare providers and physicians – and allow them to make more informed choices.
Realising huge value for the government and the national health agenda
The government recognises that digital will be a key pillar of democratising care in India and has galvanised itself on this front in the face of Covid-19. The Ministry of Health and Family Welfare, in partnership with NITI Aayog (a government of India policy thinktank), promptly released telemedicine guidelines, realising the role it would play in a world where physical distancing becomes a necessity.
AarogyaSetu, the government’s Covid-19 tracking and engagement app, became the world’s fastest-growing mobile app, with more than 50 million installs only 13 days after launch. The government has also been engaging actively with health-tech leaders to design its response to the pandemic, harnessing the power of digital to control the spread of Covid-19 and provide access to public services remotely.
This learning and collaboration is likely to carry forward into the post-Covid world, as the government recognises the value of partnering with private health-tech players to solve impending issues on the noncommunicable disease and primary care fronts.
The next phase: a huge opportunity – and a test – for health-tech insurgents
The last few months have undoubtedly marked a watershed moment for digital health in India. In 2018, approximately 28% of the country’s total Internet users were healthcare browsers, but only 2% to 4% of internet users actually transacted for a healthcare service/product online. The Covid-19 crisis has prompted a significant set of physicians and patients to start using digital health tools.
The next 12 to 18 months will be the true test of whether these health-tech platforms can embed themselves in consumers’ healthcare consumption and deliver on three key planks: driving high engagement, building differentiation and defensibility, and last but not least, creating a viable monetisation formula.
Beyond the immediate response to the pandemic, we foresee a tangible shift towards the use of apps and hardware for lifestyle enhancement, medical services and emergency care in the near future. Innovations in hardware and software, such as sensors and other potentially life-saving devices, are making this a real possibility. To be sure, the country is poised for the development of holistic technology and a data-driven overhaul of today’s digital tools, which will give patients greater control over their health and medical outcomes.
Implications and call to action for providers and pharma players
These changes stand fundamentally to alter the flows and consumption of healthcare products and services, with major implications for providers and pharmaceutical players.
Healthcare providers will move from a largely offline, physical, episodic world to a model of omnichannel engagement. This presents a huge opportunity for provider brands that have earned the vital element of patient trust. Pre-Covid-19, most leading providers had taken only an incremental approach to digital and telemedicine. They now have a chance to course correct and truly invest behind digital while curtailing the bureaucracy that can so often stymie the efforts to embrace and lead change in incumbent organisations.
THE NEXT 12 TO 18 MONTHS WILL BE THE TRUE TEST OF WHETHER THESE HEALTHTECH PLATFORMS CAN EMBED THEMSELVES
The pharmaceutical world will also undergo significant change, as online consumption and prescription grow.
Some key imperatives for incumbents include:
- Moving towards a well-designed digital-led doctor engagement and commercial model
- Creating patient connections through multiple touchpoints, beyond filling a prescription (e.g., digital therapeutics)
- Building analytics and automation into manufacturing and the supply chain
- Finding ways to engage and partner with new health-tech and online players as the channel mix changes
- Scoping out possible digital experiments and disruptions, and exploring strategic partnerships and investments to create options and hedges for the future.
These changes will necessitate a change in the operating model for pharmaceutical companies – with a shift to digital, remote ways of working and an increased need to collaborate across functions and pick up new skills.
Given the explosive interest and buzz surrounding digital healthcare generated by the Covid-19 pandemic, the industry has a unique opportunity to steer its evolution, set guardrails and amplify its positive impact on the quality of care. The lack of widely accepted protocols and standards also needs to be addressed. The industry must take the lead to help the government craft forward-looking regulations and policies governing digital health that will fuel further innovation.
In summary, the next year or two will be critical from an Indian healthcare perspective. The issues that need solutions are immense, and digital tools, if appropriately harnessed, could prove to be the elixir of life for which Indian healthcare has been yearning.