The problem of healthcare provisioning is very serious in India. The statistics on various indicators do show a shocking picture. Below is a brief profile of India medical landscape.
*****Table 1: Snapshot of Healthcare in India****
Developing countries face a problem on two fronts. The first is the problem of accessibility – access to health care and qualified doctors. Accessibility is a huge problem. On most of the above indicators, not only is India below the world average but their provisioning is inadequate for the population. Urban rural disparities are stark with urban centers getting more attention. Rural India which has 66.8 percent of the population has access to only 33 percent of the hospital beds.
The other problem is the general increase in the complexity in health care. The number of treatment options are increasing, there is new research and information coming out on a daily basis. Most of this originates in the west. It is difficult to keep up with these changes. This subsequently impacts treatment and overtime could cause some undesirable outcomes. AI can help solve these two problems by providing low cost access to healthcare in remote areas.
Pollock, Bazaldua and Dobbie in their 2008 paper “Appropriate Prescribing of Medications: An Eight-Step Approach” have pointed out 8 steps to be followed in order to arrive at the appropriate prescribing of medications. The 8 steps are “(1) evaluate and clearly define the patient’s problem; (2) specify the therapeutic objective; (3) select the appropriate drug therapy; (4) initiate therapy with appropriate details and consider nonpharmacologic therapies; (5) give information, instructions, and warnings; (6) evaluate therapy regularly (e.g., monitor treatment results, consider discontinuation of the drug); (7) consider drug cost when prescribing; and (8) use computers and other tools to reduce prescribing errors.”
AI can handle all the above-mentioned steps from diagnosis to deciding on treatment. IBM’s Watson Health has been used in oncology, drug discovery, program management and genomics. Watson diagnoses the patient based on the tests and then provides multiple treatment to the doctor with the relevant supporting research. Some researchers found that the use of an AI algorithm resulted in 41.9% better outcomes than the usual treatment while reducing the cost by 58.5%. There are start-ups such as doc.ai that help patients interpret lab results.
Not only can AI help in diagnosis and treatment, it can go beyond and help in early warning as well as post treatment monitoring. With IoT and other devices, the algorithm can understand a person’s day to day behavior such as sleep patterns, activity levels, diet, etc. and recommend changes to one’s life style. It can also help see how patients evolve over time rather than static tests at one point in time. By providing continuous monitoring, one can manage one’s health better. Post treatment complications are seen very often. Monitoring post treatment or surgery can help address such complications in advance.
Such technologies have enormous implications for healthcare services in India. With increasing mobile penetration, one can connect to the internet from some the most remote corners of the country. Setting up medical stations in panchayats can help ease the burden of health provision in remote areas. People wouldn’t have to travel hours to avail basic health care. When required, the algorithm can notify patients that they must visit the hospital and consult a doctor. It is important to note that AI can result in a cognitive offload as it can take off a lot of load from human participants. Writing things down is a form of cognitive offload. Humans have been evolving tools take the burden off their cognitive abilities. In the case of AI in medicine, it may not completely replace the human element in the medical process. Human participation will still play a crucial role as some element of human judgement will be required.
As the population keeps growing, the Indian requirements in 2034 are substantial. PwC estimates that to meet these targets using the current and traditional method would require 3.5 million hospital beds, 3 million doctors and 6 million nurses. This would imply a capital investment of US$ 245 billion. According to a PwC report, by shifting the point of care coupled with the use of technology to deliver healthcare services and preventive care could lead to savings of US$ 90 billion. A country like India needs to make use of technology and other resources to help bring about better outcomes.
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