Technology can be a tool used to make the patient experience easier. Technology is an enabler towards a better patient experience and better patient engagement. It's important that doctors and medical professionals center the human element of healthcare to improve the patient experience.

Dr. Praneet Kumar, Advisor, Executive Access India, and Helius Capital Advisors is a thought leader in the health sector with over four decades of experience as a Healthcare business manager.

Healthcare has come along in the past 5 decades

Dr. Praneet throws light on having over 4 decades of experience in Healthcare and how things have changed from then till now, “I think my generation has been witness to a major transformation in the healthcare system. Right from the day we entered the medical school where it was all paper and hands to today where it’s more of technology. Medicine has come a long way in the last 4 – 5 decades, managing a lot more diseases, for example, the cancers were diagnosed pretty late in India, in our undergraduates’ studies we used to find patients usually coming in the support stage by the time they could not be salvaged. So the better diagnostic tools have come up, and then came the CT, then MRI. Similarly on the lab side, in terms of diagnostics, there used to be a single specialty pathologist and a microbiologist and third used to be a biochemist but today, even there you find there is super specialization and sub-specialization happening. Then we have a host of equipment to assist you and monitor the patient's progress. When we started, there were no ICUs for any serious patient to be monitored, like an individual patient and a resident doctor would be made to sit with the patient. So from that era, we are talking today of remote health monitoring. So, healthcare has come a long, long way. And if you ask me, it is still probably the beginning,” he says.

Healthcare challenges in India 

Dr. Praneet presents his views, “The biggest challenge in India is that accessibility is still a challenge. You go to rural areas, smaller towns; the access is still not there. Then affordability is a major issue, public hospitals have lost confidence and people don't want to go into them. Although we all got our training in the public hospitals because the government of India's investment into health has been bare minimum, till today we are just touching 1.16% of the GDP whereas even if you compare Asian countries they are much ahead of us in terms of Bed Availability for inpatient hospitalization. The WHO recommendation has been scaled down from five to three per thousand and we are still touching around one maximum. Similarly, the Health Resource - we are short of doctors, nurses, and paramedics. On the disease burden side, we still have infectious diseases; we are still looking to provide clean safe water and sanitation to our population. And on the other side, we have already started having the outburst of lifestyle and chronic disease, India is the diabetes capital of the world. So, just imagine we are sitting on time bombs. But yet, if you invest more in primary care, you don't require much tertiary care and quaternary care, you can arrest a lot of things much before they need a hospital bed. I think now with this pandemic, the health care providers have to adapt to the new systems. Doctors are perceived to be against technology which is a myth, it is wrong. They do use a lot of technology but unfortunately, the technologists and the business world don't understand why the doctor hesitates in adopting new technology. Now, this is where I think the challenges of both the worlds have to meet, join hands, understand each other's limitations, challenges, pluses minuses, and then come out to come out with solutions that are acceptable to both. Technology is not going to take away doctors, there's a lot of stuff that you need to do physically. What they want is whatever technology is being given to them to use is safe for the patient, it will help them either in improving the outcome or shortening the process or at least in terms of research, it will help them innovate,” he says.

Future of healthcare in India post-COVID

Dr. Praneet explains, “India as a country generally lags, it also has a propensity to leapfrog. I think what this pandemic has taught the doctors is that it is not necessary to examine every patient; you can probably make conclusions as per the data. The other best thing that this pandemic has done is to trigger people to look after their health. What is now going to happen is, people will be interested in looking at a balanced diet, not consuming snacks that have trans fat, and so on. Number two, because the access to non-COVID patients in the hospital system today is very difficult, as all the beds are filled with COVID patients, the only way is you manage your disease or you will need hospitalization. The third is, the doctors' or the providers' barrier to using the technology tools has reduced. And with the experience of the last eight, nine months, probably a lot of them will probably like to continue, especially the senior ones because the seniors can't expose themselves beyond a point. Fourthly, the way the technology is evolving, and the way artificial intelligence has already started contributing to my mind, both machine learning, artificial intelligence, natural language processing, and deep learning, all these things are going to sort of contributing to the extension of healthcare systems beyond the domains of physical infrastructure. And if I'm lucky, maybe I may be able to witness in my lifetime the next level to AR and VR which is Tele-Immersion, which requires a very expensive infrastructure. So in the Tele-Immersion scenario, I would be literally guiding your hands to do the next steps of the surgery without the touching field through a three-dimensional image transfer which will save many lives and increase the quality of life, which will be commendable, and that you can't imagine. So productivity will increase which ultimately will lead to individual prosperities and the growth of the country. This pandemic probably has, for the first time triggered the Government of India in this country to start focusing on health,” he says.

Contribution to the health and social sector

Dr. Praneet was listed in Pride of Rajasthan for his contribution to the health and social sector despite the fact that he neither belongs to Rajasthan nor studied there and has been awarded Vishisht Chikitsa Ratan Award by Delhi Medical Association on Doctors Day for a contribution towards the medical and social arena, “My wife comes from Rajasthan and this group was making a coffee table book on people who have contributed to the progress of Rajasthan. So, the chief editor reached out to me and insisted, though I refused since I do not fit the criteria. But he actually dug out everything about me to find some roots in Rajasthan because he had overheard my conversation with the chief minister on the inaugural day of Fortis Escorts Hospital in Jaipur. She insisted on an explanation about the fancy infrastructure and equipment and I explained that this is the need of the day with a very small example that SMS Medical College, Jaipur is an iconic institution, but we require at least 12 to 18 months of training to acquire the skills to do the procedure independently. After this much study, half the times these boys and girls have only seen this equipment in the textbooks so there is a huge gap, so I believe every medical college should have the equipment and there should be a skill set to train these youngsters. The second was she asked me how you're contributing to the welfare of the people. So I said look, we are not an industry; we are basically a service provider.

So one is where we are taking 10% percent of patients free that is one part. Second I can do something else for you, Anganwadi and Asha workers go out and deal with the rural population and they are the first line of contact for pregnant women and small kids. So I said, we will train them and empower them to take decisions, and communicate for reconfirmation, If required, and that will improve the efficiency. And as far as DMA is concerned since I have basically lived in Delhi, the entire circle knows what I do and what I don't do, including for the welfare of the doctors, wherever whichever the hospital I commanded. I used to make sure that any doctor colleague coming with his family member should be given separate treatment. We should go all over because, at times, every doctor also needs a doctor's help. So recognition of that, and I had the privilege of being honored on the day when a legend like Professor Padmavathi was being honored,” he says.

This profession gives soul-satisfaction

Dr. Praneet shares his thoughts, “This is one profession, which gives you a lot of satisfaction, and you get soul satisfaction. But I think two things, what I clearly understood was one is like, from the medical professionals, these doctors, paramedics, staff, nurses, I think there is little resistance to using technology. So we had an internal journal, which used to go out every month and I wrote the lead article in that with examples of how we are already using the technology. When you go to your ICU’s monitor shows some variation, you do the intervention, you record the intervention in that monitor in the system itself. So you are already using the technology. Why are we afraid? I would say there is a fundamental principle in healthcare in medicine that is ‘Please do no harm.’ You cannot treat every patient. And it is not necessary with the best of the diagnosis and best of the treatment the patient may improve. So the dictum is, if you can't help, don't harm,” he says.

(Edited by Rabia Mistry Mulla)