Healthcare technology is the application of organized knowledge and skills in the form of devices, medicines, vaccines, procedures, and systems developed to solve a health problem and improve the quality of lives especially in the remote areas of an underdeveloped nation. 

Milind Ghyar, Co-founder and Managing Director, TRIARQ Health, has co-founded GloStream and is a Technology-based Healthcare Business Expert, an Entrepreneur, and a Mentor.

TRIARQ has a triple aim which is to bring in health reform; better health, better care, and better economics by intelligently aligning quality and spending in order to achieve the goal of better outcomes and sustainable healthcare for the communities they serve.

GloStream and TRIARQ health are one company

Milind throws light on his journey in the healthcare technology sector, "I started in 2001, I was doing a project with one of the healthcare companies in Kenya, East Africa that is when I started getting interested and got to know what healthcare technology is. I did a lot of work around that and in 2004 I happened to co-start GloStream which primarily is an electronic healthcare development company, so we developed software that mainly handles the patient records. We had started with a team of 4 – 5 people and grown-up to where we are today. It had an amazing transformation; it went through its own curves and paths. GloStream was a healthcare technology-driven company and around 2011 – 2012, we started to do a lot of work around revenue cycle management and value care and that is when we started rebranding it as TRIARQ health so it’s one company.  We have come a long way in our journey with healthcare technology, revenue cycle management, and now we have started with something called the MSO – Management Services Organization in the US. In the entire GloStream journey, there has been a lot of technology and operations in the US. My audience and customers have been in the US and we have been able to cater to a lot of states. So it has been a fantastic journey so far,” he says.

The National Digital Health Mission (NDHM)

Milind shares his thoughts, “Recently if you have followed the news then you would know that The National Digital Health Mission (NDHM) was inaugurated by our Prime Minister on 15th August 2020. Before we go onto it I would like to briefly talk about what is healthcare technology. In many of the developed countries, the patient never carries their own files or papers, but in India, the file has a line printed on it: ‘Please get this file on your next visit’ which means the onus of documentation is on the patient which is contradictory in many countries that a healthcare provider should maintain the patients' files which makes a lot of sense in case there is a patient who does not have the sense or understanding to carry their files, speak about their problems. So the National Digital Health Mission (NDHM) really talks about:

Independent patient record, so there would be a Health ID just like Aadhaar ID. So this ID will help all the hospitals or clinics to pull your record and gain access to the complete history for example if a person is allergic to penicillin, the healthcare providers would know and act accordingly. 

The second part is to access healthcare records across the nation. The advantage is that whatever treatment that a particular patient is on and the new treatment that needs to be provided, the healthcare provider will be able to merge it and have clear guidelines on what the patient should do and not do. 

The third is to provide data in patient care both in terms of quality and quantity at an economical cost,” he says.

Tackling affordability, accessibility, and availability issues of the Indian Healthcare System

Milind shares his view on how to tackle the 3 major prevailing issues of the Indian Healthcare System that are affordability, accessibility, and availability, “Let’s talk about availability, in India, we do not have a good patient to doctor ratio, we have very few doctors and the population is skyrocketing. So we need better technology. When we visit a doctor the waiting time is a minimum of 30 mins for even simple things like fever, cold, and flu. But the question is do we really need to go to the doctor for basic things? So we have telehealth, wherein you fix an appointment with the doctor and the doctor has access to your files and history, they ask you a set of questions, and based on some calculations they prescribe you medicines and then monitor. Then accessibility, the best way to handle it is telehealth or telemedicine. The idea is to connect the patient with the doctor and allow them to interact. We have many medical devices being developed in India for example digital stethoscope, portable ECG meters, etc if these devices are integrated into your phones so your phones become the primary care physician, obviously, it won’t be able to treat you like doctors but there are models on artificial intelligence which try to help with medical care but will never replace a doctor so doctors should not worry of being replaced by technology, it will be technology-assisted care. In remote areas where the accessibility is low or doctors do not wish to go to such areas there, we have seen health ATMs where you can go and get the testing done like pulse, body weight, etc, and with the primary diagnosis, they can get their medicines prescribed. I also believe that technology should be included in the syllabus of doctoral studies. Next, if you see the current scenario of the healthcare system in India, for example, when a patient goes to a hospital, they are asked whether they have medical insurance if they do, the hospitals have a free hand to conduct some tests that may or may not be relevant to the case, so in such a scenario, if you have the press ability of the treatment part whether the tests were required or not, would really help to solve the problems of healthcare costs making it affordable. The government of India is investing a lot of money into healthcare and the budget will increase in the future. The ability to have technology-driven healthcare will help the government to understand where the money is being used. In terms of usability, the governments can ask the doctors to take on more technology-driven consultations at subsidized rates. So when these two things come together, we will be able to take care of the complete healthcare affordability issues,” he says. 

Benefits and challenges of the Digital healthcare system in India

Milind presents his views, “Benefits from the patient’s perspective is they do not have to worry about,

For example, if they are allergic to something, then it goes into their record which is accessible to all, so the paranoia they have of going through the same ordeal of the reaction goes away.  The availability of technology makes it very convenient – especially what has happened due to COVID. Things have transformed and if in 2018 you would have asked can we do this remotely? The answer would have been no, but today we have learned to do everything remotely so why not patient healthcare as healthcare is the most lagging technology that we are seeing, we do online banking, online shopping, etc. The convenience is the biggest part as many elderly do not want to leave their house due to the COVID situation. The accessibility for village areas in any of the state will have access to a doctor for their sickness only because they can be connected through technology

Coming to challenges: 

Compliance – if there is no framework for the ecosystem to sustain then we would have a lot of misuse of technology, for example, credit card data is stolen, so what if healthcare data is stolen as they are private records only for you and your doctor to see. So there are protocols and methods to keep those things private and not made available to the public.

The doctor and patient need to build trust and the guidelines need to be followed. So if a doctor prescribes ABC, not all doctors would recommend that as they practice medicine differently, so there would be challenges here,” he says.

Future is of personalized medicine

Milind talks on the future of personalized medicine, “We should understand the basic things when we try to understand personalized medicine. Not every person’s body is the same, the characteristics and the DNA is not the same. A medicine might work for me but not for my sibling. So we need a lot of data for that. One of my major areas of research for me with regards to clinical data analytics, which identifies a lot of diagnoses, see how the patient was treated, and then you understand what the traits are. When you are able to map the body structure, characteristics, DNA, etc you understand what makes the body unique and along with diseases, it will be easier to cure the diseases in the future especially for terminal illness. So there is always a scope of personalization as to what will work for a person, like what medicines, which tests, treatment line, etc.  It is not far away that I get diagnosed for my illness and there is a medicine that is made specifically for me and shipped directly to me in the future. So data is the key. Another aspect of personalized medicine is that there are addition and elimination involved. When someone is not well, we give them medicine and we start eliminating some things from their life for example a diabetic, they are given medicines and asked to eliminate free sugars.  So data analytics will help in defining what you need to add and what you need to eliminate and you can maintain your own records like diet, exercise and that is when we can define if these medicines will work or not and that is very important,” he says.

(Edited by Rabia Mistry Mulla)