Tele-Health Delivery Models in India

The booming Indian healthcare sector is facing enormous challenges, particularly in the area of rural healthcare delivery. Inadequate infrastructure and qualified medical practitioners are considered the main reasons for the poor state of rural healthcare. Task-shifting, with paramedics taking a greater responsibility of care, is growing but this often needs to be supplemented with doctors’ opinions. Tele-health has evolved over the last decade as an interesting solution to provide distance support to healthcare workers at scale. Technology solutions can also serve to support monitoring and data management which also are major challenges in today’s healthcare systems. Most innovations are currently found in the private sector and it is important to establish a discussion on how tele-health can be integrated with the public healthcare system to address the challenges in primary care. With this background in mind, ACCESS Health International undertook a comparative analysis of three innovative models in tele-health to understand what can be done to bring good practices to scale.

The study unearthed many interesting findings, whilst highlighting how different practices can be adopted to suit different needs based on demographics, patient profiles, technology limitations etc. For instance, innovative public-private partnerships can be used to overcome capital expenditure concerns, value-added services can be extended to attract more patients etc.

The study uncovered some key hindrances to larger scale adoption of tele-health solutions in India, which include:

  1. Cost constraints – In discussions with personnel from various organizations, it was evident that the initial cost of adopting tele-health solutions was prohibitive in most cases.

  2. Lack of clarity on Return of Investment (ROI) calculations – Due to unavailability of standardized technologies, it is difficult for organizations to evaluate whether the adoption of tele-health solutions would be worthwhile from a financial perspective. As a result, the adoption decision is often driven by a philanthropic desire rather than financial considerations.

  3. Lack of standardized technology platforms – Due to lack of standardized technology platforms and solutions in the marketplace, each organization has to perform due diligence and feasibility assessment of technology solutions independently. This consumes a lot of effort and resources and also poses challenges to large-scale adoption. Lack of proven assessment frameworks and standardized technology platforms, particularly for diagnostic devices, are a major reason for slow adoption of tele-health solutions in India.

  4. Unavailability of a best-practices repository – Most tele-health organizations in India seem to be operating in silos, with very little or no opportunity for cross-learning and knowledge exchange. As a result, organizations are unable to learn from each others’ experiences resulting in slow growth and adoption.

Based on the findings of this study, ACCESS recommends the following measures to enhance the adoption of tele-health in the country:

  1. Creation of standardized technology platforms – Availability of standardized devices and platforms, particularly for handheld devices, would tremendously increase the reach of healthcare in India. A key finding in this study was the lack of support for local health workers and manual effort required in data-gather and decision-making. Availability of standardized, proven platforms would increase the adoption of tele-health devices, while reducing adoption costs simultaneously.

  2. Establishment of best-practices repository and knowledge-exchange platforms – As described earlier, most organizations in India work in silos with very little information exchange. This increases costs and effort at each stage of the process. Creation of a nationwide best-practices repository would encourage speedier adoption and would also aid in standardization of practices in this field.

  3. Enhancements to existing legal frameworks – With increasing adoption of tele-health systems, decision-making would pass into the hands of village health workers. Under the current legal framework, these workers are not authorized to prescribe medicines thereby limiting their scope of services. Archaic legal frameworks should be revisited to include increased use of technology in healthcare delivery.

  4. Public-private partnerships – There are natural synergies to be harnessed in the field of tele-health in India. Public institutions have underutilized infrastructure that can be shared with private providers to alleviate cost constrains. Public institutions, with their large scale and scope, can also aid in creating collaboration opportunities and knowledge-sharing. Private institutions can provide efficient management and state-of-the-art technology solutions to complement the physical infrastructure and reach of public healthcare institutions.

To read the full case study, click the link directly below.