Next leap in Modi 3.0: From UPI to a Unified Health Initiative

As India enters the era of Modi 3.0, the nation stands at the threshold of a health care revolution. The recent election results have reaffirmed the country's faith in Prime Minister Narendra Modi's vision of a digitally empowered India. Building on the transformative success of initiatives like UPI, it's time to envision the next frontier: A Unified Health Initiative (UHI) that harnesses the power of AI and digital tools to revolutionise India's health care landscape.

India's health care system faces formidable challenges – a severe shortage of doctors, vast language and educational barriers, and inconsistent access to quality medicines. However, amidst these challenges, a new wave of innovation powered by Artificial Intelligence (AI) offers unprecedented hope.

The economic potential of AI in health care is significant. While exact figures are difficult to predict, experts agree that AI could transform India's health care sector over the coming decade. This isn't just about market growth; it represents a fundamental shift in healthcare delivery and access across India. AI has the potential to improve efficiency, reduce costs, and enhance patient outcomes. From accelerating drug development to enabling more accurate diagnoses, the effects of AI in healthcare could contribute substantially to India's overall economic growth and development, potentially positioning India as a global leader in health technology innovation.

Across the country, startups and institutions are leveraging AI to revolutionise various aspects of health care. In the realm of diagnostics, AI algorithms are being deployed to screen for diseases like cancer, diabetic retinopathy, and cardiovascular conditions. The Tata Medical Centre and the Indian Institute of Technology, for instance, have launched a de-identified cancer image bank that utilises AI to detect biomarkers and improve cancer research outcomes.

In the pharmaceutical sector, companies like PharmEasy are using machine learning and big data to enhance pharmacy services, connecting over 80,000 pharmacies across 1,200 cities and serving five million customers. Meanwhile, firms such as SigTuple Technologies are automating the analysis of medical data, increasing the accuracy and efficiency of diagnostics, particularly in areas lacking specialist doctors.

The impact of AI extends beyond diagnostics and pharmaceuticals. In clinical trials, AI is significantly improving efficiency by speeding up design, enhancing adherence, facilitating patient recruitment, and reducing dropout rates. This acceleration in clinical trials is crucial for drug discovery and development, potentially reducing the time and cost associated with bringing new treatments to market.

Even in the operating room, AI is making its presence felt. The growing segment of robot-assisted surgeries, driven by increased funding and AI platform developments, is enhancing surgical precision, reducing recovery times, and improving patient outcomes.

As an advisor to the innovative Apna Vaidya project, I've witnessed firsthand the transformative potential of AI in health care. This initiative integrates AI with WhatsApp to offer a comprehensive health assistant bot. Apna Vaidya answers common medical queries, helps users find doctors, provides information about medications, and offers guidance on insurance and other healthcare-related questions. By leveraging a platform already widely used across India, it makes critical health information and services accessible to millions, regardless of their location or technical expertise. It's a prime example of how AI can address India's health care challenges, particularly in areas where access to medical professionals or health information might be limited.

The Indian government has not been a passive spectator in this digital health revolution. Initiatives like the National Digital Health Mission (NDHM) and the Ayushman Bharat Digital Mission (ABDM) are commendable steps towards a digitally enabled healthcare ecosystem. The proposed National Health Stack aims to facilitate the interoperability of health data across providers and enhance the efficiency of health service delivery through digital platforms – a digital circulatory system for our nation's health information.

Building on these efforts, we need a comprehensive UHI. This initiative should be ambitious in scope, yet practical in implementation. Drawing from the success of UPI in revolutionising digital payments, the UHI should aim to create a similarly transformative impact on health care. Here's what this initiative should encompass:

• A national digital health platform for secure sharing of health data across providers. This would create a seamless flow of information, ensuring that a patient's medical history is always at the fingertips of healthcare providers, regardless of location.
• AI-powered tools for diagnosis, treatment recommendations, and personalised health guidance. These tools could act as a force multiplier for our health care workforce, enhancing their capabilities and extending their reach.
• Telemedicine services to improve access to health care in remote areas, aligning with the government's focus on reaching underserved populations. This could bridge the urban-rural health care divide, bringing quality medical consultations to the most remote corners of India.
• Smart pharmacies with AI-driven inventory management and quality control. This would ensure the availability of medicines where and when they are needed, reducing wastage and potentially saving lives.
• Digital literacy programs to empower individuals to use health-tech tools effectively. This is crucial to ensure that the benefits of digital health reach all segments of our society, not just the tech-savvy urban population.

These components of the UHI, working in tandem, could revolutionise health care delivery in India, much like UPI transformed our financial transactions. However, the path to this digital health utopia is not without challenges. The digital divide in India is a complex issue, intertwining factors like socioeconomic status, education levels, and cultural attitudes towards technology. While urban areas boast internet penetration rates of over 70%, rural areas lag at around 32%. This disparity, compounded by varying levels of digital literacy, poses a significant hurdle in the equitable implementation of digital health initiatives.

Data privacy is another critical concern. The sensitive nature of health data necessitates robust protection measures, but implementing these across a diverse and fragmented healthcare system is daunting. Issues such as consent management, data localisation, and the right to be forgotten need careful consideration within the Indian context. The potential for data breaches or misuse could erode public trust in digital health initiatives, making it crucial to balance innovation with stringent safeguards.

As we navigate these challenges, we can draw valuable lessons from global initiatives in AI-driven health care. Estonia's e-Health system, which has successfully digitised 99% of health data and e-prescriptions, demonstrates the potential of a comprehensive digital health infrastructure. Their system prioritises data security and interoperability, offering a model for efficient and secure health information management.

China's rapid integration of AI in health care, exemplified by companies like Ping A Good Doctor, showcases the potential scale of AI-assisted diagnosis systems. However, it also underscores the need for careful regulation to prevent an overreliance on AI and ensure human oversight in critical medical decisions.

The United Kingdom's NHS AI Lab provides a framework for responsible AI development in health care, emphasising ethical considerations and equitable access. Their focus on ‘AI for inclusive innovation’ could guide India's efforts to ensure that AI-driven health care solutions reach all segments of our diverse population.

As we stand at the cusp of this new era in Indian health care, the potential of a UHI powered by AI and digital tools is both exciting and challenging. The journey ahead requires a collaborative effort from policymakers, health care providers, technologists, and citizens. We must invest in digital infrastructure and literacy programs, develop stringent data protection laws, foster public-private partnerships, ensure inclusivity in AI tool development, and continuously evaluate and refine our approach based on real world outcomes.

The success of initiatives like UPI has shown that India can lead the world in digital innovation. Now, it's time to bring that same spirit of innovation to health care. By doing so, we can not only transform our nation's health outcomes but also provide a model for other developing countries grappling with similar challenges.

The mandate is clear, the technology is ready, and the need is urgent. Let us seize this opportunity to create a healthier, more equitable future for all Indians. The time for a UHI is now.

This article is authored by Ashwin Gopinath, professor, MIT, co-founder and CTO, Biostate.ai