Healthcare expenditure is an important aspect of every country’s budget today. According to the World Health Organization’s (WHO) recent estimates, on an average UN member countries (192 in total) spend close to 9.7% of national gross domestic product (GDP) on healthcare. The total healthcare expenditure of the US itself is around 17.3% of their GDP, making healthcare in the US a $2.5 trillion sector. WHO defined the goals for health systems as “good health, responsiveness to the expectations of the population, and fair financial contribution.” Despite the heavy investments and policy focus, we are far from achieving these goals.
To achieve these goals, I believe that healthcare systems across the world will have to focus on providing affordable, preventive and patient-centric healthcare solutions.
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Affordability, to begin with, is a problem that exists in both developed and emerging nations. In developing nations, affordability manifests as the difficulty in providing cost-effective healthcare on time and for a wider population. In developed nations, despite the existence of different funding models, healthcare is expensive to the end-consumer, either directly through high insurance premiums or indirectly through high taxes.
The battle to make healthcare cheaper, better and more accessible to the masses is not easy, but there are organizations that are leading the way for others to emulate. Take for example, Aravind Eye Hospital, which is overcoming the lack of access to ophthalmologists in India. In India, only 10-15% of the population, predominantly in urban areas, has access to decent eye care. It was not economically viable to set up clinics in locations across the country in remote rural areas. To tackle this problem, they developed a model with which teleophthalmology could be used to interact with patients in remote centres in rural areas. They used the computers for conferencing, sharing data and providing patient diagnoses. Aravind Eye Hospital’s successful model has helped reach over 2 million patients, making it the largest eye-care provider in the world and probably one with the widest reach. What is interesting is that it was able to significantly reduce costs for the patients as well as make the model economically justifiable and sustainable.
Technology will play a pivotal role in the design and implementation of affordable healthcare solutions. At Infosys, our experience was no different. We have created a product which focuses on the delivery of primary healthcare in rural areas. This solution will allow healthcare workers to diagnose and dispense medication for basic illnesses by accessing a WHO database. Technologies like these can assist social health activists placed in several remote areas in taking real-time, effective and informed decisions. This will increase access to primary healthcare and increase awareness, helping prevent illnesses.
One of the primary issues with current healthcare models today, globally, is the focus on “curing” illnesses rather than “preventing” them. Consider these numbers—even in developed countries such as the US in which majority of the population has access to hygienic living conditions and healthcare, 100 million people are living with chronic diseases. The cure and management of these diseases accounts for 75% of healthcare spending in the US. Prevention offers a healthier alternative to this issue. Prevention isn’t just change in healthcare models, it is a change in mindset.
These evolving healthcare models will have to be duly complemented by innovations which have the potential to bring about a social revolution. Take for instance, the Tata Swach project. Access to clean water is a problem in several parts of India, as with many other emerging economies. In India alone, 75% of the rural population does not have access to safe drinking water and this is directly connected to over 80% of the diseases prevalent in this population. Purifiers were previously too expensive for people in remote areas and lower-income groups to even be considered as an alternative. Tata Swach is a water purifier that was created to address these issues of access and affordability. At Rs 750, it is considered to be one of the lowest priced water purifiers in the world. Swach provided several rural schools across the country with these water purifiers. These children, with access to clean water, acted as ambassadors to spread the awareness on the need and benefits of using clean drinking water, not only among themselves but also among their families. Initiatives such as this are helping create a preventive mindset, in an endeavour to reduce the occurrence of diseases.
While solutions such as Swach are relevant to emerging nations, different ones are being worked out for the developed nations with the same concept of prevention in mind. Aetna, one of the largest healthcare organizations in the US, for instance, is working towards preventive healthcare measures. Aetna incentivizes its employees to lead a healthier lifestyle by reducing their insurance premium. Employees are part of a programme that includes health education, weight management, exercise programmes, reducing smoking and much more. Several other large global corporations are also beginning to implement similar preventive healthcare schemes for the benefit of their employees.
For the success of preventive healthcare measures, innovation alone is not sufficient. The lack of communication between healthcare providers and consumers will have to be dealt with. What is required is a more patient-centric healthcare model. Patients today want to be active participants in the entire process right from diagnosis to remedy.
This also creates the base for personalized delivery of healthcare. Moreover, each patient reacts differently to the same healthcare solution, leading to the requirement of a more personalized method of healthcare delivery. To enable this, we need an integrated system with comprehensive patient information, including their medical histories. While traditional providers are slow in making the move, some have quickly started embracing this trend.
PatientsLikeMe, a social networking site, for instance, allows patients to put up their experiences and several details, giving them an opportunity to empathize and interact with other patients as well as understand treatments. Apart from this, the advantage is that everything from how they reacted to different medicines to how they feel is quantified and the site is able to use this quantifiable data. Pharmaceutical researchers are able to look at this as a source of live feedback and, hence, improve and innovate faster. From a small site, PatientsLikeMe has grown into a community with over 100,000 users. It has recently been identified by Fortune as one of the 15 companies that will change the world and by Fast Company as one of the top 25 most innovative companies in the world.
The future of healthcare will be very different from what it is today. It will involve fundamental changes in the way healthcare solutions are designed and delivered. The need for this new future is being felt by developing and developed nations alike. We need to act today if we wish to achieve our collective healthcare goals of ensuring good health, being responsive to the expectations of the population and with a fair financial contribution. This is the only way we can create a safe and healthy future for ourselves and future generations.
The author is set to take over as chief executive officer and managing director of Infosys Technologies Ltd on 21 August. This is the fourth in a series of articles he’s writing for Mint on seven strategic themes that Infosys has identified and sees as transforming businesses going forward.
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