India and Switzerland talk digital health by Aparna Kumaraswamy

A look back at the innovators and experts who showcased their technological solutions for enhanced healthcare delivery at the Digital Health Conclave 2019, curated by swissnex India

On 8th April, a group of healthcare enthusiasts got together to discuss the future of healthcare delivery, and the technologies that will assist in improving its quality. This motley group consisted of innovators, researchers, heads of large corporations, mid to senior level managers, and students from Switzerland and India. The one thing they had in common was their strong belief in the potential of technology to elevate the quality of healthcare and their openness to look across borders to find incredible innovations to this end. 



Looking back at the interesting ideas, insights and innovative solutions that were presented to the audience at the conclave, three broad areas emerged as current and future areas of engagement: Empowering the patient, Enabling digital health innovation, and Artificial intelligence and machine learning for global health.  Below are the key takeaways from the day.


In the first session chaired by Ms. Anjali Ajaikumar, HCG hospitals, the aspect of patient advocacy/rights was elucidated. In view of increased patient access to healthcare information, there is an expectation from the patients’ side for more informed decisions, increased interaction with physicians and more participatory treatments, including second opinions. An informed populace demands better options and thus the natural course of action is to increase patient access to their health information, better means to balance outcomes and payments to drive better treatments in the future. Pitfalls of incorrect data driving bad decisions was also touched upon.




Since enhanced patient-physician interaction is the first step towards better patient outcomes, Prof. Dr. med Andreas Trojan, a medical oncologist with nearly 35 years of experience in prominent medical institutions across Switzerland, spoke emphatically on the role of medical health apps in the empowerment of cancer patients. His startup, Mobile Health AG, has developed an app named Consilium, that gives patients improved quality of life, outcomes, continued care, better documentation and easier lab bench-to-bedside translation for better treatments. Consilium aims at achieving this with a patient reported app that captures cancer side effects and enables corrective measures early on. The app is a step towards better self-care and self-management of the disease at the patients’ end and better treatment decisions and outcomes at the physician end.  

Mr. Ahmed Abdullah from Digipharm briefly presented the concept of value based payments in Insurance that reward patient outcomes instead of procedures. This novel concept increases equitability and ensures better utilisation of insurance. 

Dr Randy Ramin Wright, representing Clinerion, talked about improving healthcare outcomes by linking real world data ecosystems. Data in silos is opened up by a novel technology that connects data generators to one another to identify best fits and improve the patient selection process for trials, thereby, leading to better treatment outcomes. The end goal is better therapies in lesser time for lesser costs.  

Laying the groundwork for future Digital health initiatives was the topic for the session chaired by Dr. Hans-Florian Zeilhofer, University of Basel. This session had prominent speakers from Indian and Swiss Universities and Public health initiatives, who emphasised on how to build novel ecosystems that enable, foster and steer future digital health initiatives. Dr. Zeilhofer mentioned that the perfect healthcare ecosystem should be a super hive that brings together diverse entities and competencies like universities, industries, entrepreneurs, engineers, hospitals, and policy makers for collective excellence.  
  
“Digital technologies enhance all levels of Indian healthcare through improved continued care and referral linkages” said Dr. Sailesh Mohan, professor at Public Health Foundation of India. He went on to talk about PHFI’s data gathering technologies such as CDAT, Swasthya Slate, neonatal health monitors and Urban Techtonix that have gone on to aid disease study and enabled the healthcare system to plug the gaps in understanding disease. PHFI’s technologies emphasize the success in tracking patients and how to prevent them from “falling through the cracks” in the healthcare system. 

Prof. Markus Melloh and Prof. Sven Hirsch from Zurich University of Applied Sciences (ZHAW) in Switzerland, enumerated the many ways in which education and healthcare can go hand-in-hand. Digital health is a chimera of technology, medicine, law and management: ZHAW aims to design Digital health programs encompassing diverse systems like  systems medicine, preventive care, pattern analysis, deep learning, biomarker analysis, data fusion, machine learning, mobile apps, management of healthcare organisations, process optimization, and law. Dr. Sven and Dr. Markus also talked about how different geographies drive digital health innovation and how linked data is key to a holistic perspective on product development. Aspects of collaboration between Universities and research bodies across India and Switzerland were discussed as well. 

Mr. Bharat Gera From St. John’s Medical College and Hospital, emphasized that compassion for the patient puts “care” into healthcare and that innovation should be guided by the 4Cs - Cure, Care, Cost and Convenience for patients. Mr. Gera spoke on the potential of digital tools to give “metadata”: the role of external factors on health and the potential for self monitoring for better diagnosis     

Mr. Samuel Cobbi from Singapore highlighted Future Health technologies program, in the Singapore-ETH centre (SEC). The Program emphasizes the scientific basis for the urgent transformation of the healthcare system by mobile digital technologies, and opens avenues for Asia-Swiss collaborations in Digital Health. 

The role of AI and ML in increasing precision in diagnosis was the crux of Deepanwita Chattopadhyay’s talk and the session chaired. Mrs. Deepanwita, Chairman and CEO of IKP Knowledge Park, discussed data quality, pitfalls in data acquisition, data analysis and translating it into a guideline for the future. AI and ML could provide solutions for previously tough-to-diagnose diseases and improve curability. This, in turn, could lead to higher social impact with better diagnoses and outcomes across populations and geographies. 

Prof. Hans Peter Beck from the Swiss Tropical and Public Health Institute talked about nabbing an old killer, Malaria, with the help of AI. Noul, a platform using AI for malaria detection, enables image analysis, which in turn reduces effort, time and decision making in the absence of trained staff. It reduces physician fatigue and helps underserved population with high social impact. 

The impact of machine learning on Tuberculosis treatment was the focus of Dr. Prajwal’s talk at the conclave. Imagine a solution that reduces the time taken to identify TB from two months to 24 hours, supports the physician in making the right diagnosis and provides faster treatment to the patient, thereby, curtailing the spread of the disease. Dr. Prajwal’s startup, Clemedi, provides all of these solutions in the cure of Tuberculosis, making it a very relevant innovation for India and other regions of the world facing emergence of drug-resistant Tuberculosis strains. 

In short, despite glitches in data connectivity, hurdles in data sharing and nebulous policies and guidelines in  digital health, the scope of AI is vast and its potential social impact is deep.    

The conclave’s final session was an exciting discussion between two healthcare veterans in India - Dr. Paul C Salins from the Mazumdar Shaw Medical Center, Narayana Hruduyalaya and Dr. Shravan Subramaniam from Roche Diagnostics India. They shared interesting insights on the potential of digital technologies in healthcare including improving diagnosis, aiding clinical decision making, reducing clinician fatigue, improving clinical outcomes and promoting interceptive medicine over preventive medicine. An interesting input was on how patient opinions are now shaping a dynamic re-evaluation of treatment regimens, and an increased awareness of patient rights. Pitfalls of such patient inputs were also considered: at what point did a patient’s input interfere with the physician’s plan of treatment. 

In terms of future areas of digital health initiatives, Dr. Salins pointed out to a need for novel technologies and ideas, not merely a retinkering of existing ideas. More tools and technologies that are cross-functional, multi-tasking, adaptable and robust are the need of the hour: these are undoubtedly high hanging fruit and require considerable thought and research. Dr. Shravan mentioned the need for greater engagement between policy makers, innovation centres and innovators. This step goes a long way in sensitizing stakeholders to expectations and outcomes and speeds up innovation uptake. Lastly, the problem of validation of novel technologies and measuring performance parameters should be addressed: the lack of proper validation will hinder technology adoption and ultimately kill the innovation itself. 

In conclusion, Dr. Shravan and Dr. Salins emphasized that diverse strengths drive innovation, and innovations should be rooted in finding solutions to real-world problems.      

Our last speaker, Dr. Balasubramanya, Senior Consultant, Bio Facilitation Cell, KITS, emphasized the Govt. of Karnataka’s commitment to fostering Innovation and Research saying “In line with the Karnataka Integrated Health Policy, 2017, we are keen to support healthcare organisations that are leveraging technologies like AI, big data, Cloud, IoT, mHealth, etc. to strengthen reproductive and child health services and aid in early detection of non-epidemic diseases in the state for providing treatment at low cost without burdening the patients”.    

The conclave went on to provide a platform for bilateral conversations between the audience and the speakers. Insightful exchanges between the participating Swiss and Indian academic institutions, startups, companies, experts and innovators ensued. The conclave was crucial in bridging the gap between innovation and institutional ambition for providing enhanced quality of healthcare, within the Swiss and Indian healthtech ecosystems. Hopefully, it will pave the way for the merging of ideas, technologies and resources in digital health between Switzerland and India, resulting in solutions that could revolutionise the industry.
Author
Aparna Kumaraswamy
Healthtech Project Manager at swissnex India, Consulate General of Switzerland. Aparna is a lifesciences enthusiast from Chennai. She has a masters in Biochemistry from the University of Houston and has worked in the biology and drug discovery space for over ten years. At swissnex, Aparna lends her support to the healthtech and lifesciences initiatives. She is an avid reader and a musicophile.

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