ArticlePDF Available

Enhancing Health Care in India -What to Expect in the Coming Decade?

  • Dr Varsha's Health Solutions

Abstract and Figures

Understanding The ABCD of the future of health care.
Content may be subject to copyright.
The Indian Practitioner q Vol.73 No.1. January 2020
Enhancing Health Care in India – What to Expect in the
Coming Decade?
Dr. Varsha Narayanan *
* Health and Pharmaceutical Consultant, Dr Varsha’s Health Solutions, Andheri West, Mumbai.
The fastest growing healthcare markets in the
world in the 2020 decade will be Asia Pacic
and Africa, with a Compound Annual Growth
Rate (CAGR) of around 13% as compared to 9% glob-
ally.1 Healthcare in India is expected to reach US$
132.84 billion by 2023 from US$ 61.79 billion in 2017.2
Health care in India represents a wide range from
basic health care and peripheral health services, to
technologically advanced apex and tertiary care hos-
pitals. A number of important factors as below can
and are expected to play a vital role in shaping the
Indian healthcare canvas in the coming 2020 decade.
The ABCD of Health care focus will be on Improving
Awareness, Building a Strong Base, Collaborative and
Combination Approach along with Eectively Using
Data and Technology.
A. Awareness
India’s internet users have registered a 40% inter-
net penetration, and 18% growth to reach 627 million
in 2019 with almost one third users coming from rural
India.3 The available information at hand is enormous
from all kinds of sources making it a challenge to access
credible information in a two-way interactive manner.
Therefore, readily accessible, interactive and health
awareness enhancing information coming from Health
Care Practitioners (HCP) especially doctors with doc-
umented medical background, experience and pub-
lished work, or from recognized medical bodies, and
clinics/hospitals can impart the right knowledge and
guidance to patients that can contribute positively to
improving patient diagnosis, treatment response and-
B. Building the Base
The base of Health care in India is built on Family
and Community Medicine with the Peripheral health
care services which cater to the major vast population.
Presently the Primary Health Centres (PHC- approxi-
mately 24,000) functions with the help of several sub
centers which reach remote corners of the country’s
rural areas, while the Community Health Centers
(CHC) are rst referral centers for every 4-5 PHCs. The
CHCs are supervised by district hospitals and tertiary
care government hospitals.5 The key to overall eec-
tive enhancement of Health care in India is improv-
ing the quality of care at the PHCs and CHCs. The
National Health Policy (2017) calls for upgradation for
all 150,000 sub-centres in the country as ‘Health and
Wellness Centres’ to provide improved primary care,
with basic preventive, diagnostic, curative and referral
In a pilot study in Palghar district in Maharashtra,
India, the auxiliary nurse midwives (ANMs) in the
sub-centres were empowered with the best-in-class
technology (a software platform to track patient data
and point-of-care diagnostics), and standardized clini-
cal protocols.7 This has enabled the sub-centers to ef-
fectively act as the Spoke clinics for the PHCs resulting
in more than 300 consultations and 90% patient satis-
faction rate recorded to date. There has also been a no-
ticeable improvement (greater than 40% improvement
in pre- and post-training test scores) in the ANM’s clin-
ical skills, such as providing antenatal care and out-
patient care for minor ailments, fevers, and infections.
C. Collaborative and Combination Approach
Two important collaborative approaches can add
immense value to the Indian health care system.
First is the collaboration between privatized and
government health care, whereby the urban advanced
specialty/super-specialty hospitals can each allocate
some resource for the enhancement of health care in
one particular CHC and its associated PHCs and sub-
centers.8 This can result in improved facilities; training
and updating knowledge and skills of peripheral doc-
tors, ANMs, and health workers on basic patient care
in relevant disease segments and therapies; facilitate a
systematic and standardized approach with account-
ability and appraisal; and give peripheral doctors ex-
posure to new drugs and changing global medical and
The Indian Practitioner q Vol.73 No.1. January 2020
scientic concepts thereby bringing in more medical
practitioners into the peripheral health care services.9
The second valuable collaboration will be that of
health care with the pharmaceutical industry. This
would involve real world evidence and data genera-
tion for medicines and drugs which will be a key fac-
tor in clinical decision and treatment strategies. Real
world evidence would include not only in-clinic drug
eectiveness but also safety and tolerance in varied
populations and associated clinical conditions.10 There
will also be an increasing collaborative role of the two
industries in developing therapeutic consensus rel-
evant to India, and cascading updated knowledge to
the periphery.
A combination approach to disease management is
gaining immense awareness and acceptance today. A
holistic integrated therapeutic approach, complement-
ing drug therapy with lifestyle, nutritional-dietary,
psychosocial and evidence based indigenous and
natural therapies, can play an important part in more
eective management of chronic diseases, strengthen-
ing peripheral health care, and reducing costs.11 This
will also increase the population wellness quotient and
long term treatment benets. And the last having an
important place in rural health care in developing na-
tions like India.12
D. Data and Technology
The organization, stratication and analysis of the
enormous data (Big data) from the healthcare industry
can help in understanding demographic, epidemiolog-
ical and seasonal disease paerns, patient risk factors,
symptom variabilities, co-existing conditions, factors
aecting treatment response, disease prognosis, and
patient compliance. Big data analysis via Electronic
Health Records (EHR) can thus not only improve dis-
ease prediction and therefore facilitate prevention,
symptom recognition, timely diagnosis, and complica-
tion reduction but also help in beer organizational ef-
ciency and cost reduction.13
India has always been at the forefront of embracing
and adapting to advances and innovations in technol-
ogy which have increased diagnostic, interventional
and surgical precision as well as reduced recovery and
hospitalization time. The 2020 decade will witness rev-
olutionizing of the health care system with Articial
Intelligence (AI) to improve diagnosis and treatment,
patient engagement and adherence, and administra-
tive eciency.14,15 This will help clinicians and HCPs
to focus time on uniquely human skills like empathy,
persuasion, integrating the big-picture and eective
clinical decision making.
AI uses machine learning, neural network and deep
learning which can help in designing treatment strate-
gies and predicting outcomes based on evaluating pa-
tient risk, and recognizing clinically relevant ne fea-
tures in imaging data. Natural Language Processing
of AI will aid applications of speech, text recognition,
translation and simulation for clinical documentation
and reports, as well as patient engagement, interac-
tions and conversations. Robotics, which surpasses hu-
man vision, and angulation to greatly increase surgical
nesse, will soon have AI-based ‘brains’ with integra-
tion of image recognition and Robotic process automa-
tion (RPA). Remote and telemedicine will be yet an-
Fig 1: ABCD of Health Care Focus 2020
The Indian Practitioner q Vol.73 No.1. January 2020
other area where AI will have widespread application.
The ABCD focus of Health Care (Fig 1) based on
Family and Community Health in India in the 2020 de-
cade involves improving right patient awareness and
knowledge, strengthening the base of healthcare at the
peripheral level, increasing Collaborations and combi-
nation approaches and moving ahead with using Data
analytics and technology. This will help to chart out
the ‘E’ in healthcare which is enhancement of clinical
decisions and treatment strategies, having best patient
outcomes, and ecient management and reach of the
health care system serving the Indian population.
1. Healthcare and Lifesciences predictions 2020: A Bold future?
Accessed Jan 2020 on hps://www2.deloi
2. Challenges in Indian Health Care Industry. Accessed Jan
2020 on hps://airs/
3. Kantar IMRB, 21st edition ICUBE Digital adoption & usage
trends:2019. Accessed Dec 2019 on hps://
4. Ventola CL et al. Social Media and Health Care Professionals:
Benets, Risks, and Best Practices. Pharmacy and Therapeutics
July 2014;39(7):491-499
5. Kumar P. How to strengthen Primary Health Care. J Family
Med Prim Care. 2016 Jul-Sep; 5(3): 543–546.
6. Health Care Policy 2017. Accessed Jan 2020 on hps://mo-les/9147562941489753121.pdf
7. Why Primary Health Care in India needs a new delivery
model. Accessed Jan 2020 on hps://
8. Bajpai V. The Challenges Confronting Public Hospitals in
India, Their Origins, and Possible Solutions. Advances in
Public Health,Volume 2014, Article ID 898502, 27 pages
9. Ghosh K. Why we don’t get doctors for rural medical service
in India? The National Medical Journal of India. 2018; 31(1);44-
10. Katkade VB et al. Real world data: an opportunity to supple-
ment existing evidence for the use of long-established medi-
cines in health care decision making. J Multidiscip Healthc.
2018; 11: 295–304
11. Shenwai RS, Tare KN. Integrated Approach Towards Holistic
Health: Current Trends and Future Scope. International
Journal of Current Research and Review. Apr 2017; 9(7), 11-14
12. Koke TE et al. New Summary Measures of Population
Health and Well-Being for Implementation by Health Plans
and Accountable Care Organizations. Preventing Chronic
Disease. 2016;13:E89
13. Indian Health Care Analysis using Big Data Programming
Tool. Procedia Computer Science. 2016; 89:521-527.
14. Davenport T, Kalakota R. The potential for articial intel-
ligence in healthcare. Future Healthc J. 2019 Jun; 6(2): 94–98.
15. Jiang F, Jiang Y, Zhi H, et al. Articial intelligence in health-
care: past, present and future. Stroke and Vascular Neurology
2017;2: e000101. doi:10.1136/svn-2017-000101.
... However, this can establish and propagate E-consulting and Tele-medicine, that can play a very positive role in the future of health care in the 2020 decade. 11 More and more testing and tracing contacts is central to tackling and containing COVID-19 in India. Currently testing in suspected cases is done with nasopharyngeal and/or oropharyngeal swab samples for presence of the nCoV-2019 RNA by RTPCR (Real-time Polymerase Chain Reaction).12 ...
Full-text available
COVID-19 (Coronavirus Disease), caused by the novel Coronavirus designated 2019-nCoV (and thereafter called SARS-CoV-2), first seen in Wuhan, China in December 2019, has now swept across most countries and surfaced as one of the major pandemics the world has seen.1 India too has been impacted with the first few cases emerging in end January-early February 2020 and the disease gaining a foothold across the country by March 2020.
Full-text available
Evidence from medication use in the real world setting can help to extrapolate and/or augment data obtained in randomized controlled trials and establishes a broad picture of a medication’s place in everyday clinical practice. By supplementing and complementing safety and efficacy data obtained in a narrowly defined (and often optimized) patient population in the clinical trial setting, real world evidence (RWE) may provide stakeholders with valuable information about the safety and effectiveness of a medication in large, heterogeneous populations. RWE is emerging as a credible information source; however, there is scope for enhancements to real world data (RWD) sources by understanding their complexities and applying the most appropriate analytical tools in order to extract relevant information. In addition to providing information for clinicians, RWE has the potential to meet the burden of evidence for regulatory considerations and may be used in approval of new indications for medications. Further understanding of RWD collection and analysis is needed if RWE is to achieve its full potential.
Full-text available
Artificial intelligence (AI) aims to mimic human cognitive functions. It is bringing a paradigm shift to healthcare, powered by increasing availability of healthcare data and rapid progress of analytics techniques. We survey the current status of AI applications in healthcare and discuss its future. AI can be applied to various types of healthcare data (structured and unstructured). Popular AI techniques include machine learning methods for structured data, such as the classical support vector machine and neural network, and the modern deep learning, as well as natural language processing for unstructured data. Major disease areas that use AI tools include cancer, neurology and cardiology. We then review in more details the AI applications in stroke, in the three major areas of early detection and diagnosis, treatment, as well as outcome prediction and prognosis evaluation. We conclude with discussion about pioneer AI systems, such as IBM Watson, and hurdles for real-life deployment of AI.
Full-text available
Realization of health care as primary objective is necessary to strengthen primary health care (PHC). There is a need to build financial viable and sustainable PHC based on rational principles to fulfill the goals of providing quality health services on an affordable and equitable basis and also ensuring fiscal prudence. Health-care leadership, innovations in primary care, family medicine specialists, and effective and accountable health governance are the key steps toward our goal.
Full-text available
Despite the implementation of National Rural Health Mission over a period of nine years since 2005, the public health system in the country continues to face formidable challenges. In the context of plans for rolling out “Universal Health Care” in the country, this paper analyzes the social, economic, and political origins of the major challenges facing public hospitals in India. The view taken therein holds the class nature of the ruling classes in the country and the development paradigm pursued by them as being at the root of the present problems being faced by public hospitals. The suggested solutions are in tune with these realities.
The complexity and rise of data in healthcare means that artificial intelligence (AI) will increasingly be applied within the field. Several types of AI are already being employed by payers and providers of care, and life sciences companies. The key categories of applications involve diagnosis and treatment recommendations, patient engagement and adherence, and administrative activities. Although there are many instances in which AI can perform healthcare tasks as well or better than humans, implementation factors will prevent large-scale automation of healthcare professional jobs for a considerable period. Ethical issues in the application of AI to healthcare are also discussed.
Modern medicine is evidence based system of medicine with its high end investigative tools, surgical procedures and continued research at molecular, genetic and pharmaceutical levels. Ayurveda is an intricate system of healing that originated in India thousands of years ago. It is designed to promote good health and longevity along with the treatment of disease. It would be more apt to call Ayurveda a completely natural way of life. But the fact is, there exists a wide gap between these two health care systems. Modern medicine has no replacement, but traditional healthcare providers still form the basis of rural healthcare in India. This review article stresses the importance and need for integrating modern medicine with the ayurvedic system of medicine. Although it will be a challenging job, but will definitely lead us towards better and holistic health. Key Words: Modern medicine, Ayurveda, Integrated approach, Holistic health
Health care professionals can use a variety of social media tools to improve or enhance networking, education, and other activities. However, these tools also present some potential risks, such as unreliable information and violations of patients' privacy rights.
Indian Health Care Analysis using Big Data Programming Tool
Indian Health Care Analysis using Big Data Programming Tool. Procedia Computer Science. 2016; 89:521-527.