CIO – The helmsman for Information Sharing

Girish Bommakanti
Chief Operations
ACCESS Health International

CIO – The helmsman for Information Sharing

Girish Bommakanti
Chief Operations at ACCESS Health International

While information sharing and centralisation are the cornerstones of many industries, Healthcare has lagged – and this has led to a multitude of challenges ranging from lack of adequate access to Healthcare, overprescription, rising costs, and inadequate coverage for the vulnerable sections of society. The key is to centralise access – then everything from oversight, cost reduction, ease of access, and customer-centricity will follow suit.

Beginning as a thinktank for analysing, curating, and ideating on problem statements, potential solutions and identifying innovation potential in the healthcare space, ACCESS Health International has transitioned to being an enabler, and a competency builder for public and private sector entities helping them to change the face of healthcare access in different geographies from the Asia Pacific, the Middle East & North Africa, to Europe and the Americas.

Girish believes that while IT solutions, software, tools and ideas exist, what is lacking in the marketplace today is a health system research database. Access Health aims to bridge this gap by bringing in the knowledge and experience to counter the deficit of India-specific research data to supplement data coming from studies like the Global Burden of Disease.

Access, Choice, Agility, and Oversight

While Access Healthcare identifies potential challenges and problem statements, they have also observed a larger, wider, and more pervasive problem – disparity.

It boils down to the system itself. When you have a system that’s almost entirely based on cash transactions, there is no data retention and thus no scope for intelligence or even oversight.

Girish says that compared to an oversight body such as the NHS in the UK, where every patient interaction is digitised and the data retained, India’s oversight system cannot track healthcare data. While oversight is an important business case, the aggregation of healthcare data, electronic health records, and patient data sharing can significantly improve healthcare efficiency and reduce risks.

The need for the hour is a control system, such as a Payer who can monitor the kind of medication prescribed and form a guidance layer for the patient to understand the cost, scope, and treatment method required for a given condition. Programs like Ayushman Bharat are available in many cities and towns in India and can form the basis for both monitoring and oversight, as well as a focal point for healthcare data aggregation.

However, achieving this would require a systemic change, but today’s Payers are more focused on claims utilisation and package costing than playing the critical role of a monitoring layer that facilitates accountability. Another business case for Payers is the out-of-pocket expenditure that patients incur, which are a result of:

  • Gaps at a care level, arising out of the unavailability of specialist doctors.
  • Gaps at a system level, arising out of unavailable or non-functional equipment.
  • Gaps at a process level that results in patients who can or should be treated at the primary care facility being transferred to a secondary or tertiary care facility.

Girish explains that technology can help bridge these gaps, but the system itself needs to undergo a large-scale transformation before we begin to see the change. Firstly, the existing infrastructure and policies need to be strengthened to bridge the gaps at the care, system, and process levels.

Secondly, patient data being centrally available allows Payers to define budgets for the treatment of different conditions and episodes, resulting in transparency and accountability.

Lastly, the payment system needs to be integrated to avoid cash transactions, which is the source of the current problem.

Bridging the gap

Access Healthcare attempts to be a partner in the system to help guide and define the way healthcare access is provided. In the light of the pandemic, Girish believes that; it is even more crucial to Patients, Payers, and Healthcare providers that the system becomes more affordable, agile, and accessible.

As we move towards NDHM (National Digital Health Mission of India), which is a common mandate, there needs to be an Information Database that covers:

  • Patient information from historical records, preexisting conditions, contraindications and risk levels.
  • Healthcare data including treatments, cost of treatment, prescription standards.
  • Healthcare availability data ranging from hospitals, their specialities, capacity, and location to facilitate routing of patients to the nearest and most comprehensive healthcare provider.

Access Healthcare’s objective in building a research database for Indian Healthcare addresses the information gap in Healthcare in India and many other countries that do not have a robust digitalised Healthcare Information System. One of the key drivers of digitalisation of Healthcare, building the national healthcare information database and the infusion of oversight and accountability, starts with exploring existing telehealth solutions.

Girish believes that the pandemic has offered some significant benefits in its wake in the form of telemedicine and online consultations for non-COVID conditions as the basis for the increased and ongoing adoption of digital technologies in the Healthcare domain.

With adoption increasing, Healthcare delivery can become digital, which would lead to digitalisation of healthcare data and, consequently, building a national Healthcare information database.

Now the biggest stumbling block is adoption, which the aftermath of the pandemic has shown to have increased tremendously.

Information and Technology leads the way

With COVID bringing the pressure and incentive for Healthcare in India towards telemedicine adoption, the policies to govern them have also been framed. As a result, telemedicine can bring about the change required in the Healthcare domain.

  • With the legalisation of telemedicine, innovation in the technology backbone is now possible, allowing for improved treatment outcomes and patient care experience, further increasing telemedicine adoption.
  • With remote diagnosis possible, more and more patients can reduce the time to access Healthcare by eliminating the time taken to travel to the nearest provider.
  • With travel reduced, healthcare costs can come down due to travel costs reducing.
  • Often, second opinions for patients are cumbersome – with consultation available at one’s fingertips, the quality of Healthcare services is bound to improve as patients have access to increased choice.

That said, as the patient data is restricted to hospitals, and hospitals have historically been looking to improve how they manage data belonging to patients within the hospital premises, than Outpatients. One major change that Girish predicts is how FinTechs can play a role in increasing the sharing of patient and Healthcare information and the adoption of digital Healthcare.

Additionally, FinTechs can bundle insurance products, copayment, service delivery cost optimisation and a variety of other value differentiators as a non-traditional Healthcare service delivery system. Girish explains with an example of a partner programme where they facilitate families to consult a doctor for INR 99/- which is virtually impossible elsewhere. When bundled with pharmacy delivery and insurance products for specific risk groups, mutual insurance, insurance for specific population segments, or even at an organisational level, the increased penetration can offer economies of scale.

While such solutions significantly reduce the cost of Healthcare delivery, it also presents an opportunity to move the entire healthcare supply chain away from the physical realm.

The road ahead

FinTechs already have their mandate in taking banking to the unbanked population, providing viable financial services to lower-income groups and marginalised communities. With credit history, risk profile, payment and collection systems all preexisting, FinTechs can disrupt healthcare access by bundling in loans and easy payment options and, consequently, incentivise low and middle-income groups to do away with hospital visits for primary care. Girish sees this beginning to take shape within the next two or three years itself, becoming the next big revolution in Healthcare.

Girish Bommakanti
Chief Operations
ACCESS Health International

20+ years of experience in public health and the private healthcare sector, including multiple senior leadership positions in India, the Middle East, and Africa. Currently heads the Health Systems Advisory Services in ACCESS Health International, providing strategic oversight to Health System Strengthening projects spanning primary and integrated healthcare, NCDs and mental health, health financing, digital and financial technologies, and quality management systems.