Shambhavi Naik (PhD) & Gedaliah Afterman (PhD)
India’s dramatic surge in COVID-19 cases has refocused the local debate on the mismatch between demand and supply of medical services across the country. This discrepancy is aggravated by local lockdowns impeding access to doctors and fear of infection, as people are encouraged to seek medical attention at home. Pleas on social media have demonstrated the need to use digital tools to address issues of information asymmetry and access of health services in non-urban areas.
Noticeably, countries have been able to direct their existing digital health solutions to augment their health infrastructure to respond quickly to COVID-19. Israel, which this week removed most COVID-19 related restrictions, is an excellent example of deploying digital health solutions. India can collaborate strategically with Israel to develop capacity in digital health, in preparation for future pandemics.
India’s experiments in recent years with adopting digital health have led to mixed responses. Challenges include lack of digital infrastructure in non-urban areas, language barriers, and the absence of basic health services in remote areas. Thus, a blanket one-size-fits-all approach to digital health adoption is unlikely to work in India.
Instead, a tiered approach or ground up building of infrastructure is required. Nonetheless, it is important to build to this goal, as digital health tools can help close several current gaps in healthcare. Electronic health records (EHR) maintained in an inter-operable manner, as envisioned under India’s Data Empowerment and Protection Architecture (DEPA), can reduce diagnostic costs and ease access to a patient’s health history for medical professionals. Such records can also form the basis for health information exchange, where EHR from remote areas can be sent to specialist doctors for their opinion.
Telemedicine can be used by doctors to patients or consult amongst his peers. COVID-19 has highlighted the importance of developing telemedicine services even in urban centers, so that patients can continue receiving health services without endangering their lives. In addition, diagnostic tools such as wearables can enable real-time monitoring of patient’s health data, leading to more effective decision-making by medical professionals.
While these tools cannot replace core medical functions, they can supplement operations and increase medical outreach. The implementation process is however accompanied by concerns about consent mechanisms for data acquisition, storage, and possible cybersecurity threats. Successful implementation of digital health therefore depends on an ecosystem that fosters not only innovation, but also trust and an adequate formulation of appropriate policies to govern digital health.
Extending the India-Israel partnership
To effectively plan and implement digital health policies, governments can learn from each other and work together. Furthermore, only by creating long-lasting cooperative structures and partnerships can they effectively prepare for future crises. Israel and India offer a particular case in point.
Israel has actively engaged digital health tools in its public health service and is well placed to share its experience and knowhow with international partners. Under the aegis of Healthcare Israel, it has already provided professional assessments on health care programs in Africa, Asia, and Europe.
Israel has successfully deployed digital health tools, but its population and infrastructural challenges are relatively small. On the other hand, India’s adoption of digital tools is still in its infancy, and choosing the right partner can help it expedite this growth. Both stand to benefit from increased cooperation in this field: India can provide an opportunity for Israel to trial technologies at scale in preparation for their international deployment. An effective way to achieve this, while safeguarding rights and health of Indian citizens, would be to create “regulatory sandboxes,” where innovators can trial promising solutions in a controlled environment under a regulator’s supervision. In exchange, Israel’s innovative capabilities make it a highly suitable partner for India.
A good starting point for such a collaboration would be to map technologies for preventive healthcare. Point-of-care diagnostics and screening, as just one example, can help in the early detection of cancer and early intervention, which would not only save lives but also reduce the demand for tertiary healthcare and the costs of surgical treatments. Collectively gathered population-level data could inform on developing infectious disease outbreaks, underpinning a health response to prevent further spread. Such preventive strategies would provide relief to strained health resources and allow their effective use, even as India builds up more capacity.
Increased investment in health infrastructure, legislation safeguarding the privacy of citizens, and the strengthening of the health regulator are three key actions that are critical for the successful adoption of digital health in both Israel and India. Creating this ecosystem can not only enable government-to-government collaboration, but also facilitate the growth of the domestic and international private sectors providing digital health services. Private sector participation will underline greater outreach of health services, contributing to improved health outcomes.
The ongoing COVID-19 outbreak has demonstrated the urgency of increased international cooperation to protect global health interests. No country can be safe from a pandemic unless all countries have adequate, accessible, and affordable healthcare. Therefore, it is a national and global interest for India, Israel, and others to use this opportunity to collaborate and lead the way in creating world-class products and services that can benefit all.
Shambhavi Naik (PhD) is the Head of Research at the Takshashila Institution
Gedaliah Afterman (PhD) is Head of the Asia Policy Program at the Abba Eban Institute for International Diplomacy.