It has been close to 18 months since the Prime Minister, Narendra Modi, launched the country-wide implementation of Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (PM-JAY), or the national health protection scheme; the initial momentum has been very encouraging. The scheme is currently being implemented in 32 of 36 States and Union Territories. It has provided 84 lakh free treatments to poor and vulnerable patients for secondary and tertiary ailments at 22,000 empanelled hospitals, countrywide. Under PM-JAY, there is one free treatment every three seconds and two beneficiaries verified every second.
Expanding the supply side
As the scale of this scheme grows, a key area of focus is to expand the secondary and tertiary hospitals empanelled under PM-JAY and ensure their quality and capacity while keeping the costs down. At present, there is one government bed for every 1,844 patients and one doctor for every 11,082 patients. In the coming years, considering 3% hospitalisation of PM-JAY-covered beneficiaries, the scheme is likely to provide treatment to 1.5 crore patients annually. This means physical and human infrastructure capacity would need to be augmented vastly. Conservative estimates suggest the we would need more than 150,000 additional beds, especially in Tier-2 and -3 cities. While a comprehensive long-term strategy will focus on expanding hospital and human resources infrastructure, an effective near-term approach is needed to improve efficiencies and bridge gaps within the existing supply and likely demand. A strong, yet under-tapped lever for accelerating health system efficiency and bridging these gaps is mainstreaming innovation in the Indian health system.
Transformative solutions
India’s burgeoning entrepreneurial spirit combined with a systematic push for the development of a start-up ecosystem has led to a plethora of innovations in health care. It is estimated that there are more than 4,000 health-care technology start-ups in India. Today, start-ups are working to bring innovative technologies and business models that leapfrog infrastructure, human resources, cost-effectiveness and efficiency challenges in Tier-2 and -3 cities. Artificial Intelligence platforms that aid in rapid radiology diagnoses in low resource settings, tele-ICU platforms to bridge the gap in high-skilled critical care personnel, centralised drone delivery of blood, medicines and vaccines to reach remote locations cost-effectively and reliably are all no longer just theoretical ideas. They are real solutions that are ready to be tested on the ground and potentially implemented. It is high time for transformative solutions to make their way into our hospitals, especially in Tier-2 and -3 cities, to turbocharge the way health care is delivered at scale.
This mainstreaming of health-care innovations, is lined with challenges at every step. The friction in their path to market often stems from multiple reasons.
Addressing the constraints
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One challenge is non-uniform regulatory and validation standards. Regulatory requirements, specifically for biomedical start-ups, are still evolving in India. As a result, hospitals often rely on foreign regulatory certifications such as FDA and CE, especially for riskier devices and instruments. In addition, it is difficult for a start-up to understand the minimum necessary validation requirements in order to qualify for procurement by hospitals. Lack of standards in this area leads to a huge variation in validation requirements at States and hospitals, forcing the start-up into a spiral of piloting studies. The government is now pushing ahead to overhaul Indian med-tech regulatory standards and product standards which will help bridge this trust-deficit.
Source: The Hindu
