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Jason Dehni, Regional President Asia Pacific, Solve.Care in an interaction with Viveka Roychowdhury talks about the measures that Indian hospitals should take to tackle the outbreak of any disease

As the world prepares for a global Coronavirus epidemic, are hospitals in India capable of meeting public health concerns to contain the virus and treat patients?

The capabilities of the Indian healthcare system to respond to public health crises have improved significantly since the H1N1 virus epidemic in 2009, yet significant work still needs to be done to address such crises. Although India has an integrated disease surveillance programme in each district, a comprehensive nationwide surveillance system is still a work in progress. A proactive campaign of public education should also be a priority for the Indian healthcare system, with India among some of the countries at greatest risk of exposure to the virus.

What can hospital administrators do to prepare for further escalation of the situation?

Ahead of any potential further escalation of the epidemic, hospital administrators must take a number of steps to ensure that their hospital and staff are prepared for every eventuality.

Firstly, units should be designated for diagnostic evaluation and additional units prepared for the treatment of 2019-nCoV patients. Secondly, administrators need to plan for surge capacity, taking into consideration estimated needs for patient beds, PPE, staff, diagnostics, including laboratory capacity and therapeutics. In addition, ensuring access to timely virological investigations in accordance with the algorithm for laboratory diagnosis of 2019-nCoV will be critical in the event of a further spike in the number of reported cases.

Of course, these are just some of the steps that administrators will need to take, in addition to gaining an awareness of related guidelines such as the minimum requirements for designated units for the management of confirmed 2019-nCoV patients.

Tackling a public health crisis of this nature calls for coordination with multiple organisations as well as the government. How can AI and blockchain facilitate this process, while maintaining patient confidentiality?

Blockchain and AI technology offer incredible potential to healthcare systems but they are not cure all solutions, nor should they be treated as such. Healthcare organisations need to be strategic by identifying use cases for such technologies and designing feasible strategies for their implementation, rather than justifying their use on a reactionary or ad-hoc basis.

While blockchain-based solutions can be purpose-built to prevent data breaches and ensure patient confidentiality, such solutions need considerable infrastructural development and testing among a variety of stakeholders before they can be considered fully robust. Ensuring that these technologies are carefully built into existing healthcare systems from the ground up, rather than hastily formed in reaction to public health crises, will be key to their enduring success. In time, blockchain solutions that give patients more direct control over their health, enabling them to communicate directly with clinicians and healthcare administrators, may lead to the early identification of symptoms and thereby help to halt the spread of contagious conditions.

What kind of projects of this nature has Solve.Care handled in the past?

Population health and chronic disease management are currently the prime focus of Solve.Care’s patient centred projects. Our partnership with the Arizona Care Network (ACN) in the United States is an example of a concrete use-case in which Solve.Care leveraged DLT to allow better tracking of patient data, and reward providers for patient outcomes. As a result of implementing our blockchain-based solution, providers now more efficiently administer and coordinate healthcare processes, improving health outcomes among patients with chronic disease conditions such as diabetes and chronic obstructive pulmonary disease.

Do Solve.Care have any clients at present in India?

India is a high-priority market for us in the long term. However, it is a complex healthcare market that requires careful study and entry in close collaboration with key players. We are currently engaged in a number of strategic partnership discussions in the market and we look to launch our presence there in the near future.

Can you share some examples of epidemiological insights from patient data or how the system improved operational efficiency etc.?

Today, the various layers of healthcare administration have created a number of barriers to operational efficiency in terms of interoperability and resource wastage. Healthcare administration structures tend to be siloed and custom built with their own data structures, thus preventing the efficient sharing of information between various healthcare providers and other stakeholders. While blockchain is still very much in its nascent stages, Solve.Care removes such silos to enable better communication of data between stakeholders, while at the same time improving the security of patient data, thereby restructuring the healthcare IT system as we know it.

How do these systems help patients in terms of better accessing the health records across multiple health systems, sourcing better payment options etc.?

The use cases of blockchain-based healthcare for patients are vast and include areas such as improved security, patient data management, drug traceability, and access to non-emergency medical transportation. Solve.Care’s partnership with Uber Health is one such example of how the platform is already leveraging blockchain technology to benefit patients through access to affordable transport to patients and caregivers. The fact that an estimated 3.6 million Americans miss medical appointments every year due to a lack of reliable transportation is a significant cost burden on the public healthcare system. By ensuring that transportation is there for when patients need it the most, Solve.Care is helping to remove transportation as a barrier to care, while also limiting undue cost wastage to the healthcare system.

What would the deployment of a typical blockchain solution for a hospital chain in India entail, in terms of investments, both financial and human resources, as well as timeline from installing the system to going live?

The design of our solutions are customisable to meet the client’s objectives and measure of success, whether that be better patient care, reduce administration, or facilitate the claims and payment process. Therefore the scope, investment and time-to-market will vary based on the breadth and depth of the solution. Having said that, we aim to launch a fully integrated solution in approximately three months.

How can such systems help prevent or mitigate such public health crisis situations in the future?

The Care.Wallet is one of our core products that allows users to connect to one or more Care Administration Networks (CAN) to manage their healthcare benefits and health conditions. It simplifies tasks such as managing prescriptions, verifying benefits, making appointments, managing disease conditions and simplifying the administrative and care coordination. With a Care.Wallet in the hands of patients, insurance policy holders or consumers in general, a health organisation can quickly deploy the right information or care protocol, to the right target population, at the right time. Additionally, the Care.Wallet facilitates the end-to-end care coordination between all relevant parties that allows for better care outcomes.

How can governments and policy makers leverage such systems?

Healthcare is a concern for every economy across the globe from India to the US. While there are differences across systems, the same core concern comes up across every healthcare system: how can we best address patient needs? In order to fully address this issue, the system needs to incorporate the interactions between a variety of stakeholders from healthcare providers, insurance companies, the government, and of course the patient themselves. Blockchain allows for better, more efficient outcomes for all the stakeholders involved in the healthcare systems, while at the same time addressing the key area of patients’ needs. While the initial implementation of blockchain may be costly, governments and policy makers should be more than willing to undergo a period of technological change to reap the long-term benefits with such a wide range of stakeholders able to benefit.

As APAC regional president of Solve.Care from August 2019, what has been your reading of how India health care organisations, and the APAC region at large, are evolving in terms of adopting emerging technologies like AI and blockchain?

The Indian healthcare industry is currently on the verge of a transition with the launch of the ambitious Ayushman Bharat Yojana and its goal to achieve the World Health Organisation’s (WHO) goal of Universal Health Coverage (UHC) by 2022. To provide quality care to beneficiaries of the scheme, India needs to leverage reliable technology that can help in accessing health information as well as improving areas such as detecting fraud in the payer management cycle.

Globally, healthcare organisations have started benefiting from blockchain technology in terms of its various applications, such as in health data management, health information exchange, provider credentialing and accreditation, and pharmaceutical supply chain management. Historically, however, the Indian healthcare industry has been shown to be a slow adopter of new technologies, and is slightly behind the cutting edge of blockchain adoption among other global healthcare systems such as that of the US.

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