Health coaches, AI-backed risk assessment platforms dawn to address avoidable mortality and health inequities in India – by Anusha Ashwin, @ashwin_anusha

The United Nations finds India’s disease burden and its associated premature mortality figures quite acute. Combined attempts are being made by the Indian healthcare stakeholders to bring about large reductions in premature mortality and simultaneously address healthcare inequities. This blog highlights how digital healthcare interventions have a profound impact on tackling mortality and inequity, especially in healthcare resource-constrained locations.

“In thy hand is the strength of thousands, and in thy health is the health of millions”…… this quote finds an apt relevance for today’s global health condition. A world that was struck, in early 2020, by a pandemic caused by the deadly Coronavirus, which is mutating itself to create several new variants.

Undeniably, there is now a global awakening on the responsibility one carries about his/her personal health and its direct correlation to community health. Personal wellness has indeed taken center stage and health has emerged as the key focus for consumers readjusting to the pandemic-induced new normal. Consumers’ approach to fitness and overall wellness has now been permanently altered, amplifying the global consumption of digital health tools for early diagnosis and intervention. The cognizance of preventing an infection or even a non-communicable disease for oneself has also become a supreme thought of concern.

This year the World Health Day (celebrated every year on April 7th) commemorated over a year of battling the pandemic together by the global community. And the theme selected for this year was ‘building a fairer and healthier world for everyone‘. This theme set by the World Health Organization could not have been more appropriate for this year as it emphasizes the collective responsibility to make sure that the policies, programs, and actions are guided towards a healthier future for all and also mitigate the pandemic at a global level.

Also, Dr. Harsh Vardhan, Union Minister for Health and Family Welfare, on World Health Day, reaffirmed on behalf of the Government of India, that it is committed to ensure all people and communities have access to quality healthcare services, where and when they are required, without suffering financial hardship and move towards building the WHO-mandated ‘Fairer, Healthier World’.

This past year has brought home to us the need to ensure universal access to healthcare services, spanning from preventive to curative for each and every citizen, irrespective of their socio-economic status. India’s response to COVID-19 and its leadership role in enhancing global cooperation has in fact set an example of this approach. It has become increasingly evident that the health of a population is fundamentally dependent on fair access to healthcare within the society.

Global Health Equity Enablers

Each year, World Health Day reminds the world that there is a need to have a uniform and equitable distribution of affordable healthcare services to all sections of the society. It is constantly iterated that preventive healthcare is the best that one can do to build a healthier society. Post-COVID-19 pandemic it was realized that the needle has to shift to preventive healthcare so that the central focus is on keeping humanity healthy and disease-free rather than treating them when they are sick.

At a global level, well-established healthcare firms and startups are convinced that with technological and digital adoption, and with the pace of innovation, patient and physician behaviors have shifted with permanency. There is an entirely new set of best practices in health, that can address inequities in healthcare delivery.

According to WHO, health inequities are preventable with strategies that place greater attention on taking healthcare to the most vulnerable groups, and the power to do that vests in digital technology. Technologies such as the IoT, virtual care, remote monitoring, AI, big data analytics, blockchain, smart wearables, platforms, tools enabling data exchange and storage that create a continuum of care have proven the potential to enhance health outcomes. Tech has aided medical diagnosis, data-based treatment decisions, digital therapeutics, clinical trials, self-management of care, and person-centered care as well as creating more evidence-based knowledge, skills, and competence for professionals to support health care.

Several Indian and international digital health companies have made significant inroads into addressing health inequities. This post features one among those several thousand startups that focus on preventative healthcare. US-headquartered limited liability company Healthy Plus forayed India with a mission to develop, organize and deliver healthcare services and resources. Making healthcare universally accessible and successful for all the stakeholders, and helping to attain the highest level of customer service for all patients is claimed to be the company’s motto.

For caregivers, Healthy Plus provides a full-service wellness screening solution that will educate, engage, and risk predicts the patient population. The company’s solutions are designed for patient population management creating a more controlled workflow for doctors and the clinical care team. On the other hand, the Healthy Plus’ system identifies patients who have chronic conditions and guides them into a recommended Virtual Care Program that allows continued disease management and lifestyle management.

The company’s CEO, Sean Bledsoe, in an interaction with me, admits Healthy Plus hit its stride in the US and with that confidence forayed India with a pre-created preventive digital health system for the benefit of post-Covid interventions. Bledsoe says that Healthy Plus is a company that strives to accomplish a mission of providing innovative approaches to increase patient population control, reduce costs, increase communication, and increase healthcare satisfaction.

Digital ecosystem for early diagnosis

Revealing more about his company’s objectives, Sean Bledsoe says, “Healthy Plus has created a high-level ecosystem of care that connects the front-end risk prediction to the back end of care management with a combination of digitized solutions integrated with a human touch. This creates a cohesive workflow and a sustained management for a healthier living. The concepts of the company’s program are pillars of the popular US Healthcare program Obamacare and the architecture was paralleled to the World Health Organization’s objectives to transitioning to preventive care. The US Trade Commission has endorsed our product for the India market and is actively assisting with referenced contacts to both State Governments as well as the Private Sector.”  

“It’s important to take a view of digital technology both pre-Covid and post-Covid. The common thread is the Indian population is rapidly outgrowing the access to doctors and physicians. This is compressing a higher burden both on the doctor accessibility and a rapid increase in healthcare cost for the patient, the insurance provider, and even in government-provided insurance. There is an understanding that for each Covid recovered patient there is a 70% chance of developing a chronic health condition. As these go undetected the compression of care needs will overwhelm the current system. At Healthy Plus we have developed a system that will early detect, present a recommended method of care and link each patient to a clinical health coach to guide and steer the patient’s care to higher levels,” explained Bledsoe.

Bledsoe says that his company has proved the positive effect of taking healthcare to remote parts of India. Healthy Plus and an NGO Jai Durga Samajik Kalyan Sansthan (JDSKS) are now working together to maximize health programs for citizens in Uttarakhand. JDSKS is committed to providing widely accessible & extended healthcare support to the people of Uttarakhand who cannot afford expensive healthcare facilities and realized that it was important to partner with firms like Healthy Plus to take advantage of pre-prepared health systems.

This partnership program is designed to reach out to the remote locations and excluded areas of Uttarakhand, where there is a scarcity of health services. JDSKS is creating an ecosystem, where staying healthy and getting health services is uncomplicated and easily accessible. JDSKS President Manish Khanduri views this as leading the path for Indian citizens to have access to care through a full ecosystem of care provided by Healthy Plus. The mission of this project, according to Khanduri is to reach 10,000 to 40,000 citizens, who are in great need of healthcare access and preventative care.

Healthy Plus, along with its implementation partner IntelliAI, has constructed mobile access and Health Coaches who are even assigned to rural areas. These mobile units are equipped to provide general assessment services, provide a series of pathology tests, and enable pharmacy access as well. The key to have the access to pharmacy, says Bledsoe, is to have an understanding of the risk determinations among rural populations. Also, Bledsoe exhorts the provision of Health Coaches is necessary for rural India in educating the people on the importance of prevention, as it is a concept that has been sowed into people’s mind only post the pandemic. Smartphone penetration and access to affordable internet has done a lot good to take these digital tools far and beyond, says Bledsoe.

According to Bledsoe, there are several new tailor-made technologies that Healthy Plus has deployed. The system has a ‘medical mapping algorithm’ that is based on the Indian culture and genetic makeup. The algorithm gathers patient information and biographical data that determines the patient’s level of risk for 126 risk categories. These determinations place a focus on low-risk assessments to high-immediate risk assessments. An analysis of the risk prediction outcome enables the doctor to structure an efficient care plan for not only a healthier living but also in early disease mitigation.

Post-Covid, increased importance to Health Risk Assessment is observed and reported and is now regarded as one of the basic components of personalized medicine that evaluates a person’s overall health and the probability of developing a certain disease. And when a digital ecosystem simplifies the process from risk assessment to prophylaxis, obviously the score for this and the demand for programs escalate.

Another route to introducing risk assessment digital programs is through corporate wellness programs. Bledsoe indicated that his company is in an advanced stage of talks with a public sector oil and gas organization, which has a large employee base, and many state governments to replicate the Uttarakhand model of digital healthcare delivery. The advantage with this route is that it ropes in a lot of people who are at potential risks but those who overlook on visiting physicians at a time when intervention is early and lifesaving.

Healthy Plus’ Program Workflow

To address avoidable mortality in India

India is one of the youngest nations with over 60% population under the age of 35 years. However, the UN finds the country’s disease burden and its associated mortality figures quite acute. Reportedly, lifestyle-induced illnesses or NCDs are taking a heavy toll. Not to deny, the rapidly ageing population has furthered the demands on health services.

In response to the “WHO Global Action Plan for the Prevention and Control of NCDs 2013-2020”, India is the first country to adopt the National Action Plan with specific national targets and indicators aimed at reducing the number of global premature deaths from NCDs by 25% by 2025.

Combined attempts are being made by the Indian healthcare stakeholders to bring about large reductions in premature mortality in the last few years. It is understood that over 60% of the NCDs can be cured and the disease burden of the country can be significantly brought down if mandatory risk assessment-based preventive health check-ups are brought into place.

The pandemic has also further highlighted the importance of risk assessments. India is being radically moved from a curative country to a preventive country. Apportioning larger funds towards preventive health and wellness segments would go a long way in tackling avoidable mortality. Placing innovative products and health services that exploit digital technologies is also crucial to addressing the challenges in healthcare delivery.

Since digital healthcare is now a staple in care management, insurance companies are also stepping up digital prevention methods rather than continuing with the outdated reactionary method of care. Owing to the rapid progress in machine learning, which takes advantage of recent advances in computer processing power and in big data, compiling and handling massive data sets has become easy, not only shortening the turnaround time of predictive analysis but also covering a large population at risk that simultaneously address the inequities in healthcare delivery.

Anusha Ashwin
Anusha Ashwin

When I started out as a trainee copy editor at a publishing house, least did I expect myself to be traveling along with the digital evolution of content. Ever since the digital model became a medium of providing content, my career kick-started. 
I consider my career to take a solid shape during the current phase, as I set shot to work in times of the digital era. Today, I am able to resonate with the demands of writing content tailored to meet the requirements of the new age consumer that is driven by SEO and SEM.
While with CyberMedia, I have handled content at premier magazines like BioSpectrum and Voice&Data – India’s foremost business magazines in the biotech & telecom verticals that have been instrumental in bridging the gaps in India’s life sciences and ICT domains respectively.
The blessing here is that, through the writings, I am on a constant self-discovery mode. I have found a passion, which is writing in focus on digital healthcare, communication-based tech startups, and health-tech entrepreneurs. Somewhere down me, there is this strong educational foundation in Microbiology and Biotechnology that had to play a part!
As India becomes more Atmanirbhar, I am destined to stay focussed on aligning my content contribution passion with Digital India plans, where I interact with numerous startup entrepreneurs and other organizations that are going to be part of the ambitious Make in India and Make for India programs.

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