Advantage Healthcare: Challenges and opportunities for India's IT Sector

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Barely one quarter into 2017, it seems like a bad year for India’s IT industry. With the Trump administration taking over, the Indian IT sector’s continued reliance on the US for its sustenance is under threat. Explaining the rounds of layoffs, doyens of IT offer a litany of excuses - immigration restrictions, automation mopping up jobs, and even an “untrainable” workforce! We believe that our IT firms must leverage their employee strengths, and begin servicing domestic clients with an innovation mindset.

IT can be broadly categorized into product development and services. Employees at product firms work fairly independently on developing core platforms in domains such as aerospace, finance and retail. Services professionals build customized solutions by closely interacting with clients, most of whom are located in the US, UK and Europe. Recent winds of “de-globalization” will affect those who are deployed “onsite”. Soon, our firms will have no choice but to play in the same league as their overseas counterparts; this is a prospect with uncertain outcomes.

For long, Indian IT services firms have worked on outsourced maintenance projects that “keep the lights on” for their clients. Rapid advances in cloud computing and machine learning have centralized service provisioning and automated routine tasks. Our IT firms are in need of a massive makeover, a move that could eliminate tens of thousands of jobs. With Indian MNCs hiring employees locally and expanding their footprint through global acquisitions, revenues and compensation packages for those working “offshore” i.e. in India, will no longer be attractive.

To overcome these challenges, a viable strategy for our IT firms would be to focus their sights on the domestic front, and target sectors whose technology needs have hitherto been unmet - Healthcare is one example. In fact, healthcare providers (HCP) the world over have been slow to adopt IT-enabled processes, and consequently suffer from glaring inefficiencies. With huge investments being made in tertiary care, India’s health sector is expected to double in revenues to $280 billion by 2020; this growth will be largely facilitated by IT.

Information systems at hospitals present a “balkanized” picture. Although a host of applications capture patient data at different points of contact, an integrated picture of the patient is missing. There has been increasing emphasis in the past two decades on ‘evidence-based’ medical practice, but HCPs have failed to equip physicians with the means to harness this evidence. The non-availability of processed information at critical points of care has frustrated many a doctor and cost several lives.

To be an effective and efficient provider of healthcare, a modern hospital must be equipped with a syncretic health management information system (HMIS) that covers all operational aspects, including governance. This will entail an ERP-style rollout, which is familiar territory for our IT professionals; they can also create interactive dashboards and help physicians access data from across the organization to make informed decisions. A critical analysis of these decisions and their outcomes could be used to hone physician practices.

Indian startups are building capabilities in big data analysis, machine learning and IoT devices. We now have homebred Davids like Flipkart and Ola in response to global Goliaths such as Amazon and Uber. However, HCPs appear to be skeptical about the ability of startup firms to deliver value. In this digital era, data is the new oil. By outfitting consenting patients with wearable devices, a huge volume of data can be generated; processing this data will lead to breakthrough applications, making a strong case for HCPs to collaborate with IT startups.

Our healthcare providers have consistently worked towards serving domestic interests, even as a few of them begin to cater to international health tourists. Hospital chains have mushroomed across towns to deliver services of increasing complexity. Accreditation has become the aspirational benchmark for HCPs; however, getting credentialed warrants large-volume information exchanges between the providers and accrediting bodies, using IT as the vehicle.

The entry of insurance and other modes of financing creates an opportunity to extend healthcare to larger sections of society; IT can ably drive this initiative. Outcome-based criteria for making provider payments shall lead to the standardisation of practices, procedures and record-keeping. IT services firms can borrow from their general insurance practices, and build platforms to streamline the complex domain of healthcare billing and payments.

An effective primary healthcare system helps in containing both communicable and chronic diseases. The expanding footprint of primary care as envisaged in public policy will perforce be dependent on point of care diagnostic devices, and the communication of alerts, images, reports and prescriptions over long distances. Telemedicine has come to stay; even government health systems have embraced this application. Given our mobile penetration, the Indian government can take primary care to new heights in rural areas with the help of smart apps.

Finally, it is not just our industry, but also our educational system that must undergo revision. Medical and engineering colleges must shed legacy content and pedagogy; they must redesign their curricula to take into account the changes brought about by ‘digital’. Those who opt for a career in healthcare may be embedded in hospitals and other settings to gain a first-hand understanding, as well as to test their innovative prowess.

To conclude, if India’s IT firms fail to seize upon the opportunities we have identified, overseas players will do so with relish, and we may lose precious ground in the battle for primacy in healthcare IT-enablement. Instead of offloading techies and eliminating middle managers, the firms could task them with building robust and innovative IT platforms after consulting with subject matter experts at HCPs. Their actions will be seen as guiding a hesitant but ambitious healthcare sector to match the best in the world at much lower costs.

- Shankar Venkatagiri and Rajluxmi Murthy are faculty in Decision Sciences & Information Systems Area at the Indian Institute of Management Bangalore. Dr.Mohan Adhyam is a Professor of Urology at St. John’s Medical College & Hospital, Bangalore. The authors are currently involved with the General Management Program for Healthcare (GMHE) that is being offered by IIMB. Opinions expressed by them in this article do not represent the views of the institutes they are affiliated to.

[This article has been published with permission from IIM Bangalore. www.iimb.ac.in Views expressed are personal.]