Rural healthcare technology: Welcome back to “The Science Of Health”, ABP Live’s weekly health column. Last week, we discussed the current incidence of lung cancer in India, the projected prevalence of the disease by the end of the decade, and how gene therapies can cure the condition in the future. This week, we discuss the role played by technology in improving the accessibility and affordability of rural healthcare in India.
Rural healthcare is an extremely important sector that has been getting significant attention of late. The number of Indians living in rural areas in the country is over 95 crores, as of April 1, 2023, according to the Department of Drinking Water and Sanitation, Ministry of Jal Shakti. The state with the highest number of Indians living in rural areas is Uttar Pradesh, where over 16 crore people live in rural areas, accounting for 16.6 per cent of the total number of people living in rural areas in India.
There are over 6,65,000 villages in India. Several adults living in rural areas die prematurely due to diseases of the circulatory system, including heart disease, and conditions affecting the respiratory system. Over 25 million Indians living in rural areas in the country have diabetes, according to The George Institute for Global Health India, a medical research institute.
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The challenges faced by people living in rural areas in India include a lack of access to healthcare, which leads to increased incidence of maternal mortality, neonatal mortality, malnutrition, and infectious diseases.
Heart diseases and diabetes are responsible for premature deaths in rural Indians. Compared to the West, these conditions occur at a much younger age in India. These diseases have a major role to play in the increasing poverty rate in India, and are the most common killers of people of working age, especially in rural areas.
People with heart diseases living in rural India do not receive regular medical care.
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The vaccination rates are also quite low in some rural areas. As a result, the life expectancy of people living in several rural areas in India is low.
There is also a lack of skilled healthcare professionals in a large number of rural regions in India.
Most importantly, a large number of rural Indians do not know how to leverage healthcare technologies. The villages in which they live may have advanced healthcare facilities, but the people living there may not be well-versed in those technologies. Therefore, it is important to educate rural Indians about the significance of advanced healthcare technologies, and workshops and training programmes must be conducted to teach them how to use these facilities.
According to The George Institute for Global Health India, innovative, simple and low-cost smartphone technologies can help address the rural healthcare challenges in India. This is because these technologies will be affordable as well as accessible, and rural Indians will be able to learn how to use them with ease.
Since several villages lack trained healthcare professionals, state-of-the-art electronic decision support systems must be built. These systems can be built using artificial intelligence (AI), and can diagnose people’s conditions and diseases based on certain health parameters. All the rural people will have to do is to answer certain questions and mention how they feel. However, they may be required to get their blood tests done or measure their blood pressure beforehand. If they are taught how to use these AI-based machines, a large number of challenges will automatically be overcome.
It is important to ensure that rural healthcare systems are evidence-based, quality-controlled, and affordable technologies. Community healthcare workers such as Anganwadi should learn how to use these technologies, and also teach others how to access them. Through innovative smartphone technologies, these healthcare workers will be able to deliver state-of-the-art personalised healthcare at a meagre amount. It is important to leverage this technology because wireless networks reach over 80 per cent of India’s population.
What role do microsatellite centres and e-clinics play in improving rural healthcare?
Microsatellite centres are revolutionising rural healthcare in India because they wirelessly connect remote locations to healthcare providers. E-clinics, which provide virtual doctor consultations to rural Indians, are also helpful. They are offline centres in rural areas equipped with medical facilities such as basic check-ups, and first aid. People can also undergo blood tests at e-clinics.
“Through a hybrid model of microsatellite centres, e-clinics and healthcare providers, a seamless connection is established. This hybrid model ensures healthcare is accessible and readily available to all, even in the most remote areas. E-clinics serve as collection points for diagnostic samples and facilitate referrals when necessary. The network of healthcare workers plays a pivotal role in the healthcare ecosystem. These healthcare experts bring specialised knowledge and experience, ensuring that individuals in rural and remote areas receive the best possible medical attention. They facilitate timely diagnosis, prescribe appropriate treatments, and guide patients through their healthcare journeys,” said Priyadarshi Mohapatra, Founder, CureBay, an Odisha-based online platform providing healthcare services.
Since microsatellite centres provide seamless connection to rural Indians, they allow physicians to share electronic health records with rural patients. These centres are built with the help of a robust telecommunication infrastructure. They facilitate communication between healthcare professionals and rural patients suffering from heart diseases, who need continuous monitoring.
Microsatellite centres also allow healthcare workers to send prescriptions to pharmacies electronically.
India has several telecardiology and telemedicine platforms. Using telecardiology, doctors remotely interpret electrocardiogram recordings.
“Microsatellite centres help rural populations and remote locations connect with urban healthcare facilities and deliver essential medical services. They facilitate healthcare providers’ online participation and enable the sharing of medical records and electronic health records (EHR) between physicians and patients. These centres leverage a robust telecommunication infrastructure, including satellite technology, high-speed internet, and mobile networks, to support immediate remote consultations and medical assessments. This real-time communication is particularly beneficial for conditions like cardiovascular diseases (CVD) and other critical complications that require continuous monitoring. In India, numerous telecardiology, telemedicine and teleconsultation platforms have harnessed these advancements, expanding healthcare access to rural areas with limited healthcare infrastructure. Additionally, healthcare providers in remote areas can electronically send prescriptions to pharmacies through microsatellite centres, ensuring timely access to medications,” said Arindam Sen, Director, i2i TeleSolutions, a Bangalore-based digital platform providing healthcare services and offering specialist training.
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Role of artificial intelligence in improving rural healthcare
AI can revolutionise the healthcare sector, especially rural healthcare, if used to complement the expertise of healthcare professionals. One must be careful not to replace professional advice with AI.
Certain AI algorithms that are trained on patient data can detect conditions. Some AI algorithms can also be used for initial consultations in regions where medical infrastructure is inadequate. Rural Indians must also be trained how to use AI-driven apps such as chatbots which can give people medical information in different local languages.
AI can also be used to educate rural Indians about diseases.
“AI has the transformative potential to elevate rural healthcare by addressing unique challenges. In rural areas, access to specialised medical expertise is limited. AI can act as a force multiplier, aiding healthcare professionals in diagnostics and treatment planning. AI algorithms, when fed with patient data, can assist in diagnosing conditions promptly and accurately, critical for effective treatment initiation. Telemedicine, empowered by AI, can connect rural patients with doctors remotely. AI algorithms can facilitate initial consultations and aid in preliminary diagnosis, enabling early intervention. This is especially crucial in regions with inadequate medical infrastructure. AI can enhance health awareness and education. AI-driven apps can provide valuable health insights, offer advice on preventive care, and encourage healthier lifestyles. Chatbots, powered by AI, can disseminate healthcare information in local languages, making it more accessible and relevant to rural communities,” said Mohapatra.
AI-driven wearable devices will allow rural Indians to monitor their heart rate and blood pressure. AI can also help identify risk factors for certain diseases in rural patients. Most importantly, AI-driven tools will facilitate early disease detection without the need to conduct extensive health examinations.
“The strategic application of predictive analytics through AI offers significant potential for early disease detection, especially in regions with limited healthcare infrastructure and slower disease identification processes, thus improving healthcare facilities in rural areas. AI-driven tools such as mobile apps, wearable monitoring devices and teleconsultation or Telecardiology platforms provide an opportunity to address these disparities and advance healthcare services for rural populations. Presently, AI is being incorporated into diagnostic algorithms to screen for various illnesses, including cancer, diabetic retinopathy, and cardiovascular diseases. By analysing clinical and lab data from patients, the digital tools with AI solution can identify new risk factors and deliver precise heart risk scores and other rapid health diagnostic results to patients without requiring an extensive health examination, facilitating early disease detection,” said Sen.
AI can also help generate health treatment plans.
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How does telecardiology work?
Telecardiology involves the use of Internet of Things (IoT) and AI services. IoT is used to describe the network of physical devices around the world embedded with sensors, software, and other technologies, and connected to the Internet. The function of these devices is to connect and exchange data with other devices over the Internet.
Telecardiology is supported by cloud computing infrastructure, which allows the delivery of computing services over the Internet.
In this way, electrocardiograms can be interpreted online.
“Telecardiology leverages advanced digital technology solutions, including IoT devices, cloud computing, and AI & Analytics, to revolutionise the patient care experience. By employing IoT-based healthcare screening and diagnosis, supported by a robust cloud computing infrastructure, and enhanced by state-of-the-art tools for clinical skill improvement, it ensures continuous ECG monitoring and immediate data sharing with doctors through mobile applications. Digital transformation with AI generated systems play a crucial role by delivering real-time alerts to physicians during critical situations requiring medical intervention and streamlining the sharing and management of medical records. This approach ensures top-notch treatment quality, enhances patient convenience, reduces hospital stays, and eliminates the necessity for in-person appointments,” said Sen.
How can healthcare awareness be increased among rural Indians, and how can they be educated about advanced healthcare technologies?
Digital platforms and mobile applications can play a major role in increasing healthcare awareness. The applications which provide information on diseases in local languages prove to be extremely helpful to rural Indians. According to Mohapatra, these technologies can educate rural Indians about preventive measures, common illnesses, and available healthcare services.
Community health workers play a major role in the healthcare sector because they serve as a bridge between healthcare facilities and rural communities. Since they are appropriately trained and have adequate knowledge, they can organise health camps, awareness drives, and provide essential information to rural Indians to improve health-seeking behaviour, said Mohapatra. “Engaging in school programs and workshops, and focusing on health education, can ingrain healthy habits from an early age. Incorporating health modules in the school curriculum can be beneficial.”
Local media can play an extremely important role in reaching a greater audience in rural areas. This is because local radio, newspapers, and television channels can broadcast healthcare information to increase awareness about diseases and enhance education in rural India, according to Mohapatra.
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Conclusion: Technology is helping improve accessibility and affordability of rural healthcare
As discussed, telemedicine, teleconsultation, remote monitoring, and telecardiology have reduced the overall health burden in India, especially in rural areas. This is because real-time medical consultations, interventions and prescriptions are possible through digital technology, said Sen.
Not only are these technologies affordable, but also easily accessible. They have also helped decrease travel expenses because several rural Indians no longer need to travel to cities to meet healthcare experts.
Doctors can seamlessly share electronic health records with rural patients.
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“Technology has ushered in a new era of healthcare in rural areas, making it more accessible, attentive, and affordable. It has the potential to bridge the healthcare gap, ensuring that rural communities receive the same high-quality care as their urban counterparts,” said Mohapatra.
Thus, electronic health records are allowing personalised attention, and telemedicine, telecardiology, and teleconsultations are enhancing the affordability of healthcare services.
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