Digitizing health in India for more effective and patient-centric care

The world increasingly relies on technology to solve its most pressing problems. In the context of global health, technology’s potential to support equitable, affordable, and effective health care systems is endless. This intersection between technology and health is called “digital health.”

In implementation, digital health applies technology-based solutions in the form of (1) hardware, such as smartphone-enabled pacemakers, portable vital sign monitors, remote analyzers for blood or urine samples, and screening devices; (2) software, including mobile health applications and platforms, behavior change solutions, dashboards, self-learning/e-training platforms; and (3) services that provide end-to-end health solutions using a combination of hardware and software development.

Globally, digital health is redefining health care systems by scaling the use of analytics, such as decision-making and predictive dashboards for caseload prediction and disease control; artificial intelligence and machine learning, such as solutions that can scan X-rays, automatically identify disease traces, and use notification based nudges to move users towards positive behavioral change and health outcomes; and systems thinking, such as the use of multiple digital health platforms to strengthen health systems and improve a patient’s journey.

In India, for example, the government is applying these digital health developments through the Ayushman Bharat Digital Mission—a comprehensive digital health service that is laying the foundation for the country’s digital health ecosystem. PATH is working closely with the government to support these digitization efforts with the goal of developing feasible, long-term, patient-centric initiatives.

With this objective in mind, PATH has adopted the following threefold approach to digitizing its health programs in India.

Optimal and customized solutions

Not every solution requires reinventing the wheel. The current health ecosystem has multiple open frameworks, digital public goods, and open licenses to build upon. Disease and intervention areas, however, seldom require identical solutions. Therefore, at PATH, we approach our digital health work by first trying to understand where we can learn from the current ecosystem and making sure our solutions are tailored to the problem at hand.

Human-centered design

In every digital health initiative, the patient remains central to the problem-solving journey—that is, their voice and perspective must be included and integrated at all touchpoints.

Collaborations and partnerships

The role of partnerships in developing as well as scaling digital health initiatives is imperative for any health program. This approach focuses on leveraging existing technologies that can be adapted through collaborations with partners—for example, technology startups. At the same time, it also calls for building partnerships that could help achieve scale, such as those with governments, donors, funders, and more.

Dashboard to predict early warning signals of an outbreak

Vector-borne diseases continue to contribute to the disease burden in Uttar Pradesh. PATH has been working in the state to ensure access to health care services and reduce the prevalence of these diseases. To further sharpen and expand the interventions, in 2020 and 2021, PATH (through the Centre for Health Research and Innovation) launched the Monitoring Dashboard for Malaria, Chikungunya, and Dengue for its Dengue, Chikungunya Control and Malaria Elimination Project in Uttar Pradesh.

This powerful dashboard, based on artificial intelligence and natural language processing, provides a broad view of the prevailing disease burden in the state and generates nudges on predefined indicators in various districts and neighborhoods. The early warning signals help curtail outbreaks at the nascent stage and contribute to the planning, implementing, and monitoring of project activities at the blocks and districts that report the outbreak.

An application to ensure access to safe human milk for vulnerable babies

Improving access to human milk is fundamental to improving neonatal health. PATH has been providing technical support to the government of India to establish Comprehensive Lactation Management Centres (CLMCs) that provide safe donor human milk to at-risk babies. Recognizing the need for a seamless system that tracks the process of collecting and providing milk, PATH developed the e-CLMC application to ensure that babies who need human milk have ongoing access.

The application automated the process of data collection related to human milk donation, which includes expression, collection, storage, processing, and disbursement of milk to babies. PATH is piloting the application at one CLMC in India, where it is used extensively by nurses, technicians, and medical officers. Over 700 donor mothers have registered on the platform, and the application has recorded data on 65,000 milliliters of donated milk. The pilot has been successful in enhancing transparency, accountability, and efficiency. The team is now extending support to roll out e-CLMC in Rajasthan and Maharashtra.

Digitization to effectively manage the oxygen ecosystem

The COVID-19 pandemic and the oxygen crisis during the second wave in India mandated the need to ensure uninterrupted supply of oxygen at all health care facilities. To address this challenge, PATH developed the O2 Digital Suite Dashboard.

This dashboard tracks and visualizes oxygen sources (pressure swing adsorption plants, liquid medical oxygen tanks, cylinders, and oxygen concentrators), integrates real-time data across preset parameters, and calculates consumption and wastage of oxygen at a facility. The dashboard has tracked oxygen supply data from 24 states in India from 2,300 pressure swing adsorption oxygen plants, 53,000 oxygen concentrators, 650 liquid medical oxygen tanks, and 300,000 oxygen cylinders. These data are used by the state team to effectively manage the oxygen ecosystem and ensure that all patients have access to oxygen if and when they need it.

Interactive e-learning modules to assist in capacity-building

Capacity-building is an essential component of managing oxygen systems at a facility to reduce waste. PATH created an interactive self-learning e-training package using live-action video, augmented reality, and animations to disseminate essential lessons on managing the oxygen system at a facility.

This introductory e-training module, with its custom learning management system, is live and can be accessed across India. A new training package with a stronger focus on operation, maintenance, and handling is currently undergoing testing.

Technology is essential to providing high-quality, sustainable health care services. PATH is exploring new ways to integrate digital and technological innovations in India’s urban and rural primary health care centers to make universal health coverage a reality. This includes enhancing the use of telemedicine, developing innovative methods to improve quality of services, and creating dashboards for better decision-making. Such solutions could improve the quality of health care services, reduce the burden on health care professionals, and ensure patients receive accessible and quality care.

As PATH continues its efforts to integrate technology in health care, sustainability and integration with the health system remains the primary objective.